What Is the HPV Vaccine?
Human papillomavirus (HPV) is the most common type of virus found in humans. The fastest route of transmission is usually sexual or through skin contact. The HPV virus can reach many areas of the body. It can spread to the penis, cervix (the part connecting the uterus to the vagina), vagina, vulva (external genital organs), anus, mouth area, oropharynx (the space just behind the throat), and other mucosal areas, and can cause cancer in these areas. To prevent its transmission and spread, an HPV vaccine is available. Thanks to the vaccine, the transmission and spread of the virus that causes genital warts or cervical cancer is prevented, helping to protect against the virus.
To prevent the virus and its transmission, an HPV vaccine called Gardasil 9, approved by the United States Food and Drug Administration (FDA), has been developed that can be administered to both girls and boys from an early age. The vaccine provides protection against many types of HPV.
The vaccine, administered to girls and women before they are exposed to the virus, minimizes the risk of cervical cancer. At the same time, by vaccinating boys, in addition to protecting them from the effects caused by the virus, transmission of the virus from men to women is prevented. After the virus is transmitted, it can present in several different ways. HPV can cause warts in the external genital area in men and women, can cause vaginal and vulvar cancer in women, anal cancers, and mouth, throat and neck cancers.
The HPV vaccine has been included in the national vaccination programs of America, Australia and most European countries. In Turkey, the HPV vaccine is not part of the Ministry of Health National Vaccination Program and is not covered by the Social Security Institution (SGK). One of the most important factors affecting vaccination is parents' lack of knowledge about the virus and vaccine, their way of thinking, and their income levels not permitting it. Thanks to the many studies conducted on the HPV virus, as people become informed, the importance of the HPV vaccine, including vaccines in the national vaccination program, is increasing, and the number of individuals being vaccinated is steadily rising.
Who Should Receive the HPV Vaccine?
The HPV vaccine is a type of vaccine that can be administered from an early age. Administration during adolescence provides the highest protection. A vaccine given after age 15 may offer less protection. Therefore, vaccination at an early age is of vital importance. The earliest age for vaccination is 9 years. The ideal age is considered to be girls and boys aged 12–13, and it is extremely important that vaccination be given up to age 26.
The HPV vaccine is not recommended for pregnant women and for severely ill patients. In the case of any serious allergy, it is extremely important to inform your doctor. Additionally, if any reaction or allergic symptoms occur after vaccination, you should see a doctor and be examined.
Why Should the HPV Vaccine Be Given? What Are Its Benefits?
The HPV vaccine is an important vaccine in preventing many diseases, especially cervical cancer. The HPV virus plays a major role in preventing anal cancer, cervical cancer, vaginal cancer and vulvar cancer. The World Health Organization (WHO) states that to prevent cervical cancer and many of the cancers mentioned above, HPV vaccination is a public health priority and is extremely important to include in national vaccination programs. In addition to providing immunity, administering the HPV vaccine to boys prevents the virus from being transmitted to women. To be protected from many diseases through early intervention, the HPV vaccine should not be overlooked.
The HPV vaccine has been found to be safe after many studies. However, there may be some conditions that require attention. In general, its effect on the body is mild. The most common side effect is pain, swelling or redness at the injection site. In some individuals, dizziness or fainting may occur after the injection. The risk of fainting can be reduced by sitting and resting for 15 minutes after the injection. Apart from headache, nausea, vomiting, fatigue and weakness may occur.
How Many Doses of the HPV Vaccine Are Given?
The HPV vaccine schedule varies by age group. For children aged 11–12, 2 doses of the HPV vaccine are recommended, provided they are given at least 6 months apart. Children aged 9–10 and children aged 13–14 are also recommended to be vaccinated according to the two-dose schedule, as for the 11–12 age group. Many studies have shown that the two-dose schedule is more effective in providing protection in children under 15 years of age. For the period from age 15 to 26, three doses of the vaccine are recommended.
The HPV vaccine should be administered with its dosage adjusted by physicians. It should not be given outside of physician supervision.
How Is HPV Infection Diagnosed?
HPV infection transmitted sexually causes many cancers, including cervical cancer and cancers of the anus, vagina, penis, vulva and oropharynx. HPV infection can also be transmitted through skin contact. In such contact, it shows different signs on the skin. In most cases, the type of virus transmitted can be determined based on these signs. It usually appears as a wart, and the HPV virus type can be identified based on the differences between wart types. Wart types are listed below.
