HPV Vaccination - Why Is It Needed? Complications And Contraindications

2024 Author: Josephine Shorter | [email protected]. Last modified: 2023-12-16 21:43

HPV vaccination

The human papillomavirus leads to the formation of papillomas and condylomas on the mucous membranes of the genitals, on the skin of the perineum, near the anus, and also in the respiratory tract.

There are over 100 types of HPV known to science. The main method of transmission of the virus is sexual intercourse, however, other routes of infection are not excluded.

These viruses are widespread in the human population. Therefore, after the onset of sexual activity, many people become infected with it. Moreover, infection occurs at a fairly young age.

When a person becomes infected with one of the types of papilloma virus, then he no longer poses a danger to him. The virus will exist in the epithelium without leading to a pronounced immune response in the body. Re-infection with the same type of virus is not excluded.

Content:

• Papilloma vaccine
• Diseases caused by HPV
• On the need for vaccination against human papillomavirus
• About the features of vaccination
• Vaccination schedule
• HPV vaccine injection site
• Where can I get vaccinated?
• Possible complications after staging the HPV vaccine
• Vaccine administration during pregnancy
• Contraindications to the administration of the HPV vaccine
• Drug price

Papilloma vaccine

The modern pharmacological industry offers two types of HPV vaccines: one of them protects against 4 types of viruses (6, 11, 16, 18), and the other against 2 types (16, 18). The first vaccine is called Gardasil (manufactured by MSD - Merck Sharp and Domu B. V, Holland), and the second is Cervarix (manufactured by GSK Biologicals, Belgium).

The preparation does not contain the DNA of the virus itself, but only fragments of its envelope (protein part). However, this is enough for the body to develop antibodies that will prevent infection upon contact with a virus carrier. Due to the fact that there are no virus DNA fragments in the vaccine, it is absolutely safe for human health and does not lead to infection.

Aluminum hydroxide is an essential component of vaccination, which is necessary for the production of antibodies to human papillomaviruses. Antibiotics, yeast and preservatives are present in the preparation.

Regardless of the type of vaccine (from 2 types of virus or from 4), each of them is sterile. The drug is enclosed in a disposable syringe or bottle. A single dose is 0.5 ml

Cervarix comes in 2 vials, which must be kept cold. The air temperature should not be more than 2-8 ° C above zero, but the vaccine should not be frozen. If the storage conditions are not observed, the drug loses its quality.

Both vaccines have passed all the necessary clinical trials and there is no doubt about their effectiveness. They give one hundred percent protection of a person against 16 and 18 types of papilloma viruses, which are capable of provoking the development of cancer. Gardasil additionally allows you to prevent infection with 11 and 6 types of viruses, which lead to the appearance of genital warts.

In addition, HPV types 31, 33, 35, 39, 45, 51, 52, 56, 58 and 59 known to science have a similar structure to types 16 and 18, therefore the introduction of the vaccine also protects to some extent against infection with these ten types of viruses. … The risk of developing oncology in a vaccinated person is reduced to 5-10%.

The vaccine can be administered to adolescents, both female and male. However, mainly girls are vaccinated, as this leads to an interruption in the chain of transmission of the virus. As a result, the male population also receives protection, albeit indirectly.

In the United States, everyone is vaccinated: both girls and boys. Nevertheless, not every state is able to provide its population with a vaccine, since this is a fairly costly item of budget expenditures.

Diseases caused by HPV

Do not underestimate the health harm that HPV can cause. Viruses can lead to the development of genital infections, which most often have a benign course and can pass on their own.

However, some infections can provoke genital cancers in both men and women, including:

• Cancer of the external genital organs;
• Cancer of the cervix and vagina;
• Penis cancer;
• Head and neck cancer;
• Anus cancer;
• The formation of genital warts around the anus and in the perineum;
• Laryngeal papillomatosis.

The higher the level of development of medicine in the country, the lower the mortality rate of the population from oncological diseases provoked by HPV. As a rule, they can be prevented in 80% of cases. However, if the state does not work in this area, then the mortality rate among the young population remains quite high. The fact is that the virus provokes the degeneration of the cells of the uterus and vagina, causing neoplasia (it is considered as precancerous). If this process remains undetected and does not undergo therapy, then after a few years (15-20) the person will develop oncology.

