E F Nigel Holland
Consultant Gynaecologist and Obstetrician
Menu Patient Leaflet 11 - Gardasil Vaccine - Back to List

This leaflet provides information about the Gardasil cervical cancer vaccination.

The treatment described here may be adapted to meet your individual medical needs so it is important to follow medical advice.

Please raise any questions you may have. It is natural to feel anxious before any medical treatment, but knowing what to expect can help.

Gardasil is a vaccination against the Human Papillomavirus (HPV). There are over 100 different types of HPV and they are passed on from person to another through sexual contact. In many cases, the virus does no harm but for some women infection can cause genital warts, ‘precancerous’ cell, cervical cancer, vaginal and vulval cancer.

The ‘precancerous’ cells on the neck of the womb as a result of HPV infection are called cervical intraepithelial neoplasia (CIN). Not all women will develop cancer with this abnormality but it does require medical investigation by colposcopy (see leaflet) and sometimes treatment by to remove the abnormal cells.

Research has shown that Gardasil provides protection against diseases caused by HPV types 6, 11, 16 and 18. HPV types 16 and 18 are responsible for approximately 70 per cent of cervical cancer cases while HPV types 6 and 11 are responsible for approximately 90 per cent of cases of genital warts.

The other vaccine available is called Cervarix which provides protection against HPV types 16 and 18 only, but not 6 and 11 (This is the vaccination adopted by the NHS).

Gardasil is given as a course of three injections, typically over a six month period. The injections are performed as an outpatient procedure, with no admission to hospital.

How does Gardasil work?

Gardasil works by stimulating the body defence mechanism (the immune system) to produce antibodies against HPV types 6,11,16 and 18. Antibodies help your body protect itself against infection with viruses or bacteria. They remain in the body and will recognise these types of HPV if they come in contact with them again and attack them to prevent infection.

Who is suitable for the Gardasil vaccination?

Gardasil is licensed for girls and women from 9 to 26 years of age. To be granted a licence for any drug, the pharmaceutical company who produces it must show the Medicines and Healthcare Products Regulatory Agency and the European Agency for the Evaluation of Medicinal Products that the drug is:

• safe - it doesn't cause too many side-effects or interactions
• effective - it works for the condition to be treated
• good quality - it has been manufactured to a high standard.

Ideally, Gardasil should be given before starting sexual activity to provide maximum protection. However, even if you are already sexually active and over 26 you may still gain some protection as you may not have come into contact with all four HPV types.

About the injections.

We will discuss the suitability and benefits and risks of Gardasil vaccination with you together with any alternatives. You will be asked whether you have any allergies and some questions about your general health and medical history. As Gardasil is not recommended for pregnant women we need to know the date of your last menstrual period and you may also be asked to consent to a pregnancy test.

Before proceeding with the injections, you will be asked to sign a consent form. This confirms you have given permission for the injections to go ahead.

You will need to attend for three different appointments. Typically, following the first injection, the second injection is given two months later and the third injection four months after that. This schedule can be flexible.

The injections will be given through the skin into the muscle of the upper arm or upper thigh.

Following the injections

After the injection we will monitor you for about fifteen minutes before you can go home.

If you miss an injection, please contact the hospital as soon as possible to rearrange your appointment.

Following the injections you should continue to have regular cervical smear tests. In time the NHS screening programme may be amended for individuals who have been vaccinated and may not require cervical smears as frequently. Gardasil does not provide protection against diseases caused by other types of HPV or from any HPV infection you may already have. Gardasil will also not provide any protection against other sexually transmitted diseases.

What are the risks

Gardasil is a very new medical treatment. Like all medical treatments there are risks as well as benefits.

Research has shown that Gardasil helps prevent diseases related to HPV types 6,11,6 and 18 in women aged 16 to 26. The vaccine also produces antibodies in 9 to 15 year old children and adolescents. Whether these antibodies prevent disease in adult men has not been tested.

For people with a weakened immune system, the vaccination could be less effective because a lower number of antibodies may be produced. At this stage, it is not known how long any protection provided by Gardasil will last. It is possible that at some stage in the future, booster injections may be needed.

Side-Effects

These are the unwanted but mostly temporary effects of a successful treatment. Possible side-effects of Gardasil are:

• pain, swelling and redness at the site of the injection (which may be accompanied by a high-temperature)
• bleeding or itching at the injection site
• feeling or being sick
• rarely, an itchy skin rash
• uncommonly, feeling dizzy or fainting

Complications

This is where problems occur during or after medical treatment. One possible complication of Gardasil is a severe allergic reaction. You will be monitored after your injections by a member of staff trained to respond should such a reaction occur. You should ask your consultant how any risks apply to you.

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