HPV

• Human papillomavirus (HPV) is the name of a family of viruses that infect the skin and mucosa that is in contact with the outside world – mouth, pharynx, cervix, anus. There are more than 200 strains of HPV.
• HPV strains can be divided into two groups regarding the problems they cause: high-risk and low-risk HPV.
• High-risk genotypes 16, 18, 45, 31, 33, 35, 39, 51, 52, 56, 58, 59 cause precancerous lesions of the cervix, cervical cancer, anal cancer, vaginal cancer, vulvar cancer, penile cancer, oropharyngeal, and laryngeal cancer.
• Low-risk genotypes 6 and 11 cause most anogenital warts and larynx papilloma and can also cause common warts anywhere on the skin.
• HPV can be found on the skin of the genitals or in the surrounding area.
• More than 8 out of 10 people get infected in their lifetime. Most of the infections are cleared by the immune system and so pass without causing problems and damage.
• It is possible to get infected with different genotypes of HPV.
• Inflammation occurs more commonly with immunodeficiency.
• Most people infected with HPV are not aware of it.
• The infection spontaneously clears in 8 to 12 months in the majority of women (90%).
• A minority of women (10%) develop a persistent HPV infection. Persistent HPV infection increases their risk for precancerous lesions of the cervix and cervical cancer.

Consequences of HPV infection

• precancerous lesions of the cervix and cervical cancer
• genital warts
• common skin warts
• vaginal and vulvar cancer (very rare cancers)
• anal cancer
• penile cancer
• head and neck cancer
• papilloma of the vocal cords and pharynx.

HPV Vaccination

• Using a condom during sexual intercourse can lower the risk of HPV infection. However, because it does not cover the whole genitalia, HPV transmission is still possible, despite using a condom.
• anti-HPV antibodies produced in the course of a natural infection do not offer complete protection against reinfection with the same genotype of HPV, and they do not provide cross-protection against infection with other types of HPV, unlike the anti-HPV antibodies that are produced following vaccination.

THEREFORE, VACCINATION IS THE ONLY TRULY EFFECTIVE PREVENTIVE MEASURE

• Since 2007 girls in the 6th grade are regularly vaccinated with a quadrivalent vaccine (4vHPV): 6, 11, 16, and 18
• Since 2015 we vaccinate with 9-valent HPV vaccine (9vHPV): 6, 11, 16, 18, 31, 33, 45, 52, and 58
• Since September 2021 we also vaccinate boys in the 6th grade with the 9-valent HPV vaccine (9vHPV): 6, 11, 16, 18, 31, 33, 45, 52, and 58

WHY IN THE 6th GRADE?

• Because the immune response and with it the vaccine efficacy is highest in 11- and 12-year-old children.
• Because they are not sexually active yet: 15% are sexually active at 14, 39% when 16 years old. For the transmission of HPV skin to skin contact is already enough, “real” sexual intercourse is not necessary.
• Because that is when the preventive examination already takes place.

WHO SHOULD GET VACCINATED?

• Children in the 6th grade.
• Adolescents up to the first year of university studies (after the age of 15, three doses are needed).
• All women without a permanent partner, women who don’t trust their partner or have other partners in addition to a permanent partner.
• Women who had at least one episode of anogenital warts – condyloma.
• Women who had a precancerous cervical lesion (HSIL, CIN II, and CIN III) and were treated for this. The chance of recurrence drops by 80% with vaccination.
• Men who have sex with men and men that could be carriers of HPV.

VACCINATION SIDE EFFECTS

• Redness and swelling of the vaccination site.
• Pain at the vaccination site.
• Hypersensitivity reactions are extremely rare.
• There were no severe reactions or deaths connected to HPV vaccination.

VACCINATION EFFECTS

• Complete prevention of anogenital warts, precancerous lesions of the cervix, and cervical cancer. 70-90% prevention of precancerous and cancerous lesions of the anus and vagina. Prevention of 40% of vulvar lesions, 47% of penile lesions, and 25-30% of oropharyngeal cancer when children in the 6th grade are vaccinated.
• 80% drop in recurrence of precancerous lesions of the cervix after surgical removal.
• Lowering the incidence of precancerous lesions of the cervix and cervical cancer to an absolute minimum.

VACCINATION OF LATECOMERS (ZZZS covered)

• Latecomers for HPV vaccination are girls who were visiting the 6th grade in the school year 2009/10 (born in 1998) or later and have not been HPV vaccinated yet. The pediatrician can carry out the vaccination at the following health check.
• Her chose gynecologist can also vaccinate a latecomer.