HPV vaccine FAQ - Frequently Asked Questions

FAQ - Frequently Asked Questions

1.  I’m over 26. Can I get HPV vaccinated? What are the benefits?

Answer: Yes, you can. Currently, it’s recommended that the HPV vaccine be given starting at age 9 to both male and female preteens. In case you have not been vaccinated before, the vaccine is still highly effective in preventing infection, as in younger people. If you've been infected with HPV, the vaccine can protect you from other strains of HPV you haven't been exposed to and prevent re-infection with the same strains, boosting the body immunity and ability to eliminate the virus. 

2. Can I get the HPV vaccine if I have had sex?
Answer: Yes, you can. Currently according to Thailand's guidelines for HPV vaccination,* all male and female preteens,  starting from age 9, and young adults, whether or not they have ever had sexual contacts, should get HPV vaccine,.
*Recommendations of the Pediatric Infectious Diseases Association of Thailand 2020 and recommendations on HPV vaccination of the Royal Thai College of Obstetricians and Gynecologists, and the Thai Gynecologic Cancer Society

3. If I’ve already been infected with HPV, is the vaccine still useful?
Answer: It is still useful. The HPV vaccine can protect you from other strains of HPV you haven't been exposed to and prevent re-infection with the same strains. This is because immunity from natural infection is not high enough to prevent the next infection. So you should get HPV vaccinated. Research has found that in women with advanced pre-cancerous lesions of the cervix (CIN2+) who have been vaccinated, after treatment, recurrence after 4-year follow-up was reduced by 80% compared to those unvaccinated. 

4. Do I need a cervical cancer screening before getting the HPV vaccine?
Answer: You can get vaccinated without getting HPV-DNA testing or the cervical cancer screening first. This is because the HPV* infection detected may be transient and does not cause a disease in the woman. In addition, the abnormal cells found may not be caused by the HPV strains contained in the vaccine. Still, after vaccination, a regular cervical cancer screening is recommended so that prevention is most effrective as some HPV strains are yet to be contained in the vaccines. 
*HPV vaccination recommendations of the Royal Thai College of Obstetricians and Gynecologists  and the Thai Gynecologic Cancer Society

5. If I plan to have children, can I get the HPV vaccine? Or, if I get HPV vaccine and then find out I'm pregnant, what should I do?
Answer: Women of reproductive age who plan to have children can get HPV vaccine but it is recommended that they complete the vaccination course before getting pregnant. This is due to limited information on using the vaccine in pregnant women. If you become pregnant after starting the HPV vaccine series, second and/or third doses should be delayed until you are no longer pregnant. Then you can continue with the next dose, with no need to start over. HPV vaccine safety studies have found that the vaccine is unlikely to harm the fetus and breastfeeding mothers can get HPV vaccinated. 

6. How many types of HPV vaccine are there in Thailand? How are they different?
Answer: There are 3 types of HPV vaccine:
1) 2-valent HPV (for protection against HPV 16/18)
2) 4-valent HPV (for protection against HPV 6/11/16/18)
3) 9-valent HPV (for protection against HPV 6/11/16/18/31/33/45/52/58)
HPV can be divided into 2 types:
1) High-risk HPVs that can cause cancer: types 16, 18, 31, 33, 45, 52 and 58 
2) Low-risk HPVs that can cause warts: types 6 and 11

The 4-valent HPV vaccine offers protection against HPVs that cause 70% of cervical cancer and 90% of genital warts. Studies have also shown its effectiveness in preventing HPV-related diseases in men including anal cancer and male genital warts.

The 9-valent HPV vaccine offers protection against HPVs that cause 94% of cervical cancer and 95% of mouth and throat cancer. Studies have also shown its effectiveness of up to 97% in preventing HPV-related cancers such as cervical cancer, vaginal cancer, vulvar cancer and anal cancer. 

7. Starting at what age can HPV vaccine be given?
Answer: Both males and females, starting at age 9, can be given HPV vaccine. 

8. In men, what are the benefits of the HPV vaccine? Is it necessary to inject?
Answer: HPV can cause diseases in all genders and ages. In men, HPV can cause various diseases such as mouth and throat cancer, penile cancer, anal cancer and genital warts. The chance of HPV infection in men is constantly high and does not decrease with age. Condoms CANNOT completely prevent HPV infection as areas not covered by condoms can be infected. Moreover, unlike women, there are no cancer screening recommendations for men.  Thus, there is no way of knowing when the infection occurred as symptoms do not appear until the infection has developed into a lesion or cancer. Recent studies have found that the incidents rate of HPV mouth and throat cancers is on the rising trend in many countries worldwide and also in Asia.  HPV vaccination is thus as necessary for men as for women. It prevents them from direct infection and from being disease carriers. 

9. I’ve completed the 2-valent and the 4-valent HPV vaccination courses. Can I also get the 9-valent? 
Answer: Studies have shown that it is safe to get a complete 3-dose 9-valent HPV vaccine after the 4-valent type vaccination is finished. Completing the course of 3 doses of the same vaccine, one gets good response to immunization against additional five HPV types with long-lasting immunity without boosting doses. 

10. I’ve you've already got 1-2 doses of an HPV vaccine type, can I change to the 9-valent HPV vaccine?
Answer: There has not been much research on the interchangeability of different HPV vaccines (i.e. a two-dose schedule of two different types of HPV vaccine). However, whether or not one has completed the previous HPV vaccine course, in switching to the 9-valent HPV vaccine, it’s recommended that the new 3-dose vaccine type should be completed.

11. How effective is the 9-valent HPV vaccine in preventing diseases? 
Answer: Long-term follow-up studies have found that the 3-dose 9-valent HPV vaccine gives good immune response to children aged 9-15.  The immunity remains above 90% after 10-year follow-up and is 100% effective in preventing the development of advanced pre-cancerous cervical lesions and genital warts in women as well as precancerous lesions and genital warts in men.

12. How is the HPV vaccine given?

Answer: The HPV vaccine is given as a series of shots:

- For those age 9 to 14, two shots of vaccine are recommended. The second shot should be given 6 to 12 months after the first one. (If the second shot is given sooner than 5 months, an additional third shot is recommended.)

- For those age 15 through 45, three shots of vaccine are recommended. The second shot should be given 2 months after the first one, the third shot 4 months after the second shot, or at 0-2-6 month schedule.

In case the vaccination schedule cannot be followed, there should be a miminum one-month interval between the first and the second shots, a minimum three-month interval between the second and the third shots, and no less than five-month interval between the first and the third shots. 
For maximum efficiency in preventing HPV infection, the whole 3-dose HPV vaccination course should be completed within one year for those over 15 years old. However, if a dose is delayed or interrupted, as recommended by the CDC (USA), vaccine doses do not need to be repeated and the next dose (of the same type of vaccine) should be given right after the scheduled date with no maximum interval.  

13. What are the side effects of the HPV vaccine?

Answer: Common side effects are soreness, swelling, redness, headache, itching, bruising, hematoma lump, fever, nausea, dizziness, and fatigue. They are mostly mild and go away on their own 3-5 days after vaccination, and medicines to relieve symptoms can be used.  

14. Is the HPV vaccine safe?
Answer: It is safe. According to the survey data on more than 300 million doses that have been administered worldwide, it causes mostly mild side effects and no vaccine-related death is reported. This is because the current HPV vaccines are based on virus-like particles (VLPs). The VLPs are not infectious because they lack the virus's DNA and thus cannot cause an HPV infection or a disease.


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