NHS 111 Wales

In Wales, girls and boys aged 12 to 13 years are routinely offered the HPV vaccination as a single dose when they're in school Year 8. Once they have received one dose of the HPV vaccine to protect them against cancers caused by HPV, they are considered fully vaccinated and do not require any further doses. A small number of young people who have a weakened immune system or who have HIV will need to have more than one dose of HPV vaccine to be protected.

If you missed your HPV vaccination when it was offered to you at school, you can still have the vaccine up to your 25th birthday. For boys this only applies if you were born on or after 1 September 2006.

What is HPV?

HPV is the name given to a very common group of viruses.

There are many types of HPV, some of which are called "high risk" because they're linked to the development of cancers such as cervical cancer, anal cancer, genital cancers, and cancers of the head and neck.

Other types can cause conditions like warts or verrucas.

Nearly all cervical cancers (more than 99%) are caused by infection with a high-risk type of HPV.

But only some types of anal and genital cancers, and cancers of the head and neck, are caused by HPV infection.

The rest of these cancers are caused by other risk factors like smoking and drinking alcohol.

HPV infections do not usually cause any symptoms, and most people will not know they're infected.

How is HPV infection spread?

The HPV virus is very common and is easily spread by skin to skin contact, including any kind of sexual contact, with another person who already has it.

There are more than 100 different types of HPV, and around 40 that affect the genital area.

Most people will be infected with HPV at some time in their life. In most cases, the virus doesn't do any harm because your immune system gets rid of the infection. But in some cases, the infection persists and can lead to health problems.

Although most young people don't start sexual activity until after they're 16 years of age, it's important that they get this protection early enough, and a good time is in the early teenage years – getting the vaccine as early as possible will protect them in the future.

Using a condom during sex can help to prevent HPV infection. However, as condoms do not cover the entire genital area and are often put on after sexual contact has begun, a condom is no guarantee against the spread of HPV.

What are the different types of HPV and what they do?

There are more than 100 different types of HPV, and around 40 that affect the genital area. HPV is very common and can be caught through any kind of sexual contact with another person who already has it.

Most people will get an HPV infection at some point in their lives and their bodies will get rid of it naturally without treatment.

But some people infected with a high-risk type of HPV will not be able to clear it.

Over time, this can cause abnormal tissue growth as well as other changes, which can lead to cancer if not treated.

High-risk types of HPV are linked to different types of cancer, including:

cervical cancer
vaginal cancer
vulval cancer
anal cancer
cancer of the penis
some cancers of the head and neck

Infection with other types of HPV may cause:

genital warts – small growths or skin changes on or around the genital or anal area; they're the most common viral sexually transmitted infection (STI) in the UK
skin warts and verrucas – not on the genital area
warts on the voice box or vocal cords (laryngeal papillomas)

How does the HPV vaccine work?

Gardasil 9 is the HPV vaccine given in Wales. It provides protection against 9 types of HPV: 6, 11, 16, 18, 31, 33, 45, 52, 58.

HPV types 16 and 18 are the cause of most cervical cancers in the UK (between them, responsible for more than 70%). These types of HPV also cause some anal and genital cancers, and some cancers of the head and neck.

HPV types 6 and 11 cause around 90% of genital warts, so using Gardasil 9 helps protect boys and girls against some types of cancer and also genital warts.

HPV vaccination does not protect against other infections spread during sex, such as chlamydia, and it will not stop girls getting pregnant, so it's still very important to practise safe sex.

Who can have the HPV vaccine through the NHS vaccination programme?

The HPV vaccine is routinely offered as a single dose to girls and boys aged 12 and 13 in school Year 8.

People who miss their HPV vaccine at school should speak to their school immunisation team or GP surgery and make an appointment to get up-to-date as soon as possible.

People who missed their HPV vaccination and are in the eligible groups can still be vaccinated on the NHS up to their 25th birthday. For boys this only applies if you were born on or after 1 September 2006.

Why is the HPV vaccine given at such a young age?

HPV infections can be spread by any skin-to-skin contact and are usually found on the fingers, hands, mouth and genitals.

This means the virus can be spread during any kind of sexual activity, including touching.

The HPV vaccine works best if girls and boys get it before they come into contact with HPV (in other words, before they become sexually active).

So getting the vaccine when recommended will help protect them during their teenage years and beyond.

Most people who have not received the HPV vaccine will be infected with some type of HPV at some time in their life.

In most cases, the virus does not do any harm because their immune system clears the infection.

But in some cases the infection stays in the body for many years and then, for no apparent reason, it may start to cause damage.

HPV vaccination for gay, bisexual and other men who have sex with men (GBMSM)

From April 2017, gay, bisexual and other men who have sex with men (GBMSM) up to and including the age of 45 became eligible for free HPV vaccination on the NHS when they visit sexual health clinics in Wales. More information is available here: Who should have the HPV vaccine?

Ask the doctor or nurse at the clinic for more details.

HPV vaccination for transgender people

Trans women (people who were assigned male at birth) are eligible in the same way as GBMSM if their risk of getting HPV is similar to the risk of GBMSM who are eligible for the HPV vaccine.

Trans men (people who were assigned female at birth) are eligible if they have sex with other men and are aged 45 or under.

If trans men have previously completed a course of HPV vaccination as part of the girls' HPV vaccine programme, no further doses are needed.

How is the HPV vaccine given?

The HPV vaccine is currently given as 1 injection into the upper arm.

1 dose is offered on the routine adolescent programme.

Young people who were offered but missed their HPV vaccination at school can get the vaccine for free up to their 25th birthday. More information is available here: How is the HPV vaccine given?

1 dose is offered to GBMSM vaccinated before their 25th birthday on the GBMSM programme.

2 doses are offered to GBMSM from the age of 25 to 45, where vaccination is commenced on or after the individual’s 25th birthday. The second dose should be given at least 6 months after the first.

3 doses are offered to people who have a weakened immune system at the time of vaccination. For example, individuals who have HIV and those taking medicines that weaken their immune system.

For those who need 3 doses of the vaccine:

the second dose should be given at least 1 month after the first
the third dose should be given at least 3 months after the second dose

If you’re HIV positive or have a weakened immune system, it's important to have all vaccine doses to be properly protected.

How long does the HPV vaccine protect for?

Studies have already shown that the vaccine protects against HPV infection for at least 10 years, although experts expect protection to last for much longer.

But because the HPV vaccine does not protect against all types of HPV that can cause cervical cancer, it's important that all girls who receive the HPV vaccine also have regular cervical screening once they reach the age of 25.