Flashcards in HPV vaccination Deck (15)
What cancers can HPV cause?
Some head and neck
Which strains cause most cervical cancers?
16 and 18 (70-80%)
Which strains cause genital warts?
6 and 11
Benefits of HPV vaccination:
- Reduces infection of vaccine related HPV types
- Reduces the incidence of precursor lesions and potentially malignant lesions
Who is vaccinated in Australia/NZ?
- Boys and girls
- High school age in Australia
- 9-27 in NZ
How do the HPV vaccines work?
- Contain virus like proteins (not live or attenuated)
- IM injection *--
- Induce antibody response
- Not therapeutic
Which vaccine is used in Australia and New Zealand?
- Gardasil 9
Which strains do Gardasil protect against?
- 6, 11, 16, 18, (13, 33, 45, 52, 58)
- Prevents 90% of cervical cancers
Dosage of Gardasil
- 2 doses 5-13 months apart
- If immunocompromised or older than 15 need 3 doses
- Serious: Anaphylaxis (around 1-3 per million)
- Mild: Headache, fever, dizziness, muscle pain, local reaction
- Not recommended for use in pregnancy
Which strains do cervarix protect against?
16 and 18
Describe the viral composition of Gardasil HPV vaccine. (2 marks)
• No live, attenuated or killed virus present
• Virus-like proteins designed to mimic the HPV L1 capsid protein
o Antibodies then develop to the capsid protein
• Contains virus like proteins of HPV 6, 11, 16 & 18
b. Discuss four (4) benefits and three (3) limitations of Gardasil HPV vaccination in preventing genital tract dysplasia. (7 marks)
• Prevention from contracting HPV 16 and 18, which causes 80% of cervical cancers
• Prevention from VAIN/VIN from 16 &18 and their associated cancers
• Some cross-immunity against other strains may be present
• Highly effective when given in young women (ideally before the age of sexual debut)
• Reduces HPV risk in the male partner
• Excellent safety profile
• Does not cover all strains of HPV implicated in VIN/VAIN
• Not protective against strains of HPV that a woman has already been exposed to
• Reduced effectiveness in immunosuppressed women
• No evidence that effective in women over the age of 45 and immunogenic response declines with age
• Does not abolish the need for cervical screening
• Long term effects and duration of immunity unknown
c. Discuss one (1) benefit and one (1) limitation of Gardasil HPV vaccination in preventing genital warts. (2 marks)
• Highly effective in preventing development of genital warts from HPV 6 and 11- 90%
• Effectiveness may be reduced in immnosuppressed women
• Does not cover the other HPV types that cause 10% of genital warts