The in­tro­duc­tion of the Hu­man Pa­pil­lo­ma Virus (HPV) vac­cine by the Min­istry of Health in Jan­u­ary of this year was a pos­i­tive step in im­prov­ing the health care of women in Trinidad and To­ba­go.

Op­po­si­tion to the vac­cine on "moral" grounds claim­ing that it en­cour­ages sex­u­al ac­tiv­i­ty in young women is not on­ly false but al­so in­sult­ing to the young women of our na­tion.

The one good thing that has re­sult­ed from the con­tro­ver­sy sur­round­ing the vac­cine is that it has raised aware­ness. Now more than ever women have be­gun ask­ing ques­tions about the vac­cine, not on­ly for their daugh­ters but al­so for them­selves and even their sons.

The fol­low­ing are some of the most com­mon ques­tions that I have been asked about the HPV vac­cine.

Why is HPV vac­ci­na­tion­im­por­tant?

The Hu­man Pa­pil­lo­ma Virus is a virus that is spread through sex­u­al ac­tiv­i­ty by di­rect skin to skin con­tact. There are over forty types of HPV that can af­fect the gen­i­tal area. The HPV vac­cines help to pre­vent against the most com­mon dis­ease caus­ing types of the virus. In­fec­tion with cer­tain types of HPV can lead to many types of can­cer in­clud­ing can­cer of the en­trance to the womb (cer­vi­cal), vagi­nal, vul­val (en­trance to the vagi­na), anal and pe­nile. HPV in­fec­tion can al­so lead to the de­vel­op­ment of gen­i­tal warts. HPV vac­ci­na­tion can help de­crease your chances of de­vel­op­ing these dis­eases. It is im­por­tant to note that the HPV vac­cine does not com­plete­ly pro­tect against all HPV in­fec­tions and it is not a treat­ment for HPV.

My daugh­ter is on­ly 12 years old and not sex­u­al­ly ac­tive, why should she be vac­ci­nat­ed from now?

For the HPV vac­cine to be most ef­fec­tive it must be giv­en long be­fore sex­u­al con­tact has tak­en place. Al­so when giv­en at this age, the body pro­duces more an­ti­bod­ies to help pre­vent in­fec­tion as com­pared to when giv­en at old­er ages.

I have al­ready been sex­u­al­ly ac­tive, can I still get the vac­cine?

Yes, you can al­so ben­e­fit from the vac­cine. Pro­tec­tion is best be­fore any sex­u­al con­tact and HPV ex­po­sure has oc­curred. How­ev­er few women would have been ex­posed to all the types of HPV. You may not have been ex­posed to the par­tic­u­lar strains of the virus that the vac­cine pre­vents; there­fore you can still get some de­gree of pro­tec­tion by be­ing vac­ci­nat­ed.

What about vac­ci­nat­ing boys and men?

HPV in­fec­tion af­fects both men and women. In the Unit­ed States HPV vac­ci­na­tion is rou­tine­ly rec­om­mend­ed for boys aged 11 or 12 years. This is to help pre­vent the risk of gen­i­tal warts, anal and pe­nile can­cer. Al­so by pre­vent­ing HPV in­fec­tion in men they will not trans­fer the in­fec­tion to their part­ners.

How is the vac­cine giv­en?

The vac­cine is giv­en ei­ther in the up­per arm or the thigh. Three dos­es are ad­min­is­tered over a 6 month pe­ri­od. The 2nd and 3rd dos­es should be giv­en 2 months and 6 months af­ter the first. For ex­am­ple if you re­ceived your first dose in Jan­u­ary the sec­ond dose will be in March and the last dose in June.

Is HPV vac­ci­na­tion safe?

Health au­thor­i­ties through­out the world agree that the HPV vac­cine is gen­er­al­ly very safe. Se­ri­ous prob­lems caused by the vac­cine are rare. About 10% of per­sons re­ceiv­ing the vac­cine may ex­pe­ri­ence mi­nor side ef­fects. These may in­clude pain, swelling and red­ness around the in­jec­tion site, headache, mus­cle aches and tired­ness. Faint­ing has al­so been not­ed af­ter HPV vac­ci­na­tion and pa­tients are ad­vised to sit or lie down for about 15 min­utes af­ter be­ing vac­ci­nat­ed.

Will I still need to do pap smears if I am vac­ci­nat­ed?

Yes. HPV vac­ci­na­tion pro­tects against most, but not all HPV types that cause cer­vi­cal can­cer. It is there­fore im­por­tant to con­tin­ue hav­ing reg­u­lar pap smears re­gard­less of whether you have been vac­ci­nat­ed or not.

The ques­tion that I am al­most in­evitably asked and the one that prob­a­bly car­ries the most weight is "If you had a daugh­ter, would you give her the vac­cine?"

When­ev­er I am faced with a dif­fi­cult de­ci­sion in med­i­cine, I al­ways ask my­self what you would do if this was some­one that you loved. I have found that it al­ways leads to the right de­ci­sion. In this case how­ev­er the an­swer is easy for me. If there is any­thing that I can do to pre­vent a loved one from de­vel­op­ing or dy­ing from can­cer, you can bet your bot­tom dol­lar that I will do it... and I have found that most par­ents agree.

Dr. Reiaz Mo­hammed

MBBS (UWI), MRCOG (UK)

Spe­cial­ist Ob­ste­tri­cian & Gy­nae­col­o­gist

Gulf View Med­ical Cen­tre