HPV types 6 and 11 in 90% of cases lead to the formation of benign condylomas and papillomas, and HPV types 16 and 18 can provoke cancer.

In connection with these circumstances, in the Russian Federation, since 2006, the introduction of the HPV vaccine has been allowed.

On the need for vaccination against human papillomavirus

The vaccine is recommended to be administered to girls from 12 years old, since over time, the human papillomavirus can lead to the development of cervical cancer. Moreover, the disease develops in women at a fairly young age. It has been proven that cervical cancer is provoked by HPV, and not by other diseases. Timely introduced vaccination is able to reliably protect against oncology.

About the features of vaccination

The introduction of the vaccine is possible for young people of both sexes under the age of 26 years. Girls and boys are recommended to stage it at 9-14 years old, and girls and boys at 18-26 years old. Doctors practicing in the Russian Federation strongly advise to vaccinate children under the age of 12. WHO makes the following recommendations in this regard:

• 10-13 years old
• 16-23 years old.

If the child has not had sexual intercourse and has not met the human papillomavirus, then the vaccination allows him to maximally protect him from the consequences of infection. In this regard, in the EU countries and in America, the vaccine is administered precisely at the age of 10-14 years. Although, if women are not infected with HPV, then vaccination is possible before the age of 26 years.

In adolescence, a stronger immunity to viruses is developed than with the introduction of the vaccine at an older age. Therefore, the sooner it is done, the higher the chances of protecting the child from developing cervical cancer or penis cancer in the future.

Only the Gardasil vaccine is allowed for males. The fact is that clinical trials regarding the introduction of Cervarix to boys have not been carried out.

When the child is guaranteed not to have sexual intercourse, then no additional tests are required before the vaccine is administered. In the event that young people and girls have already had experience of intimate life, then it is necessary to conduct a study to detect HPV types 11, 16 and 18. When there are no viruses in the body, the vaccine can be administered.

If the infection has already occurred, then its setting is meaningless. However, studies conducted in Russia have shown that when women under 35 are given the vaccine, they can fight HPV more effectively. Therefore, most practicing gynecologists recommend not to give up vaccination even if the fact of infection is established.

Three times the vaccine gives 100% protection against HPV after 30 days. However, with its help, it will not be possible to protect against other STDs. Naturally, the vaccine does not provide protection against unwanted pregnancies.

The experience of administering Cervarix and Gardasil to people over the age of 26 is absent. Therefore, there are no objective data on the formation of immunity in older people.

Vaccination schedule

In order for the vaccine to allow the body to form high-quality immunity against the HPV virus, it must be injected at least 3 times.

1. Scheme of administration of Gardasil: 0 - 2 - 6. That is, after the first dose is given, the second is administered 2 months later, and the third six months after the date of the first vaccination. If necessary, the time interval can be shortened between the first and second vaccines to 4 weeks, and between 2 and 3 vaccines to 12 weeks.
2. Scheme of administration of Cervarix: 0 - 1 - 6. That is, the 2nd dose is administered one month later, and the third one six months after the first vaccination. The compressed scheme of drug administration is as follows: 0 - 1 - 2.5.

As to whether it is possible to implement a different scheme of drug administration, research is currently underway.

If a person received 1 dose, and the next two were not administered, then repeating the vaccination cycle is not advisable. It will only be necessary to put down the missing quantity of vaccines in the appropriate time frame.

When, after the first and second vaccinations, the vaccinated had unprotected intimacy, then one should not worry about infection. Even the level of antibodies that were formed in the body after the introduction of 1 and 2 doses will already be enough to form protection against HPV. The third vaccination is needed to "consolidate" the result. Therefore, the last vaccination is possible without additional tests for papillomavirus.

Doctors do not recommend replacing one vaccine with another (Cervarix to Gardasil and vice versa). Such a substitution is not excluded only if there is no way at all to deliver the required vaccine on time.

During vaccination against HPV, it is possible to simultaneously administer such vaccinations as:

1. DPT with Tetrakok, Infanrix and Pentaxim.
2. Polio vaccine, such as Pentaxim.
3. Hepatitis B vaccination.

When several vaccinations are given at the same time, injections should be given in different places and with different syringes. It is strictly forbidden to mix vaccines in 1 syringe.

HPV vaccine injection site

The drug is administered exclusively intramuscularly. If it is injected subcutaneously, then immunity will not be formed. The vaccine, when injected into a muscle, is absorbed into the blood in parts. This allows the production of the required amount of antibodies that can resist the virus.

