Vaccination to prevent cervical cancer offered to all girls in grade 7 (age 12-13)

Transcription

1 About HPV-vaccination in The Norwegian Childhood Immunisation Programme Information for children and parents in English Vaccination to prevent cervical cancer offered to all girls in grade 7 (age 12-13) Text is based on the brochure: Om HPV-vaksinen I barnevaksinasjonsprogrammet published by the Norwegian Institute of Public Health Photo: colourbox.com

2 2 THE NORWEGIAN IMMUNISATION PROGRAMME CHILD/PARENT INFORMATION VACCINE AGAINST HPV LAST UPDATED SEPTEMBER 2014 All girls in Norway in grade 7 (age 12-13) are offered human papilloma virus (HPV) vaccination. As in the case of all vaccines in the Norwegian Childhood Immunisation Programme, this is an offer you can choose to accept. Girls should be well informed about the vaccine, and parents should take their wishes into account. Please read and discuss the contents of this brochure with your daughter. This publication gives you information about cervical cancer and how the HPV vaccine offers protection for young girls against disease later in life. The brochure explains how the vaccine is given and provides information about its potential side effects. For more information about HPV and the HPV vaccine, talk to your school nurse or consult the Norwegian Institute of Public Health website: CERVICAL CANCER IS CAUSED BY A VIRUS Cancer of the neck of the womb (cervix) is caused by a virus called human papilloma virus (HPV). There are many types of HPV virus. Each type has its own number. At least 12 HPV types can cause cervical cancer. The commonest ones that cause cancer are HPV 16 and HPV 18. In Norway, these two types of virus cause about 70 per cent of all cervical cancers. HPV infection is easily contracted from sexual contact and does not usually cause symptoms. Most women contract an HPV infection at some stage in their lives, and usually at a young age. In most cases, HPV infections resolve of their own accord. But if an infection with cancer-causing HPV lasts a long time, it may progress to precancerous changes in the cells lining the cervix (dysplasia). These precancerous changes may develop into cervical cancer. See the figure of the cervix. Illustration: Kari Toverud

3 Ill ABOUT CERVICAL CANCER Cervical cancer is a life-threatening disease. Each year, around 300 women in Norway are diagnosed with the disease, and women die of this cancer. Each year, around 3000 women have surgery for serious precancerous changes in order to prevent progression to cancer. Pregnant women who have had such surgery have a higher risk of miscarriage or premature birth. The progression to cervical cancer typically takes years. Some are diagnosed with cervical cancer when they are young, and just under 30% of those diagnosed are under the age of 45. ABOUT GENITAL WARTS Some types of HPV may cause warts around the genitals/anus, but these types do not cause cancer. Genital warts often resolve without treatment. They can also be treated. Almost all cases of genital warts are caused by HPV 6 or 11. HOW THE HPV VACCINE PROVIDES PROTECTION The HPV vaccine has a preventive effect and should be given to girls before there is any risk of infection. This is why the Norwegian Childhood Immunisation Programme offers HPV vaccination to girls well before the Norwegian average age of first sexual activity. The HPV vaccine protects against HPV 16 and 18 and the precancerous changes caused by these two types of HPV. The vaccine does not protect against other cancer-causing types of HPV. Cervical cancer is always preceded by precancerous changes. Because cancer takes a long time to develop, it may be years before the protective effect of the HPV vaccine against cervical cancer can be finally confirmed. The HPV vaccine given in the Norwegian Childhood Immunisation Programme (Gardasil ) also provides protection against genital warts caused by HPV 6 and 11. The vaccine provides more than 95% protection against HPV 6, 11, 16 and 18. The first girls given the vaccine almost ten years ago are still well protected. The vaccine is likely to provide long-term, perhaps lifelong, protection. Follow-up over time of those that have been vaccinated will indicate whether a booster dose is needed later in life to prolong the protection. HOW THE VACCINE IS GIVEN The vaccine is given over 6 12 months. The second dose is usually given 2 months after the first one, and the last dose is given 6 months after the first. Before the vaccination, the nurse will ask if you are healthy and if you have had reactions to previous vaccines. Remember to tell the nurse if you have allergies, take medicines or have other health problems. You can safely be vaccinated even if you have a cold or are less fit than usual. However, vaccination is usually postponed if you are acutely ill or have a fever of more than 38 degrees. Some girls find it hurts a bit and is uncomfortable to have the vaccine, and a few may faint. If you are worried about this, or have previously become unwell from vaccination, you can ask if you can lie down when the vaccine is given. As with all other vaccines, you must be supervised by the nurse for about 20 minutes after being injected.all vaccination is voluntary.

