Why is HPV vaccination the most prescribed strategy for cervical cancer prevention

In India, 511.4 million women aged 15 and above are at risk of having cervical cancer. According to a report by Globocan 2020, Cervical cancer is the second most common cancer in India, with an estimated 1, 23,907 new cases and 77, 348 deaths annually which is close to one-fifth of the global burden of this cancer. Almost all cervical cancers are caused by persistent infection with one of the 14 high-risk types of human papillomavirus (HPV) with HPV types 16 and 18 accounting for 73% of cervical cancers globally and 80 – 85% of cervical cancers in India.

HPV is a family of more than 200 viruses. HPV infection is a well-established cause of cervical cancer. The virus is highly contagious and can be transmitted through intimate skin-to-skin contact, including sexual activity. Many people who are infected with HPV may not show any symptoms, making it challenging to detect and control the virus.

Age & Dosage Recommendations
The HPV vaccine, commonly known as Gardasil or Cervarix, is a cancer-prevention tool that targets the most high-risk HPV strains. It is usually given to adolescents and young adults in the form of a series of shots.

Preferred target age group for taking vaccines starts from 9-14 years. Two doses: 0 & 6 months (second dose may be given at 5-15 months)

Catch-up vaccination (15-26 years) Three doses: 0, 1, 6 months (Bivalent, No longer available in India) 0, 2, 6 months (Quadrivalent & Nonavalent)

Older age groups (27-45 years) Three doses: 0, 1, 6 months (Bivalent) & 0, 2, 6 months (Quadrivalent & Nonavalent).

HPV vaccination prevents future HPV infections but does not treat existing HPV infections or illnesses. The vast majority of sexually active individuals have already been exposed to HPV, though not necessarily to all of the HPV strains targeted by vaccination. Having a new sex partner at any age increases your chances of contracting a new HPV infection. People in long-term, mutually monogamous relationships are unlikely to get a new HPV infection. 'Before the Sexual Debut' is the best time to get the immunisation. HPV vaccinations, like any other vaccine or treatment, might have minimal side effects.

The most typical side effects
In the arm where the shot is administered, there may be pain, redness, or fainting. Dizziness or fainting (fainting after any immunisation, including the HPV vaccine, is more common in teens), nausea/headache, and so on. Adolescents should be seated or lying down during immunisation and for 15 minutes afterwards to avoid fainting.

HPV vaccine is our strongest line of defence against HPV-related malignancies. India has a strong track record in childhood immunisation including the vaccination for COVID-19. The addition of the HPV vaccine to the national immunisation schedule will surely help in the fight against cervical cancer.
(Dr Salim V P is Senior consultant, Surgical oncologist and Robotic Surgeon , Aster MIMS, Kozhikode)