Vaccination against cervical cancer/HPV

[nooshoo]

This vaccination protects against a sexually transmitted virus which can lead to cancer and other problems. Does anyone know why is it recommended as standard for children from 11 years, is it because there is perceived realistic risk of sexual contact occuring from this age?

I forgot to answer this earlier. The current recommended vaccine is Gardasil9 and according to a quick google it provides 6 years cover. Its predecessors provided 10/11 years cover from memory. So no, it isn't lifelong. If a child has it when they are 11, it covers them for 6 years, so will need another vaccination at 17.

I think you might have misunderstood what I wrote as I haven't asserted anything, I have just asked questions, and re DC I have said that they have told me about what goes on around them at school (so peer pressure isn't really relevant) -
but -
it is really good to know about your DC's school and I would be really interested to know what sort of school it is (private/ grammar/ what sort of state school etc ) it is, and approximate region (nothing identifying of course!)? Thanks!

Honestly OP, if you're actually looking for answers to your questions I don't think your going to get them from mumsnet.

You should write to your local health authority for the clarity/information you are looking for.

Is this an anti vax thread, or a whipping up a moral panic about adolescent sexuality thread, or both?

No booster needed.

Yes, there is. I am in the cervical screening program having had precancerous lesions removed from my cervix years ago. I have a paper smear every year, which includes a test for HPV as well as any cell changes. I can resume five yearly testing when I have no HPV for two consecutive years. Through the public system, I have had many different specialists tell me that my body can clear HPV and not one of them has suggested that it lies dormant. So you can argue with that and the article all you like and believe what you want to believe. I’m not here to argue with people on the internet, I just thought that some facts would be better than misinformation and beliefs.

Maybe they do things differently on your side of the world. Where I am, they test for the virus as well as cell changes.

Also, I never says people ALWAYS clear HPV. I said most people. Translation: usually. You are splitting hairs.

I think a lot of PP have already responded to you but is not incorrect that in the UK they only check for HPV in the smear now, whether or not that is the right thing.

Also they are done by nurses not doctors. You don't get a choice on it unless you go private, which most people can't afford. It's literally just a swab and then you're called back if you have HPV. Yes there are concerns around this and maybe they'll reinstate the cervical smear looking for cell changes in the future but given the lack of funds the NHS has, or misappropriated funds, it's likely to get phased out all together for those vaccinated. I'm not saying that's the right thing, I'm saying that's probably what will happen.

Also to the OP, research suggests that teenagers are actually less sexually active than ever and the age of first time sex is much older than it used to be. They suggested that young people are more protected and socialise IRL less, giving less chance for sexual encounters.

I mean you must be able to see that from the teenage pregnancy rates which have plummeted and that's not just due to contraception.

The vaccine is a separate issue to try and reduce the rates of people dying from preventable cancers. I think many PPs have responded to you on the reasoning behind it.

I paid for DS1 to have the HPV vaccine as he wasn’t entitled to it at school. I’d read about it on the NHS website. DS2 got it at school. I was told by a consultant it’s 100% effective against some penis and anal cancers.

HPV can also be the cause of head and neck cancers. A relative of mine had an aggressive form of cancer caused by HPV. It’s really common.

The cover lasts 6 years. This means that after 6 years, the vaccine is not effective. What makes you think this isn't right?

What? Where did you read that? Is it just that they’ve been measuring the antibodies in the first cohorts that had one dose of the vaccine and they had data for 6 years at the point the study was carried out?

I am not sure where you are, but what you have said doesn't apply to where I live. But I assume you are talking about the UK as a whole. Could you link your source? Thanks

It lasts a lot longer than 6 years. Quotes stating 'at least 6 years' are because research follow ups are still ongoing. They're following women for 12 years how who have ongoing immunity. They can't put a definitive figure on it when the research is unfolding.

This vaccine has been around in various forms since at least 2007. They will have been monitoring it’s effectiveness since that time. If it was no longer effective after 6 years then they would have started a booster program and we’d all be getting boosters every five years. They have made improvements since 2007. I think the version I had only covered 4 strains of the virus and it was a series of 3 shots, 6 months apart. Now it covers 9 strains and only requires one dose when given to kids in early secondary school.
www.nhs.uk/vaccinations/hpv-vaccine/

How about the NICE Guidance?

https://www.gov.uk/government/publications/hpv-universal-vaccination-guidance-for-health-professionals/hpv-vaccination-guidance-for-healthcare-practitioners

Current studies suggest that protection is maintained for at least 10 years although it is expected to last longer and may be lifelong. Long term follow up studies are underway to evaluate this and will determine the need for any boosters.