4 SIDE EFFECTS AND SAFETY The HPV vaccine has undergone large-scale international trials and is approved by the Norwegian Medicines Agency. This approval is based on a thorough evaluation of the benefits and risks of the vaccines. The commonest side effects of the vaccine in the Norwegian Childhood Immunisation Programme (Gardasil) are: Swelling, soreness of the arm at the site of the injection, headache (more than 1 in 10 of those vaccinated). Fever, nausea, pain in the arm (more than 1 in 100). These symptoms disappear after a few days. Any vaccine can in rare cases cause an allergic reaction such as a rash or itching shortly after the vaccine was given. In rare cases, vaccines can cause more serious allergic reactions. Healthcare personnel who give vaccines are prepared to deal with this type of reaction. Apart from some very rare allergic reactions, it has not been documented that HPV vaccine has caused serious disease. Extremely rare side-effects cannot be completely excluded and may not be discovered until a large number of people have been given a new medicinal product. All severe and unexpected symptoms occurring after vaccination must be reported to the Norwegian Medicines Agency. The reports are examined to determine if the symptoms were caused by the vaccine or by the onset of a disease coinciding with the vaccination. Symptoms experienced after vaccination are not necessarily a reaction to the vaccine, but may be signs of a disease requiring medical attention. For this reason, you should contact your doctor if you have concerns. REGISTRATION IN THE NORWEGIAN IMMUNISATION REGISTRY Your HPV vaccination is recorded in the vaccinator's system and in the Norwegian Immunisation Registry (SYSVAK). To see which vaccines you or your child have had, use the Mine vaksiner service at REGULAR CERVICAL CANCER SCREENING PROGRAMME All women in Norway are invited to have a cervical smear test or pap smear every 3 years from the age of 25. The aim of this is to reduce the number of deaths from cervical cancer by early detection of cancer or precancerous changes. The Norwegian screening programme has resulted in a significant decrease in the number of cases of cervical cancer. It is important that girls and women who have been vaccinated against HPV participate in the screening programme. This is because the vaccines do not provide protection against all cancercausing types of HPV, and it is not yet known how long the vaccines will provide protection. In addition, other types of cancer-causing HPV might possibly be a more significant cause of cancer than the two types the vaccine protects against. The aim is for vaccination and regular cervical screening to provide the best possible protection against cervical cancer. Research is underway to monitor how the immunisation programme affects the incidence of HPV infection and cervical cancer in Norway. The Norwegian Institute of Public Health is responsible for the follow-up programme.

5 GOOD TO KNOW: The World Health Organization (WHO) recommends that HPV vaccination is included in national childhood immunisation programmes. HPV vaccine is included in the childhood immunisation programme in a number of countries. 205 million doses of the HPV vaccine Gardasil have been distributed worldwide (December 2015). The HPV vaccine consists of artificially manufactured particles resembling parts of the surface of HPV. The vaccine is not live, does not contain viral DNA and cannot cause HPV infection. No vaccines, including the HPV vaccine, in the Norwegian Childhood Immunisation Programme contain mercury as a preserving agent. A condom does not provide adequate protection against HPV infection because the virus is also found on areas of skin near the genitals, which a condom does not cover or protect. The HPV vaccine provides no protection against other sexually transmitted diseases. A condom is also important for those who have had the HPV vaccine. The Norwegian Institute of Public Health has recommended that boys, like girls, be offered the HPV vaccine under the Norwegian Childhood Immunisation Programme. This recommendation is currently (May 2016) awaiting a parliamentary hearing.