HPV, or human papillomavirus vaccine

The HPV vaccine gives protection against cancers and serious harms caused by the human papillomavirus. In particular, it prevents cervical cancer and precancerous stages. 

It additionally prevents some

  • cancers of the vagina and vulva
  • cancers in the head and neck area
  • cancers of the anus and penis.

Vaccine-preventable diseases

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To whom is the HPV vaccine administered?

In the national vaccination programme, the vaccine is offered free of charge to all 10-12-year-olds, i.e. pupils in grades 5 and 6. 

If a child or young person has not for some reason received the HPV vaccinations in grades 5–6, they may also receive these free of charge in grades 7–9, upper secondary school, or vocational institutions. 

HPV vaccinations not included in the national vaccination programme

Those who are not entitled to the HPV vaccine as part of the national vaccination programme can ask for a prescription and buy the vaccine in a pharmacy. The product available in pharmacies is called Gardasil 9. 

The vaccine is intended for persons aged 9 or over. As the age at which people are exposed to sexually transmitted viruses in their youth varies, those older than the age at which the vaccination is administered in the national programme may also benefit from the vaccine. 

The vaccine has little benefit for those aged over 30, as by this age, most papillomavirus infections have already been contracted.

Which vaccine is used and what does it contain?

The product used in the national vaccination programme is called Cervarix.

  • The vaccine does not contain live pathogens and it thus cannot cause a HPV infection.
  • The active substance consists of surface proteins from two different papillomavirus strains.
  • The adjuvant is AS04, which consists of a lipid compound (MPL) and an aluminium compound.
  • The excipients are salts and purified water.
  • The vaccine contains no preservatives.

Dosage and schedule

A single dose of the vaccine is 0.5 ml.

  • The Cervarix vaccination series offered to recipients aged under 15 in the national programme includes two injections. The interval between the first and second dose must be at least five months. 
  • The first dose in the national vaccination programme is given in grade 5, and the second dose in grade 6. 
  • If a pupil in grade 6 has not received the HPV vaccine, the first dose is administered at this stage.
  •  School health care gives instructions on HPV vaccinations in grades 7 to 9.
  • Student health care gives instructions on the HPV vaccinations in higher secondary schools and vocational schools.
  • If the vaccinations are started after the young person turns 15, three doses should be given in total. In this case the minimum schedule is 0, 1 and 6 months.
  • The intervals between the doses should not be shortened, but if they are slightly longer, this does not matter. 

It is currently not known if boosters will be required. The protection afforded by the vaccination is long-lasting – likely lasting up to several decadeslasts 

What are the contraindications and precautions associated with the vaccine?

The vaccine may not be administered to a person who has had a confirmed anaphylactic reaction following a previous dose of an HPV vaccine or a vaccine containing similar components.

The vaccine is not recommended for those under the age of 9 or pregnant women, as the effects of the vaccine in them have not been studied.

The vaccination should be postponed if the recipient has a fever or febrile infection.

What are the benefits of the HPV vaccine?

    The HPV vaccine provides an excellent protection and prevents numerous cancers.

  • A series of two doses affords protection which has in studies prevented almost 100% of infections caused by the HPV types covered by the vaccine. Research indicates that this protection is also likely to be long-lasting: the effects may last for several decades.
  • The HPV vaccine prevents precancerous stages, and thus also cancers, in the cervix, vagina and vulva. 
  • The papillomavirus additionally causes some of the cancers of the anus and penis as well as cancers in the head and neck area. The HPV vaccine also helps prevent these cancers. 
  • Thanks to the HPV vaccinations, fewer people will become ill and die of these types of cancers. An increasing number will also avoid major surgery as well as radiation and cytostatic therapies.
  • The Cervarix vaccine offered in the vaccination programme prevents up to 95% of severe precancerous stages of cervical cancers caused by HPV types 16 and 18. Most importantly, the vaccine prevents precancerous stages caused by HPV type 16, as this specific type causes the most rapidly progressing precancerous stages that have the highest likelihood of developing into cancers.
  • The Cervarix vaccine specifically protects against two types of papillomavirus (HPV-16 and HPV-18), but it also affords protection against infections caused by some other papillomaviruses (types 31, 33, 35 and 45). This is called cross-protection. 
  • Due to the cross-protection effect, Cervarix vaccine prevents 90% of cervical cancers. As HPV vaccinations become widespread, very few patients will develop cervical cancers in the future. 
  • In Scotland, Cervarix has been found to prevent 80% of all cervical cell changes and tumours at population level. The availability of the HPV vaccine also means that fewer people will need to be monitored and treated because of precancerous stages.

HPV vaccine protects against many forms of cancer

What are the potential adverse effects of the HPV vaccine?

The most common adverse effects are local symptoms at the injection site, including pain, redness and swelling. Transient generalised symptoms such as headache, nausea, muscle pain or a mild fever have also been commonly described after the vaccination.

Local and generalised symptoms usually begin within a few days of administration and go on for some days. They may be treated with antipyretics and painkillers.

Local and generalised symptoms are not a contraindication for further vaccinations.

Actual hypersensitivity reactions are rare. A severe immediate reaction, or anaphylaxis, is extremely rare.

The summary of product characteristics warns of the possibility of fainting in connection with vaccine administration. Rather than being in any way caused by the product, fainting is associated with the administration of a vaccination to adolescents. The possibility of fainting should be prepared for. If a recipient faints, the following dose should be administrated while she is lying down.

Swelling and changes in skin colour have been reported to some extent in the arm in which the vaccine is administered. In some cases, the symptoms have been associated with such sensations as pain or coldness.

Similar reactions also occasionally occur following DTaP boosters, for example. The described symptoms are similar as in the swelling leg reaction occurring in young children. The exact mechanism causing the symptoms is unclear, but it is probably a vasomotor response affecting the blood vessel diameter.

The condition is transient. The purplish colouring in the skin usually returns to normal relatively quickly, while the swelling takes slightly longer to disappear. The swelling may be treated with cold compresses and keeping the arm raised. The reaction is not a contraindication for further vaccinations.

Symptoms occurring after a HPV vaccination are not necessary caused by the vaccine

Even serious symptoms or illnesses have been at times associated with HPV vaccinations, especially on social media. As the incidence of these illnesses or symptoms in vaccinated and unvaccinated subjects has been compared in large-scale studies, they have been found to be equally common in both groups. 

In some population groups, neurological and some other symptoms have been more common since the vaccine was introduced than they were a decade ago. Incidence of some of these symptoms increased already before HPV vaccinations started. These symptoms also became more common in boys, even though they were not even offered HPV vaccination. 

There currently is no evidence of the HPV vaccine causing any serious illnesses. People often tend to associate illnesses whose origin is not known with vaccinations.

History of the vaccine in the national vaccination programme

The vaccine was introduced in the vaccination programme in autumn 2013 for girls and in autumn 2020 for boys. As a rule, the vaccinations are offered at primary school age.

If a young person has not received the vaccine at primary school age, the vaccinations may also have been administered to them at secondary school age. Since 2022 a young person might have had the HPV vaccine at higher secondary school age.