It is possible to administer the vaccine in the shoulder or thigh. There is little subcutaneous fat in these places, and the muscles are well developed, so the injection will be easy.

If the vaccine is given through a vein, it will lead to an overreaction. As a result, immunity destroys the virus envelope protein, and antibodies to it will not have time to develop.

If the vaccine is injected under the skin, then the dose of the drug enters the bloodstream too slowly, which also leads to the destruction of antigens by the forces of the immune system. In addition, subcutaneous administration is dangerous due to the appearance of a painful induration. Such a lump will disperse for a very long time - for many weeks.

When the vaccine is injected into the buttock, there is a high risk of injection into the sciatic nerve. In addition, the fatty layer in this area is large enough that the drug will enter the bloodstream too slowly.

Where can I get vaccinated?

There are many organizations that can supply HPV vaccines, including:

• Polyclinic at the place of residence.
• Cancer centers.
• Gynecology departments in hospitals.
• Specialized centers for vaccination.
• Private clinic or medical center.

Private clinics provide their clients with home visits by a team of doctors, which has a number of positive aspects:

• The person will be protected from contact with sick people;
• The risk of contracting infectious diseases, such as ARVI or influenza, is reduced;
• The vaccine will be administered to a person in a comfortable environment.

Possible complications after staging the HPV vaccine

As a rule, the vaccine is very well tolerated by patients and does not cause adverse reactions.

Most often, the following minor complications are observed:

• Soreness in the area of injection;
• The appearance of the seal;
• Itching at the site of the vaccination;
• Hyperemia of the skin.

It is extremely rare for the vaccinated to have an increase in body temperature, headaches, and weakness. On the part of the digestive system, disorders such as diarrhea, vomiting, nausea, pain in the epigastric region, etc.

As for local reactions, they do not require any specific treatment and after a few days they stop on their own. The temperature can rise to 38 ° C, therefore, if you feel unwell, it is allowed to take an antipyretic agent. Drugs such as Nimesulide, Paracetamol, Ibuprofen, etc. can help.

If a person has a tendency to allergic reactions, then the vaccine should be given under antihistamine cover. For this purpose, such drugs as: Zyrtec, Erius, Telfast are suitable. It is better to refuse the use of the first generation drugs (Suprastin or Diphenhydramine), since they cause a significant number of side effects.

There is evidence of an increase in the incidence of syncope in vaccinated adolescents. As a rule, after the onset of puberty, fainting occurs. However, such children require more careful medical supervision. It is noted that when the vaccine is given to girls aged 16-26 years, fainting is not observed.

Overdose cases are still unknown.

The vaccine does not lead to human papillomavirus infection, however, there is a risk of developing infertility.

HPV immunity lasts for at least 6 years.

Vaccine administration during pregnancy

There is no data on the administration of the vaccine to pregnant women. However, science knows cases of drug administration to girls in position. At the same time, no negative effects on the fetus were found. This only applies to the Gardasil vaccine. It is also allowed to inject nursing mothers. Nevertheless, doctors still recommend abandoning the vaccination until the end of lactation.

There is no experience of using the Cervarix vaccine in lactating women.

Contraindications to the administration of the HPV vaccine

• The presence of allergic reactions to the first injection of the drug.
• The presence of allergies to the components that make up the vaccine.

Also, the vaccine should not be administered in case of exacerbation of chronic diseases until the stage of remission is reached. Any acute illness is a temporary contraindication.

When a person is infected with the HPV virus at the time of the vaccine administration, but the disease has a mild course, then antiviral drugs and drugs aimed at increasing immunity should be treated.

Drug price

Gardasil can be purchased at a price of 5500 to 8500 rubles. The cost of Cervarix is 3500-5500 rubles. The difference in price comes down to exactly where the vaccine will be delivered.

In order not to risk your own health, you need to be vaccinated exclusively in trusted medical institutions, where the storage conditions of the drug are 100% respected.

The author of the article: Lapikova Valentina Vladimirovna | Gynecologist, reproductologist

Education: Diploma in Obstetrics and Gynecology received at the Russian State Medical University of the Federal Agency for Healthcare and Social Development (2010). In 2013 completed postgraduate studies at N. N. N. I. Pirogova.