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Download Vaccination to prevent cervical cancer – offered to all girls in grade 7
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AboutHPV-vaccination inTheNorwegianChildhoodImmunisationProgramme InformationforchildrenandparentsinEnglish Vaccinationtopreventcervicalcancer –offeredtoallgirlsingrade7(age12-13) Textisbasedonthebrochure:OmHPV-vaksinenIbarnevaksinasjonsprogrammet publishedbytheNorwegianInstituteofPublicHealth Photo:colourbox.com ENGLISH 2 THENORWEGIANIMMUNISATIONPROGRAMME•CHILD/PARENTINFORMATION VACCINEAGAINSTHPV LASTUPDATEDSEPTEMBER2014 _________________________________________________________________________________________________________ AllgirlsinNorwayingrade7(age12-13)areofferedhumanpapillomavirus(HPV) vaccination.AsinthecaseofallvaccinesintheNorwegianChildhoodImmunisation Programme,thisisanofferyoucanchoosetoaccept.Girlsshouldbewellinformedaboutthe vaccine,andparentsshouldtaketheirwishesintoaccount.Pleasereadanddiscussthe contentsofthisbrochurewithyourdaughter. ThispublicationgivesyouinformationaboutcervicalcancerandhowtheHPVvaccineoffers protectionforyounggirlsagainstdiseaselaterinlife.Thebrochureexplainshowthevaccineis givenandprovidesinformationaboutitspotentialsideeffects.Formoreinformationabout HPVandtheHPVvaccine,talktoyourschoolnurseorconsulttheNorwegianInstituteofPublic Healthwebsite:www.fhi.no/vaksine CERVICALCANCERISCAUSEDBYAVIRUS Canceroftheneckofthewomb(cervix)iscausedbyaviruscalledhumanpapillomavirus(HPV). TherearemanytypesofHPVvirus.Eachtypehasitsownnumber.Atleast12HPVtypescancause cervicalcancer.ThecommonestonesthatcausecancerareHPV16andHPV18.InNorway,thesetwo typesofviruscauseabout70percentofallcervicalcancers. HPVinfectioniseasilycontractedfromsexualcontactanddoesnotusuallycausesymptoms.Most womencontractanHPVinfectionatsomestageintheirlives,andusuallyatayoungage. Inmostcases,HPVinfectionsresolveoftheirownaccord.Butifaninfectionwithcancer-causingHPV lastsalongtime,itmayprogresstoprecancerouschangesinthecellsliningthecervix(dysplasia). Theseprecancerouschangesmaydevelopintocervicalcancer.Seethefigureofthecervix. Illustration:KariToverud ENGLISH THENORWEGIANIMMUNISATIONPROGRAMME•CHILD/PARENTINFORMATION VACCINEAGAINSTHPV LASTUPDATEDSEPTEMBER2014 ___________________________________________________________________________________________________________ Ill ABOUTCERVICALCANCER Cervicalcancerisalife-threateningdisease.Eachyear,around300womeninNorwayarediagnosed withthedisease,and65-100womendieofthiscancer.Eachyear,around3000womenhavesurgery forseriousprecancerouschangesinordertopreventprogressiontocancer.Pregnantwomenwho havehadsuchsurgeryhaveahigherriskofmiscarriageorprematurebirth. Theprogressiontocervicalcancertypicallytakes10-30years.Somearediagnosedwithcervical cancerwhentheyareyoung,andjustunder30%ofthosediagnosedareundertheageof45. ABOUTGENITALWARTS SometypesofHPVmaycausewartsaroundthegenitals/anus,butthesetypesdonotcausecancer. Genitalwartsoftenresolvewithouttreatment.Theycanalsobetreated.Almostallcasesofgenital wartsarecausedbyHPV6or11. HOWTHEHPVVACCINEPROVIDESPROTECTION TheHPVvaccinehasapreventiveeffectandshouldbegiventogirlsbeforethereisanyriskof infection.ThisiswhytheNorwegianChildhoodImmunisationProgrammeoffersHPVvaccinationto girlswellbeforetheNorwegianaverageageoffirstsexualactivity. TheHPVvaccineprotectsagainstHPV16and18andtheprecancerouschangescausedbythesetwo typesofHPV.Thevaccinedoesnotprotectagainstothercancer-causingtypesofHPV. Cervicalcancerisalwaysprecededbyprecancerouschanges.Becausecancertakesalongtimeto develop,itmaybe10-30yearsbeforetheprotectiveeffectoftheHPVvaccineagainstcervicalcancer canbefinallyconfirmed. TheHPVvaccinegivenintheNorwegianChildhoodImmunisationProgramme(Gardasil®)also providesprotectionagainstgenitalwartscausedbyHPV6and11. Thevaccineprovidesmorethan95%protectionagainstHPV6,11,16and18. Thefirstgirlsgiventhevaccinealmosttenyearsagoarestillwellprotected.Thevaccineislikelyto providelong-term,perhapslifelong,protection.Follow-upovertimeofthosethathavebeen vaccinatedwillindicatewhetheraboosterdoseisneededlaterinlifetoprolongtheprotection. HOWTHEVACCINEISGIVEN Thevaccineisgivenover6–12months.Theseconddoseisusuallygiven2monthsafterthefirstone, andthelastdoseisgiven6monthsafterthefirst. Beforethevaccination,thenursewillaskifyouarehealthyandifyouhavehadreactionstoprevious vaccines.Remembertotellthenurseifyouhaveallergies,takemedicinesorhaveotherhealth