Cervical Cancer – The Vaccine

The Vaccine –

The vaccine contains HPV Virons – ( Virus like HPV Particles ) . Like other vaccines they evoke a antibody reaction in the body preventing infection from setting in if the individual is exposed to the virus. Since HPV types 16 and 18 cause the maximum number of cases of cervical cancer a vaccine containing the most important oncogenic types (HPV 16 and 18) could prevent up to 70% – 80% of Cervical Cancers.

Available –  two types-

Quadrivalent ( Gardasil )- 4 Different Components ( HPV 16,18,6,11)

HPV 16 & 18 – associated with cervical cancer and vulva- vaginal disease

HPV 6 & 11 associated with genital warts. (Though self limiting they result in emotional / quality of life burden)

 

 

Bivalent ( Cervarix)  – 2 components ( HPV 16 ,18)

Very Efficacious for prevention of cervical cancer and vulva- vaginal disease.

Clinical trials to date showed additional protection specifically against virus types 31 and 45  causative agents of some cervical cancers.

 

Both available vaccines  are 95- 100% effective.

Dosage – Intramuscular injection of 3 doses/0.5mL each

• 1^st dose                        0
• 2^nd dose                       at 1 month (bivalent)
•                                       at 2 months (quadrivalent)
• 3^rd dose                       at 6 months

 

Recommended Age –  from 9 to 45 years.

 

Prophylactic vaccine :-

Immunization before onset of sexual activity is ideal.

Recommended age: 11-12 yrs, with catch up age up-to 26 years (Advisory Committee on Immunization Practices- ACIP) .Clinical trials underway in women >26 years- found to be immunogenic, safe and effective in older women (up-to 55 years for Cervarix and 45 years for Gardasil).

Both vaccines  approved for use up to 45 years.

The reason for inoculating older and married women is since women of all age groups are potentially at risk and studies have shown each year, 5-10% of women above 25 will acquire a new infection with HPV 16 or 18.

Both vaccines are preventative vaccines. They are prophylactic, they prevent disease. They don’t treat it once it’s there.

Vaccination does not obliviate the need for future screening – because it does not protect against other strains of the virus (Small percentage which contribute to causing cancer) or such sexually transmitted diseases as HIV. So those who have been vaccinated should still receive annual Pap smears and practice safe sex.

Safety and side effects – Proved to be very safe. No major side effects. Minor rash or pain may occur. Many countries have it now in their health programme of vaccination. In India organisations like FOGSI ( Federation of Obstetricians and Gynecologists) and IPA ( Indian Pediatric Association) recommend it to all those who can afford it . (The total cost (3 doses) may come upto Rs 9000/-).

Pregnancy & vaccination – The use of the vaccine in pregnancy is not recommended

Women who become pregnant before completion of vaccination are advised to postpone the remaining dose until after the pregnancy.Lactating women can receive the HPV vaccine and still continue breastfeeding because it is a vaccine without live viral DNA.