What is HPV?
Human Papilloma Virus is a viral skin disease. There are approximately 100 types of HPV. Some HPV types only infect the genital area and may cause warts; some cause mild changes in cervical cells that do not turn into cancer, and some cause changes that may become cervical cancer or other types of cancer (includine penile, anal and oropharyngeal-mouth and throat-cancers) if present for many years.
In adults, the disorder is considered a sexually transmitted infection, passed from person to person through intimate contact including vaginal sex, anal sex, and oral sex. Infection with HPV is very common, although the majority of people have no symptoms (asymptomatic). In several studies done on college women, nearly half were positive for HPV; however, only 1 to 2% had visible warts and less than 10% had ever had any visible genital warts.
What are HPV related cancers, precancerous lesions, and genital warts?
Cervical cancer, oralpharyngeal cancers and other HPV related cancers are serious diseases that can be life-threatening. These diseases are caused by certain HPV types that can cause the cells in the lining of the cervix, throat, vulva, vagina, anus, or penis to change from normal to precancerous lesions. If these are not treated, they can turn cancerous.
Among HPV-related cancers, cervical cancer is the most common, with about 10,800 people getting cervical cancer each year in the US. Other cancers caused by HPV are less common, but oropharyngeal cancers (cancers of the throat, base of tongue and tonsils) are on the rise. According to the Centers for Disease Control, 8,400 people get oropharyngeal cancer each year. Some of these cases are related to tobacco or alcohol use, but it is thought that 72% of these cases are now HPV-related.
Other cancers that are linked to HPV include vulvar cancer (2300 people develop this type of cancer each year), vaginal cancer (600 people each year), penile cancer (800 people each year), and anal cancer (2500 people each year).
Genital warts are caused by certain types of HPV and often appear as skin-colored growths on the inside or outside of the genitals. They can hurt, itch, bleed, or cause discomfort. Topical and surgical treatments are available for the treatment of warts.
What is the HPV vaccine and how is it given?
The vaccine for HPV, called Gardasil, protects against 9 types of HPV (types 6, 11, 16, 18, 31, 33, 45, 52, and 58) that are linked to the majority of cases of cervical cancer and genital warts. The vaccine has also been shown to provide protection against penile and anal cancers, and, while studies have not yet been done, it is thought that the vaccine provides protection from oral cancers as well.
It is not used to treat HPV.
It is ideal to be vaccinated before you begin having sex, but it is not too late to get the vaccine if you have already been sexually active. The HPV vaccine is strongly recommended for people of all genders up to age 26.
For people aged 15 or older at the time of the first dose, Gardasil is given as a 3 dose injection. (If someone starts the series at ages 11-14, only two doses are now recommended.) The second dose is given 2 months after the first injection and the third dose is given 6 months after the first injection. You are able to receive all 3 injections in the series at University Health Services, even if you have had any of the doses given by a provider outside of Brown. You should receive all 3 doses to get the full benefits of the vaccine. If you have missed a dose, or have not followed the recommended schedule, contact your medical provider to get the next dose and to make a plan to complete the series. You will not need to repeat any doses that you have already received.
If you received your first and/or second dose with the prior generation 4-valent vaccine, you can get your remaining doses with the new 9-valent vaccine. If you have been fully vaccinated with the 4-valent HPV vaccine, you do not need to be re-vaccinated with the 9-valent, but you can discuss this with your medical provider if you have concerns or questions.
You can call 401.863-3953 to make an appointment at Health Services.
Who should not receive Gardasil?
Gardasil is approved and recommended for people of all genders. You should not receive Gardasil if you:
- are pregnant
- have had an allergic reaction after getting Gardasil doses or are allergic to any of the ingredients in the vaccine (purified inactive proteins that come from HPV types 6, 11, 16, and 18, amorphous aluminum hydorxyphosphate, sulfate, sodium chloride, L histidine, polysorbate 80, sodium borate, and water)
Will Gardasil help me if I have already had HPV in the past?
Even if you have been infected with HPV in the past, you may still benefit from the vaccine. Although HPV is common among sexually active people, most are not infected with all four types of HPV that the vaccination prevents. In clinical trials, individuals with current or past infections with one or more vaccine-related HPV types prior to vaccination were protected from disease caused by the remaining vaccine HPV types.
What are the possible side effects of Gardasil?
As with all vaccines, there is a possibility of side effects with Gardasil. Although it has been shown to be generally well tolerated, the most commonly reported side effects include:
pain, swelling, itching, and redness at the injection site
What should I tell my medical provider before I am vaccinated with Gardasil?
It is important to tell you medical provider if you
have had an allergic reaction to the vaccine
have had a bleeding disorder and cannot receive injections in the arm
have a weakened immune system
are pregnant or planning to become pregnant
have any illness with a fever higher than 100F
take or plan to take any medicines, even over-the-counter medicines.
Do I still need to have a Pap smear if I receive Gardasil?
You still need to have routine gynecological exams and pap smears if you have had the vaccine. Gardasil does not substitute for routine cervical cancer screening. Remember, the vaccine does not protect against all of the HPV types that are linked with cervical cancer, nor does it protect against other sexually transmitted infections (STIs). Therefore, safer sex protection, such as use of condoms and dental dams, is still recommended. Additionally, a regular gynecological exam is an opportunity to maintain your overall reproductive health. As with all vaccines, Gardasil may not fully protect everyone who gets the vaccine.