When should your child get their HPV vaccine?

The Centre for Health Protection (CHP) reported that cervical cancer is the ninth commonest cancer among females in Hong Kong and accounted for 3.2% of all new cancer cases in females in 2017. In 2018, a total of 163 women died from this cancer, accounting for 2.7% of female cancer deaths.⁷

This blog covers the frequently asked questions around one of the most common causes of cervical cancer, Human Papillomavirus (HPV), and the significance of HPV vaccines among children – for both boys and girls.

What is HPV?

Human Papillomavirus, also known as HPV, is the most prevalent sexually transmitted infection in the world. There are more than 100 types of HPV, with about 40 of them affecting the genital area and at least 14 can cause cancer. HPV 16 and 18 together are responsible for about 70% of cervical cancers.¹ Although most infections with HPV resolve spontaneously and cause no symptoms, persistent infection can lead to cancer.

What is the link between HPV and cervical cancer?

Cervical cancer is caused by sexually acquired infection with certain types of HPV.⁸ HPV infection accounts for a large proportion of cervical and vaginal cancers among women and of oropharyngeal and anal cancers among both men and women. In 2018, cervical cancer was the fourth most common cancer among women globally. With an estimated 570,000 new cases, about 311,000 women died from the disease.¹ The peak incidence rate of cervical cancer between 2015 and 2017 in the UK was among the 30–34 age group.²

How to prevent cervical cancer?

An effective and primary prevention is with HPV vaccination. Secondary prevention is population-based screening and treatment of precancerous lesions, which can prevent most cases of cervical cancer. To find out more about regular cervical screenings at OT&P, visit our blog here.

What is the HPV vaccine?

HPV vaccines do not contain any live biological material or viral DNA. Which means they do not cause infection with the virus and cannot cause cancer. The vaccines are made using recombinant technology that recreates some of the proteins on the outside of the virus. By resembling the virus, the vaccine stimulates the immune system to produce protective antibodies against HPV infection. 

Who is the vaccine for, and when should it be given?

The HPV vaccine is recommended for girls and boys at the age of 11 or 12, although it can be given as early as 9. The vaccine has already been a part of the NHS vaccination programme in the United Kingdom for girls and boys at age 12–13. In contrast, eligible girls will receive theirs in Primary 5 and 6 under the Hong Kong Childhood Immunisation Programme. We cover the child vaccination schedule in Hong Kong here. HPV vaccination is also recommended for everyone through the age of 26 years, if not vaccinated already. Visit our blog here to learn more about adult vaccination in Hong Kong.

Why should my son get the HPV vaccine?

HPV vaccines protect males against the infections that can cause cancers of the anus, penis and mouth/throat. Additionally, when boys are vaccinated, they are less likely to spread HPV to their current and future partners.

Is the vaccine safe? Does the HPV vaccine have a side-effect?

The majority of side effects are mild, such as fever or muscle pain, and usually last for a day or two. As with any vaccination or medicine, unexpected reactions may occur, but no serious harm has been found. In such a scenario, we recommend seeing your doctor immediately.

How effective are these vaccines? 

The HPV vaccine is safe to use with no significant side effects and it is also very effective. The vaccine is found to provide nearly 100% protection against persistent cervical infections with HPV types 16 and 18 (cancer-causing) and the cervical cell changes that these infections can cause.³ It also demonstrates nearly 100% effectiveness in preventing cervical, vulvar and vaginal diseases caused by those targeted HPV strains. A study published in Paediatrics in 2019 found that not only did the vaccine protect against the HPV strains for women aged 13–26, but they were less likely to be infected by other strains.⁴ 

In other words, the vaccine showed cross-protection against other HPV strains not covered by the vaccine. Additionally, it was found that women who did not get the vaccine became less likely to be infected with HPV, also known as herd immunity. 

How long does the protection last? 

To date, protection against the targeted HPV strains has been found to last at least ten years, but experts believe it could provide lifelong protection. Long-term studies of vaccine efficacy are still in progress to better understand the total duration of protection.  

Why do my children need the vaccine at such a young age?

