HPV9 Vaccine Contraindications

What are HPV vaccines？
HPV vaccines prevent HPV infection by stimulating the immune system to produce antibodies that will protect against the virus. This antibody then exists in human body fluids. If HPV appears in the body, the antibodies will immediately play a role in its removal, preventing an HPV infection.

Are HPV vaccines safe？
Yes, they are safe. HPV vaccines were launched in 2006 and their safety has been tested and approved by the WHO. At present, the food and drug administrations in most countries in the world (including China) have approved HPV vaccines. They have been listed in more than 160 countries and regions around the world. Many developed countries already include HPV vaccines into their national immunization programs.

How many kinds of HPV vaccine are available？
Three types of HPV vaccine (Gardasil, Gardasil-9, and Cervarix) are globally available to prevent HPV infections from certain strains known to cause cervical cancer.
◎ Cervarix (HPV2) is produced by GlaxoSmithKline, and it helps to prevent infection from HPV types 16 and 18 (those that are most likely to cause cervical cancer).
◎ Gardasil (HPV4) is produced by Merck, and it helps to prevent infection from four HPV types: 6, 11, 16, and 18. These are responsible for the majority of cervical cancer and genital warts cases.
◎ Gardasil-9 (HPV9) is also produced by Merck, and it helps to prevent infection from nine HPV types (6, 11, 16, 18, 31, 33, 45, 52, and 58).

Who should get an HPV vaccination？
The WHO recommends that all girls between the ages of 9 and 13 years get an HPV vaccination. At this age, compared to older teens and young women, girls will have a higher immune response the vaccine, resulting in higher levels of antibodies and greater protection against the disease.

If I have been vaccinated with three doses of HPV2/4, can I still get vaccinated with the HPV9？
According to the vaccine insert and clinical studies, if the 9-valent vaccination is required after completing the three-dose 4-valent, the vaccination can only be started after at least 12 months of completing the the three-dose vaccination.

There are currently no relevant clinical studies to support that 9-valent can be given after the 2-valent vaccination.
Who should NOT get an HPV vaccine？

 Anyone who has a severe (life-threatening) allergy to any component of the HPV vaccine should not get the vaccine. Tell your doctor if you have any severe allergies that you know of, including a severe allergy to yeast.

 The HPV vaccine is not recommended for pregnant women. However, if you learn that you were pregnant when you were vaccinated, there is no reason to expect any problems for you or your baby. If you learn that you were pregnant after the first dose, you may continue the series after giving birth. Women who are breastfeeding may be vaccinated.

 If you have a mild illness, such as a cold, you can probably get the vaccine. If you are moderately or severely ill, you should probably wait until you recover. Your doctor can advise you.

 The bivalent Cervarix HPV vaccine should not be administered to men since it only provides protection against cervical cancer. The 4-valent and 9-valent vaccine is available for men in some countries, however not yet in China.
Why should I get regular cervical cancer screening after vaccination？
HPV vaccination is not effective in removing pre-existing HPV infections, genital warts, or precancerous lesions such as CIN, and vaccines do not prevent infection with all subtypes of HPV known to cause cervical cancer.

Therefore, whether or not you have been vaccinated against HPV, you should be regularly screened for cervical cancer.

In the United States, the recommended minimum age to start screening is 21 years old (or after starting sexual activity) and generally ends at age 65. A cervical smear (TCT) is recommended every three years, and those over 30 years old can continue to choose to have a TCT every three years, or a combination of TCT and HPV every five years.

Reference:

• Product instruction
• Chesson HW, Laprise JF, Brisson M, Markowitz LE. Impact and cost-effectiveness of 3 doses of 9-valent human papillomavirus (HPV) vaccine among US females previously vaccinated with 4-valent HPV vaccine. J Infect Dis 2016;213:1694-700
• VanDamme, Pierre. Use of the nonavalent HPV vaccine in individuals previously fully orpartially vaccinated with bivalent or quadrivalent HPV vaccines.  Vaccine 34 (2016) 757–761
• ACIP recommendation
• 中国癌症基金会《认识HPV疫苗》
• Human Papillomavirus (HPV) and cervical cancer (www.who.int/mediacentre/factsheets/fs380/en/)
• Genital HPV Infection Fact Sheet (www.cdc.gov/STD/HPV/STDFact-HPV.htm)
• http://www.acog.org/Patients/FAQs/Human-Papillomavirus-HPV-Vaccination

 

The HPV-9 vaccine approved in China’s mainland is not recommended for those who are:

1. Currently suffering from acute diseases (including fever);
2. Known to be allergic to active or excipient ingredients of the HPV4 and HPV9 vaccines;
3. Pregnant or planning for conception;
4. Pregnant or still lactating;
5. Male.

Further consultation with a doctor is recommended for those who:

1. Have been diagnosed with cervical cancer;
2. Are using immunosuppressive drugs;
3. Have severe congenital or hereditary diseases;

No restriction is applied for those who

1. of menstruating age;
2. have had sexual experience;
3. used to be or are infected with HPV*

* Vaccines are for prevention only, not for the treatment of existing HPV lesions.