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Boys 12 and 13 years old will be vaccinated against HPV as of January

By Indrojit chaterji

Beginning in January 2017, boys aged 12 and 13 will receive the HPV vaccine. HPV is a virus that affects the skin and mucous membranes and can cause warts or cancer-causing lesions, such as cervical and throat cancers. 3.6 million children should be immunized. By 2020, the age range should be increased to 9-13 years.

In 2014, the federal government began free HPV immunization in girls aged 9 to 13 years with the quadrivalent vaccine. The age group was chosen because it showed greater benefit because of the high production of antibodies and because it was less exposed to the virus through sexual relations.

Check out the definitions and guidelines released by the National Cancer Institute and the Ministry of Health about HPV infection, its relation to various types of cancer, and the importance of vaccination - including for boys.

Is there more than one type of vaccine?

There are two HPV vaccines approved and registered by the National Sanitary Surveillance Agency and commercially available in Brazil: the quadrivalent, used in the public network, which provides protection against subtypes 6, 11, 16 and 18; and bivalent, which protects against subtypes 16 and 18.

How does the HPV vaccination scheme work?

This year, the government changed the HPV vaccination schedule for girls, reducing the required doses three to two (the second, six months after the first). Only women between 9 and 26 years old with HIV should continue to receive all three doses, the third being five years after the first.

The same vaccination schedule will be maintained by the ministry for the immunization of children against HPV from 2017 - including the three-dose rule for those living with HIV.

Who can be vaccinated?

Currently, girls aged 9 to 13 have the vaccine guaranteed under the Unified Health System. From the coming year, children 12 and 13 years old will have the same right. Other groups may have the vaccine in private services.

Is it Worth Vaccinating Men Against HPV?

The efficacy of the HPV vaccine has been proven in men for the prevention of genital warts and precursor lesions of penile and anus cancer. In addition, vaccinating men against the virus is a strategy that ends up protecting women from the so-called indirect or herd immunity, as the virus is sexually transmitted.

How long is the vaccine effective?

The duration of HPV vaccine efficacy has been proven to be up to nine years, but there are still gaps in the duration of long-term immunity and the need for booster doses (application of new doses of the vaccine in the future in the already vaccinated population).

Is the HPV vaccine safe?

The vaccine against HPV is considered safe and well tolerated. The most observed adverse events after immunization include pain, swelling and redness at the injection site, in addition to mild to moderate intensity headache.

Is there contraindication to the vaccine?

The dose against HPV is contraindicated for pregnant women, patients with acute illnesses and people with hypersensitivity to the components (active principles or excipients).

Where is it possible to get vaccinated?

The vaccine for girls aged 9 to 13 is available at public health clinics and at schools that join the vaccination campaigns. The same strategy should be adopted for the immunization of boys from January 2017.

What is the relationship between HPV and cancer?

HPV infection is quite frequent but transient, regressing spontaneously most of the time. In cases where it persists, there is a risk of developing precursor lesions that, if unidentified and treated, can progress to cancer - especially in the cervix, but also in the vagina, vulva, anus, penis, oropharynx, and mouth.

What are the most dangerous subtypes?

There are more than 150 HPV subtypes and about 40 of them can infect the genital tract of men and women. At least 13 subtypes are considered oncogenic (with potential to cause cancer) and are at higher risk of provoking persistent infections, in addition to being associated with precursor lesions. Among them, the 16 and 18 are present in 70% of the cases of cervical cancer registered in the world.

Does the infected person necessarily have signs and symptoms?

The majority of HPV infections are asymptomatic. This means that both the man and the woman can be infected without presenting any symptoms. Usually, the infection presents as microscopic lesions or even produces lesions. Therefore, even when there are no visible lesions, it can not be guaranteed that the virus is not present.

What are the main manifestations of the infection?

About 5% of people infected with HPV develop some form of manifestation. Clinical lesions present as warts, popularly called cock crest, fig tree or crest horse. They look like cauliflower and vary in size. In women, they may appear in the cervix, vagina, vulva, pubic, perineal, perianal and anus regions. In men, they can arise in the penis (usually in the glans), in the scrotal sac, pubic region, perianal region and in the anus. Lesions may also appear in the mouth and throat in both sexes.

How is HPV transmitted?

Virus transmission is by direct contact with infected skin or mucosa. The main form is through the sexual route, which includes oral-genital, genital-genital or even manual-genital contact. Thus, HPV infection can occur even in the absence of vaginal or anal penetration. There may also be transmission during delivery. However, the possibility of contamination by objects, use of a toilet and swimming pool, or the sharing of towels and underwear is not proven.

How can men and women be prevented?

Although recommended, condom use during sexual contact, with or without penetration, does not fully protect against HPV infection, since the condom does not cover all areas that can be infected. In the presence of infection in the vulva, pubic, perineal, perianal region and scrotal sac, for example, the virus can be transmitted even with the use of condoms. The female condom, which also covers the vulva, more effectively avoids contagion - since it has been used since the beginning of sexual intercourse.

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