problems. Youcansafelybevaccinatedevenifyouhaveacoldorarelessfitthanusual.However,vaccinationis usuallypostponedifyouareacutelyillorhaveafeverofmorethan38degrees. Somegirlsfindithurtsabitandisuncomfortabletohavethevaccine,andafewmayfaint.Ifyouare worriedaboutthis,orhavepreviouslybecomeunwellfromvaccination,youcanaskifyoucanlie downwhenthevaccineisgiven.Aswithallothervaccines,youmustbesupervisedbythenursefor about20minutesafterbeinginjected.All vaccination is voluntary. ENGLISH THENORWEGIANIMMUNISATIONPROGRAMME•CHILD/PARENTINFORMATION VACCINEAGAINSTHPV LASTUPDATEDSEPTEMBER2014 ___________________________________________________________________________________________________________ SIDEEFFECTSANDSAFETY TheHPVvaccinehasundergonelarge-scaleinternationaltrialsandisapprovedbytheNorwegian MedicinesAgency.Thisapprovalisbasedonathoroughevaluationofthebenefitsandrisksofthe vaccines. ThecommonestsideeffectsofthevaccineintheNorwegianChildhoodImmunisationProgramme (Gardasil)are: • • Swelling,sorenessofthearmatthesiteoftheinjection,headache(morethan1in10ofthose vaccinated). Fever,nausea,paininthearm(morethan1in100). Thesesymptomsdisappearafterafewdays. Anyvaccinecaninrarecasescauseanallergicreactionsuchasarashoritchingshortlyafterthe vaccinewasgiven.Inrarecases,vaccinescancausemoreseriousallergicreactions.Healthcare personnelwhogivevaccinesarepreparedtodealwiththistypeofreaction. Apartfromsomeveryrareallergicreactions,ithasnotbeendocumentedthatHPVvaccinehascaused seriousdisease.Extremelyrareside-effectscannotbecompletelyexcludedandmaynotbediscovered untilalargenumberofpeoplehavebeengivenanewmedicinalproduct.Allsevereandunexpected symptomsoccurringaftervaccinationmustbereportedtotheNorwegianMedicinesAgency.The reportsareexaminedtodetermineifthesymptomswerecausedbythevaccineorbytheonsetofa diseasecoincidingwiththevaccination. Symptomsexperiencedaftervaccinationarenotnecessarilyareactiontothevaccine,butmaybesigns ofadiseaserequiringmedicalattention.Forthisreason,youshouldcontactyourdoctorifyouhave concerns. REGISTRATIONINTHENORWEGIANIMMUNISATIONREGISTRY YourHPVvaccinationisrecordedinthevaccinator'ssystemandintheNorwegianImmunisation Registry(SYSVAK).Toseewhichvaccinesyouoryourchildhavehad,usetheMinevaksinerserviceat www.helsenorge.no. REGULARCERVICALCANCERSCREENINGPROGRAMME AllwomeninNorwayareinvitedtohaveacervicalsmeartestorpapsmearevery3yearsfromtheage of25.Theaimofthisistoreducethenumberofdeathsfromcervicalcancerbyearlydetectionof cancerorprecancerouschanges.TheNorwegianscreeningprogrammehasresultedinasignificant decreaseinthenumberofcasesofcervicalcancer. ItisimportantthatgirlsandwomenwhohavebeenvaccinatedagainstHPVparticipateinthe screeningprogramme.ThisisbecausethevaccinesdonotprovideprotectionagainstallcancercausingtypesofHPV,anditisnotyetknownhowlongthevaccineswillprovideprotection. Inaddition,othertypesofcancer-causingHPVmightpossiblybeamoresignificantcauseofcancer thanthetwotypesthevaccineprotectsagainst.Theaimisforvaccinationandregularcervical screeningtoprovidethebestpossibleprotectionagainstcervicalcancer. ResearchisunderwaytomonitorhowtheimmunisationprogrammeaffectstheincidenceofHPV infectionandcervicalcancerinNorway.TheNorwegianInstituteofPublicHealthisresponsiblefor thefollow-upprogramme. ENGLISH THENORWEGIANIMMUNISATIONPROGRAMME•CHILD/PARENTINFORMATION VACCINEAGAINSTHPV LASTUPDATEDSEPTEMBER2014 ___________________________________________________________________________________________________________ GOODTOKNOW: • • • • • • • TheWorldHealthOrganization(WHO)recommendsthatHPVvaccinationisincludedin nationalchildhoodimmunisationprogrammes.HPVvaccineisincludedinthechildhood immunisationprogrammeinanumberofcountries. 205milliondosesoftheHPVvaccineGardasilhavebeendistributedworldwide(December 2015). TheHPVvaccineconsistsofartificiallymanufacturedparticlesresemblingpartsofthe surfaceofHPV.Thevaccineisnotlive,doesnotcontainviralDNAandcannotcauseHPV infection. Novaccines,includingtheHPVvaccine,intheNorwegianChildhoodImmunisation Programmecontainmercuryasapreservingagent. AcondomdoesnotprovideadequateprotectionagainstHPVinfectionbecausethevirusis alsofoundonareasofskinnearthegenitals,whichacondomdoesnotcoverorprotect. TheHPVvaccineprovidesnoprotectionagainstothersexuallytransmitteddiseases.A condomisalsoimportantforthosewhohavehadtheHPVvaccine. TheNorwegianInstituteofPublicHealthhasrecommendedthatboys,likegirls,beoffered theHPVvaccineundertheNorwegianChildhoodImmunisationProgramme.This recommendationiscurrently(May2016)awaitingaparliamentaryhearing. ENGLISH
