Free HPV vaccine available for young women
Almost all cases of cervical cancer are caused by the human papillomavirus (HPV). HPV is transmitted during sexual activity and is very common. Women born in 1991 or later are now being offered free HPV vaccination. The offer began on November 1st, 2016 and will be available for two years.
Vaccination will be organised by each municipality.
Why am I being offered the HPV vaccine?
70 per cent of sexually active people will become infected with human papillomavirus (HPV), most at a young age. In a Norwegian study, approximately 45 per cent of 21-year-old women had an ongoing HPV infection. HPV is spread by sexual activity and is very common. The vaccine is recommended whether you have had none, one or many sexual partners. Most HPV infections are asymptomatic and will pass, but about 10 per cent will develop into a chronic infection, which may cause cervical cancer. There are many different strains of HPV.
What is the HPV vaccine?
HPV vaccine protects against two of the most common HPV strains that can lead to cancer. It is recommended for young women, even those who have had sexual intercourse. Vaccination consists of three doses that are given over a 6-12 month period. The offer of free vaccination will last for two years from November 2016. This means that vaccination should begin by the end of 2018, at the latest.
- The HPV vaccine used is called Cervarix.
- The vaccine is injected into the upper arm and needs to be given three times.
- The second dose is given at least one month after the first. The last dose is given at least five months after the second dose.
- Pregnant women should not take the HPV vaccine.
- Medicines authorities have approved the vaccine after a thorough assessment of its efficacy and side effects.
- The vaccine protects against the HPV 16 and 18 strains that cause 70 per cent of all cases of cervical cancer.
- The vaccine can also provide partial protection against infection from some other HPV strains (cross-protection).
- The effect is expected to be long-term and possibly lifelong. The first group who were vaccinated have been monitored on an ongoing basis (nine years), and there are no signs that their immunity has diminished. The vaccine can be taken by women who have an HPV infection but it will not cure an ongoing infection.
- It is not recommended to test for HPV infection before vaccination.
- The vaccine does not protect against genital warts.
- The vaccine protects against new infection among those who have previously had a HPV infection.
- The vaccine protects against two HPV strains. If you are infected with one of the strains, the vaccine will still protect you from the other.
All vaccine doses given are registered in the Norwegian immunisation registry, SYSVAK. You can check which vaccines you have had via the online service, My Vaccines.
What is HPV?
There are many different HPV strains and they have different properties.
Some are harmless, while others can cause cancer. Some HPV types cause common warts and genital warts, while others can cause cancer in various organs. In women, cervical cancer is the most common but HPV can also cause cancers of the vagina, vulva, rectum or throat. Men can develop cancer because of HPV infection in the penis, rectum or throat. It is difficult to be well protected protect when HPV is transmitted sexually. Condoms offer limited protection because the virus is also found on the skin around the genitals.
How does HPV lead to cervical cancer?
Infection with a high-risk strain of HPV can cause a chronic HPV infection which may lead to cervical cancer in the long-term. Cervical cancer usually develops over the course of about 10-30 years.
How many women develop cervical cancer each year in Norway?
Every year in Norway:
- 3,000 women undergo surgery for serious cervical dysplasia (precancerous cell changes). Many are quite young.
- 300 women develop cervical cancer. Many of those who survive have long-term complaints following cancer treatment.
- 70 women die from the disease.
In case of severe cervical dysplasia, part of the cervix is surgically removed to prevent the development of cancer. Pregnant women who have had this surgery are at increased risk of miscarriage and premature birth.
Can the HPV vaccine cause side effects?
All vaccines may cause some unwanted effects, including the HPV vaccine. The most common side effects of the HPV vaccine offered are mild and temporary such as:
- Tenderness, redness and swelling at the injection site. This is very common (more than 1 in 10).
- Headaches, fatigue or muscle pains. This is very common (more than 1 in 10).
- Fever is common (1-10 of 100 vaccinated). Joint pain, itching, skin rash, nausea, vomiting / diarrhoea or abdominal pain can also occur.
Some people may experience dizziness, feeling light-headed and fainting. This is usually caused by discomfort or anxiety associated with injections. Tell the healthcare professional who is vaccinating you if you have fainted before in similar situations. Severe allergic reactions can occur, but are rare. You will be asked to wait at the clinic for 20 minutes after vaccination and healthcare professionals who vaccinate are prepared to deal with these situations. There is no evidence that the HPV vaccine has been responsible for another serious illness in Norway or other countries.
Questions have been raised about whether HPV vaccination is linked to a complex pattern of symptoms including rapid heart rate, dizziness and fatigue that have been registered in Denmark. These symptoms have also seen among unvaccinated individuals. The medicines authorities have investigated this further and have found no evidence to suggest that these symptoms are due to the vaccine.
More information about side effects is available in the package insert for Cervarix.
Symptoms that arise after vaccination are not necessarily due to a reaction to the vaccine but can be signs of an untreated disease. Consult your doctor if you are concerned.
If you experience serious or unexpected symptoms after vaccination, contact your healthcare provider who will notify the regulatory authorities. Suspected adverse reactions can also be reported by individuals directly via the Norwegian Medicines Agency's website, but it is not so easy to follow up these notifications.
- Side effects of the vaccine NIPH
- Side effects and drug safety (Norwegian Medicines Agency – only in Norwegian)
Should I attend regular cervical cancer screening even though I have taken the HPV vaccine?
The cervical cancer screening programme, where a cell sample is taken from the cervix, is offered to all women in Norway every 3 years from the age of 25. The purpose is to detect cancer or cervical dysplasia as early as possible. It is important that vaccinated women follow the programme because the HPV vaccine does not protect against all cancer-causing HPV types. The best protection against cervical cancer is to take the vaccine and follow the programme.
More information: Cervical Cancer Screening Programme - Cancer Registry