HPV Vaccine Were you Missed?

Aug 23, 2013

By Barret Procyshyn and Melanie Hawranik-Sobering

Five years ago parents of grade six girls started getting letters from the school asking for consent to give their daughters the HPV vaccine. The province continues to offerall Grade Six girls the human papillomavirus vaccine or HPV Vaccine. I would like to once again discuss HPV because the province has recently increased the availability of the vaccine to a wider range of age groups in our province.

There is also still some unease, controversy and a lot of questions about the vaccine because of what it protects against. HPV is a virus of over 100 types. There are about 15 types which are known to be high risk, causing pre-cancerous lesions and cervical cancer. Over 99% of cervical cancer is caused by persistent HPV infection. Most of these are sexually transmitted. In Manitoba, there are up 50 cases per year of cervical cancer alone, causing approximately 15 deaths annually. HPV is the most common sexually transmitted infection (STI). The HPV infection, which cannot be cured, has also been linked to oral cancer and anal cancer. HPV is also responsible for genital warts. As you can see this is not the easiest topic to discuss, but it is an important one!

The immunization is a series of three needles. For grade six girls they typically take place in October, December and in the spring. All parents must either consent or not consent to the vaccine. Controversy for the HPV vaccine arises because we are giving a vaccine to girls to prevent a sexually transmitted virus at a young age. However; Grade 6 was chosen because it provides protection for the future. Studies show Canadians become sexually active around the age of 15 and 50% will contract some type of HPV virus in their lifetime.

Melanie Hawranik-Sobering, a Public Health Nurse in Dauphin who has a Masters and Bachelor of Nursing Degree contributed the following information. The province has increased its eligibility of this vaccine, as the province knows the importance of prevention. At this time, only females are eligible to receive this vaccine. All girls in grade 6 receive this immunization as part of Public Healths school-based programming; girls who missed the vaccine in Grade 6 who are born on or after January 1, 1997 and females between the ages of 9-26 years of age who may have increased risk of HPV infection, as determined by a health care provider, are also eligible. Now when I say have increased risk that is defined as those who have had a previously abnormal pap test, or who have a family history of HPV-associated cancers. Also, those who initiate sexual activity at an early age, have multiple sexual partners in their lifetime, have had a previous STI or become pregnant as an adolescent are deemed at risk and are eligible to receive this vaccine.

The HPV virus is spread by direct contact. People who are sexually active will likely have at least one HPV infection in their lifetime. HPV infection can occur without any symptoms and it is easy for those who are infected to pass it to their partners without knowing it! In addition, over 90% of HPV infections appear to clear on their own within 2 years. Also, someone who is infected can live for years without knowing they have a HPV infection! HPV is spread by genital contact and oral sex with an infected partner. Using preventative methods, such as condoms may lower the risk but does not 100% prevent the spread of a HPV infection. So you can see how prevalent this virus is, and how if not prevented with the vaccine or treated, can be quite upsetting.

Hawranik-Sobering had the following answer to those who are wondering if you need to see your doctor to receive the vaccine. If you meet the criteria, you do not require a prescription from your physician for this vaccine! It is Free if you meet the eligibility criteria and you can present to your local Public Health Nurse and receive the vaccine there! The Dauphin Public Health Office is located next to the hospital.

While the vaccine only provides coverage against four types of HPV, these strains account for almost 70% of cervical cancer cases and 90% of genital warts. New vaccines must show effectiveness in studies before they are approved. Studies were performed in which females received the vaccine and some received no vaccine. While it was unethical to wait to see if the females who did not receive the vaccine develop more cancer, scientists were able to see the vaccine did a very good job of preventing precursors to cancer.

Short term data gives us every reason to believe the vaccine is safe. Over 35 million doses of the HPV vaccine have been given, with very few adverse effects. In original drug trials people who received the vaccine did not have any more significant side effects than the people who received placebo. Health Canada has approved the vaccine to be safe and continues to monitor its use and any adverse events that may occur. The most common side effects from the vaccine are mild. They include pain, swelling and redness in the area where the needle was given.

Just because you or your daughter receives the vaccine does not mean there is 100% protection. Regular physicals and pap tests are still recommended. HPV infections occur without any symptoms and the progression of the HPV virus to cancerous cells often has no symptoms. Regular health checks are essential.

Hawranik-Sobering added While most HPV infections go away over time and do not require treatment, some do not and can go on to cause cancer. There are 15 known types of HPV that are high risk of causing growths that can lead to cancer. HPV can cause changes in the cells on the cervix, called cervical dysplasia or abnormal cells. Over time, if these changed cells remain and are not treated, cancer of the cervix can develop.

If you or a family member have not received the vaccine and are interested in it you should speak to your family physician. You can receive the vaccine from the Public Health Nurse or Physician directly without a prescription and it is targeted for females between the ages of 9 and 26. The Public Health Agency of Canada has now approved the vaccine for males between the ages of 9 and 26 for the prevention of genital warts. While there is currently no vaccine coverage available for males from the province of Manitoba, you can speak to your pharmacist, public health nurse or physician about obtaining the vaccine.

Anytime we can prevent illness in ourselves or our children we usually try and do it!We have been using vaccines for decades to prevent certain diseases. Anytime we decide to act, there is a small risk involved. However; the potential benefit of preventing a serious problem often outweighs the small risk. You need to weigh the small risks of the HPV vaccine versus the potential benefit. I think it will make the choice that much easier.

Melanie Hawranik-Sobering wishes to remind the public that if you think you may be a candidate for the HPV vaccine and have not yet received it you should contact your local Public Health Nurse or Family Doctor.

Special thanks to Melanie Hawranik-Sobering and Public Health for their contributions to this article.

The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.


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