The HPV vaccine: who, when, why

The HPV vaccine is the closest thing modern medicine has to a cancer vaccine. It doesn't treat cancer; it prevents the infection that causes the great majority of cervical cancer (and several other cancers as well). This article walks through what the vaccine is, who Australia funds it for, and whether you should consider it as an adult.

What's in the vaccine

The vaccine used in Australia and most other developed countries is Gardasil 9.

It protects against nine HPV types - 6, 11, 16, 18, 31, 33, 45, 52, and 58. Cancer Council Australia notes these nine types are responsible for approximately 90% of cervical cancers.

The two most important types it covers are HPV 16 and 18. The WHO writes these two types alone:

Gardasil 9 catches them both, plus the next seven highest-risk types.

Australia's program: who gets it for free

The HPV vaccine is free for everyone aged 12 to 25 in Australia, through the National Immunisation Program.

At school (most common path):

• Delivered to boys and girls aged 12 to 13 through school-based programs
• Currently a single dose is sufficient under the Australian schedule

Catch-up vaccination (free up to age 25):

If you missed the school program, or you weren't vaccinated for any reason, you can still get it free up to your 26th birthday. Talk to your GP.

I'm older than 25 - is it worth it?

If you're between 26 and 45, the vaccine is not free under the program, but it's still available privately through your GP.

The CDC takes a measured position:

The decision depends on your individual situation - new partners, your existing HPV status, your immune health. If this applies to you, ask your GP. Privately, the vaccine course in Australia typically costs around AUD $200 to $250.

Does it actually work?

Yes - and the data is strong.

Since the HPV vaccine was introduced in 2006, the CDC reports:

• Infections dropped 88% among teen girls
• Infections dropped 81% among young adult women
• Cervical pre-cancers declined 40% among vaccinated women

The CDC summarises the long-term potential:

Australia's program has been one of the world's most successful. Cancer Council Australia notes:

I had the vaccine. Do I still need screening?

Yes. This is the single most important thing to know about the vaccine.

Cancer Council Australia is direct:

Two reasons screening is still essential:

1. The vaccine doesn't cover every high-risk type. Gardasil 9 covers nine types, including the two most dangerous ones - but there are other high-risk types it doesn't cover.
2. The vaccine works best before exposure. If you were exposed to a covered HPV type before vaccination, the vaccine cannot retroactively clear it.

Both vaccination and screening are part of the WHO's global strategy. Either one alone helps. Both together is what the evidence currently supports.

What to expect after the shot

Common side effects are mild and short-lived:

• Soreness at the injection site (most common)
• Headache, mild fever, or nausea in some people
• Fainting can occur in some recipients - which is why you typically sit or lie down for around 15 minutes after the shot

The CDC has tracked the vaccine's safety closely since 2006 and the safety profile remains strong.

How to get the vaccine

• For school-age children (12 to 13): the school program handles it. You may receive a consent form from the school.
• For catch-up (under 26): book a GP appointment. Mention 'HPV vaccination - National Immunisation Program.'
• For private vaccination (26 to 45): book a GP appointment to discuss whether it makes sense for your situation.