There is currently no recommendation for any booster dose of HPV vaccine following a primary course.

Or maybe the Green Book?

https://assets.publishing.service.gov.uk/media/649032b6b32b9e000ca969a7/HPV-green-book-chapter-18a-June-2023.pdf

National adolescent HPV vaccination programme

The objective of the HPV immunisation programme for adolescents is to vaccinate boys and girls before they reach an age when the risk of HPV infection increases and puts them at subsequent risk of cervical or other HPV-related cancers.

Early evidence of the impact of the national HPV immunisation programme on cervical cancer in England has shown dramatic reductions in cervical cancer and CIN3 in young women who were offered the bivalent Cervarix® vaccine at the age of 12-13 years since the introduction of the vaccine’ to ‘when compared to an unvaccinated population (Falcaro et al., 2021). These findings suggest that the HPV vaccine will save hundreds and eventually thousands of lives in the UK.

Your source for six years? We have 10-12 years evidence so far with no expectation of a drop in antibodies after that

https://www.gov.uk/government/publications/single-dose-of-hpv-vaccine-jcvi-concluding-advice/jcvi-statement-on-a-one-dose-schedule-for-the-routine-hpv-immunisation-programme

https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/infections-eg-hpv-and-cancer/the-hpv-vaccine

If you google it, you'll find the same info in numerous sources. This from the National Cancer Institute:

"To date, protection against infections with the targeted HPV types has been found to last for at least 10 years with Gardasil, up to 11 years with Cervarix, and at least 6 years with Gardasil 9"

Others state just 6 years not at least 6 years for Gardasil 9, and at least 11 years with Cervarix so there is that discrepency.

So if you think about it, Cervarix was given to 15 year olds from 2008 lasting for 11 years so up to 26 years - key years for early sexual activity - whereas Gardasil9 is given to 11/12/13 year olds effective for 6 years which takes you up to 17 years or so - so not effective for long and not covering prime sexual activity years (we hope). Which means the fact that the immune system is at its prime at age 11 is somewhat irrelevant/ And I am not sure that the success with the first vaccines, given later, could be repeated with Gardasil9 unless boosters are given at around 17.

Your post crossed with mine - see above. I googled "how long is gardasil 9 effective for" and found the same or similar information in several links.

No, you are misunderstanding what those figures mean. Like I guessed, it means they measured effectiveness - probably by doing blood tests of a sample of vaccinated people - to check for continuing immunity to the virus. When it says ´at least 6 years’ that means they have tested people vaccinated with gardasil 9 and found it was still effective after 6 years. It absolutely does not mean immunity wanes or disappears at that point.
The incidence of cervical cancer has dropped hugely for women just a little younger than me (so early 30s) who were in the first year groups routinely vaccinated with gardasil 4. That’s another kind of evidence that this vaccine is really effective.

Okay, well, that might be the case. But that isn't how the information is presented in the links I have seen. I guess we will need to wait and see.

I think it is unlikely that there will not need to be boosters, or to change to a different vaccine but time will tell. I googled the vaccine maker generally and found they had suspended production, and there are various commercial issues.

When that study was done, gardasil 9 had presumably been used for 6 years.
There’s no reason to assume gardasil 4 is radically less effective than gardasil 9. The numbers refer to the number of the strains of the virus the vaccine contains. They added more strains to make the vaccine more effective. The basic premise of how it works hasn’t changed.

Gardasil 9 only started being given six years ago in the UK. That's why they don't have 10+ years of data on it yet; time travel hasn't been invented.

It isn't either. In relation to the vaccination it is questioning which vaccine is best and when is the best time to start it. Not questioning the validity of vaccination for HPV (if cancers are reduced by it, that is a very good thing).

Re teenage sex, as far as I am concerned it isn't a question about morality. It is a question of what is developmentally better for children. My belief is that sex is pretty awesome in adulthood, but that teens are not mature enough to handle the emotional side of it, nor to make informed decisions and fully understand consequnces, and in terms of development teen years are really important in relation to many things but not sex.

I meant "but not having sex" not "but not sex".

Waiting until you're at uni to have sex wouldn't stop you from getting HPV if you hadn't already had the vaccine. You can get HPV at ANY age as long as you're sexually active and unvaccinated against it.

also not all sex is consensual and what initiatives do you think should be available to stop teens having sex?