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Informed decision

Confused about the HPV vaccine? We ask some city doctors what they think about the vaccine that can protect you from cervical cancer.

health and fitness Updated: Apr 22, 2010 12:53 IST
Sai Raje Sai Raje

The HPV vaccine that protects women against the human papillomavirus that causes cervical cancer has run into trouble. A vaccination programme being conducted in Andhra Pradesh and Gujarat was suspended earlier this month, following six deaths that are currently being investigated.

This has raised a lot of questions for women who have been recommended the vaccine. Is it safe to use? When should one get it? And what are the side effects?
“None of my patients have reported any side effects so far,” says Dr Ashwini Bhalerao Gandhi, consultant gynaecologist, P D Hinduja Hospital, who has been administering the vaccine for a year. Common side effects reported from around the world include mild nausea and headache. The right age City gynaecologists recommend the vaccine.

“It’s a miracle vaccine against cancer. Ideally, girls should get themselves vaccinated after they reach puberty and before their first sexual encounter,” says Dr Kiran Coelho, consultant gynaecologist, Lilavati Hospital, Bandra. In India, this translates to the 14 to 17 years age group. “We first do a PAP smear test to rule out the presence of the virus, after which, the vaccine is administered,” says Coelho.

In fact, according to gynaecologist Dr Duru Shah, any woman under 45 who tests negative in the PAP smear test and is sexually active, can still opt for the vaccine.Is it safe?
It is yet to be confirmed that the deaths are related to the vaccine that has been administered to over 24,000 girls in the project till date. “Some-times different vaccines are given together. So we can’t say that the deaths were purely because of the HPV vaccine,” says Coelho.

However, there are some, like pregnant women and nursing mothers, who should avoid the vaccine. “Girls under the age of 10 too shouldn’t be administered the HPV vaccine,” says Dr Anita Soni, consultant obstetrician and gynaecologist, Dr L H Hiranandani Hospital.

Medication

The vaccines
The human papillomavirus spreads through sexual contact and can cause cervical cancer that affects the lining of the cervix in women. The recently developed HPV vaccine protects the body against this virus, keeping cervical cancer at bay. Two vaccines recommended by WHO — Gardasil and Cervarix — can protect you against most forms of HPV.

Gardasil produced by Merck, protects against four HPV types: 6, 11, 16, and 18. Cervarix, produced by GlaxoSmithKline, targets two HPV types: 16 and 18. Both vaccines are given in three doses over 6 months.

Side effects
1. A higher proportion of fainting and venous thrombolic events (blood clots) were seen with Gardasil than are usually seen with other vaccines. It is recommended to keep the vaccinated person seated for up to 15 minutes after vaccination.
2. Other side effects reported include headache, nausea, and fever.
3. Guillain-Barré Syndrome (GBS), which is a rare disorder that causes muscle weakness, has been reported too. However, there is no evidence that Gardasil has increased the rate of the syndrome above that expected in the population. Sources: Centre for Disease Control and Prevention, National Cancer Institute.

Controversial demo
With 78,000 deaths due to cervical cancer in India every year, an HPV vaccination programme for girls in a district of Andhra Pradesh and Gujarat was jointly conducted by the respective state governments, the vaccine manufacturers, an international NGO PATH, and the Indian Council of Medical Research (ICMR).

Over 24,000 children were vaccinated in the past year but four have died in Andhra Pradesh and two in Gujarat. The cause of death has been determined as unrelated to the vaccine by ICMR. Nevertheless, the project has been put on hold and an independent committee is investigating the matter.