Dr.Deyn  | 9 April 2023

HPV VACCINE

As you may have known there are many types of HPV (Human Papilloma Virus) and some of them such as type 6, 11, 16, 18 are the leading cause to cervical cancer in women as well as anal cancer in men. More than 9 of every 10 cases of cervical cancer are caused by HPV. HPV doesn’t only affect women. Nearly 4 out of every 10 cases of cancer caused by HPV occur among men. Every year in the U.S., over 13,000 men get cancers caused by HPV. These cancers can be largely prevented by the HPV vaccine.

6 types of cancer caused by HPV

HPV can cause cancers of the:

• Anus and back of the throat, including the base of the tongue and tonsils (oropharynx), in both women and men 
• Penis in men
• Cervix, vagina, and vulva in women

Cancer often takes years, even decades, to develop after a person gets HPV. Center of Disease Control recommends HPV vaccination at ages 11-12 to protect against these cancers. There is no way to know which people with HPV will develop cancer or other health problems. People with weakened immune systems (including individuals with HIV/AIDS) may be less able to fight off HPV and more likely to develop health problems from it.

Information about the vaccine

There are 3 types of HPV vaccine, all of them are non-infectious vaccine 

• 2v = bivalent HPV vaccine (Cervarix, HPV 16, 18)
• 4v = quadrivalent HPV vaccine (Gardasil^®4, HPV 6, 11, 16, 18)
• 9v = nonavalent HPV vaccine (Gardasil^®9, HPV 6, 11, 16, 18, 31, 33, 45, 52, 58)

2v, 4v, 9v all target HPV 16, 18 which are the cause of cervical cancer (66%) and are the main cause of HPV-associated cancers in male and female (6 types mentioned above).

Both 4v, 9v also work to prevent HPV 6, 11 which are the main causes of anal wart and genital wart. 
9v has prevention for 5-additional types; HPV 31, 33, 45, 52, 58 which are 15% cause of cervical cancer.

9v HPV vaccine (9vHPV, Gardasil^®9, Merck&Co.) has been licensed from USFDA to be used among male and female since December 2014.

in February 2015, the Advisory Committee on Immunization Practice (ACIP) recommended that Gardasil^®9 used for cancer prevention among male and female. It is widely used for prevention in developed countries.

When to start HPV Vaccine and how many doses do I need?

As soon as possible. In October 2016 ACIP recommended HPV dosage according to age starting the first dose.

• Age less than 15 years old:  2-doses regimen (day 1 and month 6)
• Age above 15 years old: 3-doses regimen (day 1, month 1-2, month 6)
• Immunocompromised people such as HIV infected patient:   3-doses regimen (day 1, month 1-2, month 6) regardless of age

HPV Vaccine at PULSE clinic

Information for persons who started HPV vaccination series with 4v or 2v and want to complete with 9v

If you started with 2v or 4v, can you complete with 9v?

YES, you can. If you completed 2v or 4v course, do you need to receive 9v course again, what would we suggest?

• Most HPV-related cancers are caused by HPV 16, 18 which is already covered by 4v or 2v.
• The benefit of 5-additional types (9v) would be for women, as mentioned above (HPV 31, 33, 45, 52, 58 which are 15% cause of cervical cancer.)
• You still need cervical cancer screening from age 21-65 years old regardless if you are a vaccinated or unvaccinated women.

The HPV vaccine is safe and highly efficacious, and can significantly reduce the burden of HPV-related genital warts and cancers among men, in addition to promoting herd immunity.

Why should gay men be immunized?

Gay men attending sexual health and HIV clinics are known to have a higher risk of HPV infection and disease. The risk of anal cancer in gay men is higher than in heterosexual men.  If you're living with HIV, this risk is higher again. HPV vaccine is a very effective way to reduce your risk of genital warts and your risk of developing cancer caused by HPV.

Possible side effects Like any vaccine or medicine,
HPV vaccination can cause side effects.
The most common side effects are mild and include:

• Pain, redness, or swelling in the arm where the shot was given
  Dizziness or fainting (fainting after any vaccine, including HPV vaccine, is more common among adolescents)
• Nausea
• Headache
  The benefits of HPV vaccination far outweigh any potential risk of side effects.