Despite all the positive results from clinical studies, the vaccine uptake rate is still suboptimal in the US and some EU countries.⁵ Even though the vaccine can be given as early as 9 years old;  some families may hesitate to consider vaccinating their young children against sexually transmitted infections. On the contrary, the vaccine works best if the vaccination course is completed well before they start to have any sexual exposure. Parents may even find it easier to get their preteen children vaccinated and complete the vaccine series, rather than waiting until they get older. The immune system is also more robust at younger ages, only two doses of the vaccine are required compared to three doses for age 15 and above. Doing it early before being exposed to HPV ensures protection to all targeted HPV types. 

Parents who have concerns that vaccinating their children means permitting them to have sex should not worry, as studies have found otherwise. A 2018 study conducted in Canada found no evidence that teenage girls took more sexual risks after the school launched the HPV vaccination program.⁶ In addition, their sexual health choices actually improved with more girls in the study saying they would use condoms or birth control pills. 

HPV vaccination is about prevention of cancers. It is a safe, effective vaccine that all parents should feel at ease with when it comes to making the decision to vaccinate their children. 

Help at OT&P

At OT&P Healthcare, we are firm believers in preventive medicine. Our dedicated team of healthcare professionals can offer you and your child a safe and child-friendly environment to get vaccinated. Our family medicine and paediatric doctors are knowledgeable to answer any questions you might have.

Book an appointment or call our registration desk to find out more.

References

1. (2020). ’Global strategy to accelerate the elimination of cervical cancer as a public health problem’. World Health Organization. 17 November. Available at: <https://www.who.int/publications/i/item/9789240014107>

2. ’Cervical Cancer Incidence Statistics’. Cancer Research UK. Available at: <https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/cervical-cancer/incidence>

3. Joura EA, Giuliano AR, Iversen OE, Bouchard C, Mao C, Mehlsen J, Moreira ED Jr, Ngan Y, Petersen LK, Lazcano-Ponce E, Pitisuttithum P, Restrepo JA, Stuart G, Woelber L, Yang YC, Cuzick J, Garland SM, Huh W, Kjaer SK, Bautista OM, Chan IS, Chen J, Gesser R, Moeller E, Ritter M, Vuocolo S, Luxembourg A; Broad Spectrum HPV Vaccine Study. A 9-valent HPV vaccine against infection and intraepithelial neoplasia in women. N Engl J Med. 2015 Feb 19;372(8): 711–23.

4. Spinner C, Ding L, Bernstein DI, Brown DR, Franco EL, Covert C, Kahn JA. Human Papillomavirus Vaccine Effectiveness and Herd Protection in Young Women. Pediatrics. 2019 Feb; 143(2): e20181902. doi: 10.1542/peds.2018-1902. Epub 2019 Jan 22.

5. Karafillakis E, Simas C, Jarrett C, Verger P, Peretti-Watel P, Dib F, De Angelis S, Takacs J, Ali KA, Pastore Celentano L, Larson H. HPV vaccination in a context of public mistrust and uncertainty: a systematic literature review of determinants of HPV vaccine hesitancy in Europe. Hum Vaccin Immunother. 2019; 15(7-8): 1615–1627.

6. Ogilvie GS, Phan F, Pedersen HN, Dobson SR, Naus M, Saewyc EM. Population-level sexual behaviours in adolescent girls before and after introduction of the human papillomavirus vaccine (2003-2013). CMAJ. 2018 Oct 15;190(41): E1221–E1226.

7. (2020). ‘Cervical Cancer’. Centre for Health Protection (CHP). 20 May. Available at: <https://www.chp.gov.hk/en/healthtopics/content/25/56.html>

8. (2020). ’Human papillomavirus (HPV) and cervical cancer’. World Health Organisation.11 November. Available at: <https://www.who.int/news-room/fact-sheets/detail/human-papillomavirus-(hpv)-and-cervical-cancer#:~:text=Cervical%20cancer%20is%20caused%20by,%2C%20vagina%2C%20penis%20and%20oropharynx>