To have paid for an HPV vaccine myself today...

[happiestblonde]

(posted this in 'vaccines' but doubt will have much response and I want to know if I'm being unreasonable to a) get it and b) resent being, through no fault of my own, within an age group whose health has been disregarded)...

I'm in the unfortunate age group that Labour missed out when changing various health policies. Basically, I cannot get a smear test on the NHS until I'm 25 and am too old by a fair few years to get the HPV vaccine on the NHS. A friend of mine who is young, healthy etc - but happens to have parents living in Monaco who demanded she went for a smear test whilst visiting them - found she had pre-cancerous cells and had to have them lazered out. I truly hate to think what could have happened if she hadn't had the test.

So, today I had to pay £60 for a smear test and £580 for the jab (including £100 for the consultation) at a private medical practice because I value my health more than the money (which wasn't lying around, I'm now in a terrible position rent-wise). I understand money is tight and there are various medical reasons for putting the age back but my doctor, and my usual GP, both agreed that there are young women within a certain age range who have been seriously let down and are now at risk.

Am I being unreasonable to think this is terrible?

There are 120 types of HPV. Only some cause Cancer. Chances are I might have had one form but I'd rather pay to avoid the cancerous forms in addition to having smears.

is the over 25 thing for smears in england only? im in NI and every opportunity they have i get a smear (age 23) [hmmm] no real reason for it. no history etc, but my doctor seems to think everything painful below the waist is gynae.

but if you DID have cells how would you know?

If you have had sex its pretty pointless isnt it? Once you are sexually active (unless both virgins) your fairly likely to have been exposed to HPV..that was my understanding?

Of ourse you don't think YABU.

Didn't stop you posting in the AIBU? topic, though,did it?!

And exatly...your friend was 22, which is why I think you should have annual smears (yes,maybe the NHS should pay for them, but I really see no point in someone who has had several partners,and plans never to have any more to have the vaccine.

That was partly my point - the NHS should pay and there shouldn't be this bloody great big gap between people under 25 and people young enough to be eligible for vaccine

About sex... there are so many varieties of hpv but only some lead to cancer. You can have had some but the vaccine will protect you from harmful ones - even if sexually active (this from Dr today).

Maighdlin - 25 in England.

glitter - by having a smear until have had all 3 doses of vaccine...

The recent Q&A done on Mumsnet last week for the C word cervical campaign answers many of these questions. I think you should be able to get to it from the homepage.

Happiest, it doesn't protect you from the 'harmful ones', it protects against some of the strains that are more likely to ( not definitely) develop into cancerous cells. The vaccine was a waste of your money IMO. It may not work and you should still be screened regularly to check if you have any abnormal cells. (this is why I worry about this vaccine- false sense of security) An annual smear would make more sense and I agree that it should be offered earlier in England on the nhs ( I'm in NI.) If you were v worried, 6 monthly smears would have still been more cost effective for you.

Sorry, I think the vaccine was an unnecessary expense. I know you don't want to hear that because you've spent a lot of money but I would be inclined to stick with paying for regular private smears until you are entitled to them on the nhs if you are worried.

Also, just because you have hpv does not mean you will get cancer. A very small percentage of people with hpv will go on to develop cervical cancer. I, too had abnormal cells removed ( picked up by screening when I was 22). I have had no further problems since but I would not blindly be putting my faith in a vaccine to protect me.

Types 16 and 18 are the most likely types to lead to cervical cancer and the vaccine does protect against these types.

OP, I think its such a hard question to say if you are being unreasonable or not. Its almost saying if you were already infected with these strains YABU because its too late, if not, YANBU because you are now vaccinated. Who can know that?!

Its a really difficult one to call because you wont know the outcome for many years.

I think for your peace of mind, YANBU.

And condoms protect against but do not prevent the infection.

Source
Cancer Reseach UK

I think YABabitU.

I don't want to belittle your feelings, and it's very sad about your friend taking ill, but the chances are so slim.

Maybe I'm speaking with a bit of bias though and can't fully know how you feel. I live in NI where they give smears for women from 20 years of age. As far as I know they don't even ask if you've been sexually active or not.

I was sexually active at that age so that was fair enough. My sister doesn't turn 20 until later this month and she got a GP letter inviting her for her smear test 2 months ago. Sister isn't sexually active, so clearly the clinic is just going by her date of birth.

'Sidge - so you think it's 'cost effective' to greatly increase the chances of women under 25 developing cervical cancer? wow.

It is reduced yes, but the jab still hugely reduces the chances. TBH what is £480 compared with your health!?'

happiestblonde no that's not what I said at all. Please don't misquote me. Not offering a smear routinely to under 25s does not greatly increase the chance of them developing cervical cancer. I said that screening women under 25 is counterproductive - the chances of a smear coming back with borderline changes is increased, the vast majority of which will go back to normal with no intervention. However historically women with borderline changes received treatment which was unnecessary and could compromise their cervix. It is not cost effective or in the woman's interest to be routinely screened before 25. However a woman would always be offered a smear if clinically indicated. You are confusing screening with clinically necessary treatment.

The HPV vaccine is now being offered to all young women so reducing their chances of cervical cancer even further. Older women aren't offered the vaccine because their risk of exposure to HPV is already substantial and they are receiving regular smears as well, so limiting the chances of developing cancer.

yanbu its your money and if it makes you feel more secure of your health then money well spent i guess

the under 25 thing is strange, sometimes have been asked by midwives about when did you have last smear and i say never and they are like you should have smear if you have had kids but then you are told not allowed to have it til 25

sidge, what treatment is offered over there for borderline changes? In NI you have a repeat smear to allow the cells time to go back to normal if they are going to. If that repeat smear is still abnormal then you are sent for a colposcopy to allow them to examine it more closely. No treatment is given until that colposcopy determines that it is necessary.

Do people who get the vaccine not still need need to have smear tests? If not, then how do you know if the vaccine worked for you or if you caught a strain that the vaccine doesn't protect against. I would be very worried about the false sense of security that this vaccine promotes. "I'm safe now because I got the vaccine". Not a good thing!

Yes it's much the same here, what happens after an abnormal smear depends on the degree of cell change. For very minor changes it's repeat smear 6-12 months after with treatment of needed, and colposcopy straight away if more abnormal.

Someone with far more pathology knowledge than me has answered the question here as to why screening under 25s is not routine. (Scroll down to the question by marsedotes)

Yes all girls and young women that have received the HPV vaccine will still be invited for smears and certainly are encouraged to attend regardless of whether they have been vaccinated or not.

I think YANBU, if you wish to have it then have it. Obviously your money = you decide how to spend it!

I am interested in having it to be honest. I am the same age as you OP, and I know it is omst effective to have it before becoming sexually active, but just because you have been active, does not mean you have definately been exposed to the exact HPV's which can lead to cervical cancer. I want to have it based on the hope that if I haven't been exposed I may as well protect myself. Have to wait for a bit as lots of other money things to do first Grrrr!

I think the smear system in this country is all over the place. During each pregnancy midwife has said you must have a smear after - after each doc said not till your 25. there seems to be a misunderstanding between the midwifes and docters.

Baggycoconut, I think the different messages from midwives and GPs reflects that the midwives aren't up to date with NHS screening guidance. The ages changed 6 years ago, but it is peripheral to the midwives job.
I work in a screening lab and we are involved with sample taker training and updates. We don't tend to see many midwives come, and as they don't usually take the samples, when are they likely to have been told?
Not saying this is good, of course!

Just came across this thread, i just wanted to say the symptoms you have described i have had for the last 5 years and the hospitals and gp's have refused continuously to do a smear test