Genital warts appear as small, raised, bump-like projections the size of a grain. In women, genital warts are most often located on the vulva, but they can also form around the anus, on the cervix and in the vagina. In some cases, genital warts may also form inside the vagina. In men, genital warts are usually seen on the penis and testicles or around the anus. Genital warts may itch and become irritated, but they do not cause severe pain.
Common/Simple warts Common/Simple warts are round in shape and have a rough texture. They are usually found on the hands, fingers and legs. In most cases they are bothersome due to their roughness and size. They may be prone to injury, bleeding and pain when affected by the environment.
Plantar warts Plantar warts are a type of wart that can form on the hands, feet and fingers. Their pain varies depending on the area in which they are located. Plantar warts cause discomfort when they form firmly on the heel and sole of the foot.
Flat warts Flat warts are a type of wart with slight thickening of the skin, and a flat, slightly dark-colored surface. They can appear anywhere. In children they are usually seen on the face, in men on the beard area, and in women on the legs.
Your doctor may diagnose HPV infection by examining your warts. However, if genital warts are not visible, you will need one or more of the following tests:
The physician and hospital are very important; during this treatment process, the medications given to the patient and the tests and examinations performed should proceed in proper proportion.
Vinegar (acetic acid) solution test A vinegar solution applied to the genital area. It can be identified by whitening the treated area.
Pap smear test The doctor takes a tissue sample from the cervix or vagina to send for laboratory analysis. Through Pap smear tests, any condition that could lead to cancer can be detected.
HPV DNA test Performed with a swab taken from the cervix. Through this test, it is determined whether cancer cells are present in the genital area. If there are warts in the genital area, a sample is also taken from the warts. It is recommended to be performed together with Pap smear tests.
Care should be taken that the tests are performed in an area that meets all hygiene standards. If there is an abnormal HPV or Pap test result, a procedure called colposcopy, performed by a gynecologist, will be carried out. Using an instrument that provides a magnified view of the cervix (colposcope), the doctor will closely examine the cervix and take samples (biopsy) from areas that appear abnormal.Any lesion in the body with a high likelihood of turning into cancer must be removed. Options include freezing (cryosurgery), laser, surgical excision, the Loop electrosurgical excision procedure (LEEP) and cold-knife conization. The Loop electrosurgical excision procedure (LEEP) uses a thin wire loop charged with electric current to remove a thin section of the cervix, and is a surgical procedure that removes a cone-shaped piece of the cervix with a cold knife.
Warts, especially in children, may resolve without treatment. However, since there is no treatment for the HPV virus, they may reappear in the same area or in other areas. In such cases, the physician and hospital are very important. Diagnosis should be made based on the tests and proper examinations performed to determine the type of warts that have formed on the body. There are many treatments for warts that are not considered a sign of disease and that resolve on their own. It is important that such treatments be applied directly to the problem area. Examples that can be used in practice are:
Salicylic acid Over-the-counter treatments containing salicylic acid gradually remove the top layer of the wart. Salicylic acid may cause skin irritation; in this case, it is not considered suitable for use on the face.
Imiquimod Imiquimod is a prescription cream. It is applied directly to warts. After application, it may cause side effects such as redness and swelling.
Podofilox Podofilox is a prescription medication used for warts in the genital area. It is used to destroy genital wart tissue. After application, it causes burning and itching.
Trichloroacetic acid Trichloroacetic acid is a chemical agent used to burn warts found on the palms, soles and genitals. Since it is applied locally, it may cause irritation.
If medications are not effective, your doctor may recommend removing the warts using different methods. These methods are:
Freezing with liquid nitrogen (cryotherapy)
Burning with electric current (electrocautery)
Surgical removal
Removal by laser surgery
Can a Vaccine Be Given After HPV Infection?
Vaccination can be given to individuals carrying human papillomavirus. While it provides protection against other viruses they have not yet contracted, it prevents the virus already present in the body from being transmitted to other individuals. Vaccination does not treat a virus already present in the body. It is recommended only to prevent transmission of the virus to other individuals through sexual or skin contact.
To protect against the virus, regular general check-ups by physicians are recommended. Vaccines found to be missing should be administered on time. The methods and doses deemed appropriate by physicians should be used.
