HPV vaccination: facts versus fears

Numerous cancers have been attributed to the human papilloma virus (HPV), including cervical, vaginal, vulvar, penile, anorectal, and oropharyngeal. The incidence of HPV-related cancers in Ireland is 420 cases annually, resulting in 130 deaths. HPV is most frequently associated with cervical cancer; globally, over half a million women are diagnosed with this cancer each year. Serotypes HPV16 and HPV18 are associated with the highest cancer risk. The Irish prevention strategies include a national screening programme to detect cervical pre-cancer and cancerous lesions (namely cervical intraepithelial neoplasia; CIN) in women aged 25-60, as well as a national HPV vaccination programme. The HPV vaccine is recommended for young girls in the first year of second-level school, to provide protection against HPV prior to expected sexual exposure, thereby reducing the risk of HPV infection. There are a number of different HPV vaccines available; the two main types are Cervarix and Gardasil. Cervarix is a bivalent vaccine protecting against cancer-associated serotypes HPV16 and HPV18. Gardasil is a quadrivalent vaccine protecting against HPV16 and HPV18, as well as the genital warts-associated strains HPV6 and HPV11. The Gardasil vaccine was first introduced to Ireland’s national screening programme in 2011, but this has not been without contention.