They say, “Age is just a number”. This holds true according to recent research that suggests when it comes to getting vaccinated for Human Papillomavirus (HPV), age doesn’t matter much. The study found that the strength of the immune response to HPV vaccination remains largely unaffected by the age at which it is administered, even if the vaccine is given up to 18 years of age[1]. This challenges the earlier belief that the HPV vaccine is most effective against HPV-related disease outcomes when given at younger ages, emphasizing the importance of on-time vaccination[2].
Understanding HPV & HPV Vaccine
HPV is the most commonly transmitted viral reproductive tract infection, with some of the strains responsible for causing India’s second most common cancer in women- cervical cancer[3]. For most people, HPV infection clears on its own, but for those it does not, can lead to cancer and other related diseases later in life.
Over 200 related viruses have been identified, with over 40 transmitted through direct sexual contact. As a ray of hope, the HPV vaccine helps the body recognize and fight specific HPV strains if a person gets exposed. This vaccine can help prevent infections caused by the various strains, including:
-Low-risk types (6 and 11)- responsible for 90% of genital warts
-High-risk types (16 and 18)- causing cervical cancer in 80% of cases
-High-risk types (31, 33, 45, 52, and 58)- causing cancer of the cervix, anus, vulva/vagina, penis, or throat.
Dosage & Efficacy
HPV vaccine is recommended for everyone aged 9 to 45 to guard against genital warts and various HPV types linked to cancer.
-The HPV vaccine is recommended for adolescents aged 9 to 12.
-Individuals between 13 and 26 are recommended to get the HPV vaccine if not vaccinated earlier.
-For those under 15, two doses are given six months apart.
-Individuals aged 15 and older receive three doses, with the second given one to two months
after the first, and the third given six to 12 months after the first.
-Those aged 27 to 45 can discuss vaccination with their healthcare provider.
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Until the recent study was released, it was advised that children receive the vaccine at the age of 11 or 12 for full protection well before becoming sexually active. Immunity to vaccines or infections typically develops within one to two weeks. For the HPV vaccine, the initial and, if applicable, the second dose (if the person is on the three-dose series) prompt a primary immune response, resulting in varying levels of protection. The important last dose, administered at least six months later, enhances the memory immune response. The highest level of protection is achieved approximately one to two weeks after receiving the final vaccine dose
However, the recent research with the methodology for an in-depth analysis of a sizable sample within the 15-18 age group, comparing vaccine outcomes with those receiving the standard multiple-dose regimen, has created a buzz stating that irrespective of age, high protection is required, even if the first dose of HPV vaccine is given to girls of the 15-18 years age group. This pivotal research not only challenges conventional vaccination norms but also carries significant implications for public health strategies and disease prevention efforts.
While prior research has primarily focused on administering multiple doses to younger individuals, the recent study challenges assumptions, potentially prompting a reevaluation of vaccination protocols across different age brackets.
Do You Still Need HPV Vaccination?
It is always said that prevention is better than cure but did you know that prevention can also cost less than cure when it comes to HPV? Maximizing protection against cervical cancer involves a combination of HPV vaccination and cervical screening. The vaccines can potentially decrease the necessity for multiple screenings, subsequent medical interventions, biopsies, and invasive procedures linked to abnormal cervical screening. This may contribute to lowering healthcare costs and alleviating anxieties related to follow-up procedures.
However, ongoing cervical cancer screening is crucial, even after completing the recommended HPV vaccine doses, as HPV vaccination lowers the risk of cancers caused by HPV in areas beyond the cervix but it doesn’t cover all types of cervical cancer.
HPV Vaccines Currently Available in India
India offers two globally licensed vaccines – quadrivalent and nonvalent. Quadrivalent HPV vaccine contains HPV serotypes 16, 18, 6, and 11 while nonavalent vaccine with HPV serotypes 6,11,16, 18,31,33, 45, 52, and 58 is 96.3% more effective in reducing the incidence of cervical cancers[4].
HPV vaccines are covered by most private health insurance plans. In case of no insurance, the Vaccines for Children (VFC) program may offer assistance[5].
Whether the research on age-related protection of the HPV vaccine is ongoing, let us not forget that vaccination not only safeguards those who receive it against targeted HPV types but also diminishes the prevalence of these types in the overall population.
(The article is written by Dr.Subita Alagh, Senior Executive, and reviewed by Monalisa Deka, Senior Health Content Editor)
References
1.As reported from https://timesofindia.indiatimes.com/city/delhi/study-age-at-hpv-vaccination-and-immune-response/articleshow/105946888.cms
2.Ellingson MK, Sheikha H, et al. Human papillomavirus vaccine effectiveness by age at vaccination: A systematic review. Hum Vaccin Immunother. 2023 Aug 1;19(2):2239085. Available online from:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10399474/
3.Singh M, Jha RP, et al. Secular trends in incidence and mortality of cervical cancer in India and its states, 1990-2019: data from the Global Burden of Disease 2019 Study. BMC Cancer. 2022 Feb 7;22(1):149. Available online from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8819855/
4.Yusupov A, Popovsky D, et al. The nonavalent vaccine: a review of high-risk HPVs and a plea to the CDC. Am J Stem Cells. 2019 Dec 15;8(3):52-64. Available online from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6971474/
5.Available online from: https://www.cdc.gov/vaccines/programs/vfc/parents/qa-detailed.html