It affects the skin and moist membrane surfaces of the body i.e. mouth, throat, vagina, cervix, penis, anus.

HPV can affect people in different ways depending on the type of virus they have, and their general health. It can cause a range of things from benign skin lesions, such as verrucas and warts, to certain types of cancer. Most infections are asymptomatic (no symptoms), including those with high-risk HPV types.

HPV is spread through skin-to-skin contact (touching the skin of someone who has the infection) and it spreads very easily.

Genital infection is usually spread via sexual contact:

• Vaginal, anal or oral sex.
• Touching the genital area.
• Sharing sex toys.

Genital HPV types are categorised according to their association with cervical cancer into low-risk and high-risk.

Low-risk HPV can cause warts around your genitals, anus, mouth or throat.

High-risk HPV can cause certain types of cancers:

• Cervical (most common cancer caused by HPV)
• Anal, oral/throat, vaginal/vulval, penile (these are rare).

There are 13 high-risk types of HPV – you are tested for these when you get your smear test as these types are more likely to become persistent infections (not cleared by your immune system).

As these infections are usually asymptomatic, you can be infected for years without knowing. When a high-risk HPV infection persists for many years, it can lead to cell changes (abnormal cells). If these are not treated, they can get worse over time and may develop into cancer.

There is no cure for HPV and it is likely that you will not know you have this infection as the majority of people do not have any symptoms. However, most of these infections are cleared by your body’s immune system; over 90% of infections are cleared within 2 years. If your body cannot clear this infection, it becomes known as a “persistent infection”.

If you have a weakened immune system, your body may find it more difficult to clear HPV infection.

HPV can be associated with the development of the following conditions.

Cervical Cancer
Cervical cancer is the most common cancer in women under the age of 35 years. HPV is responsible for 99% of cervical cancers.

7 HPV types are responsible for 89% of cervical cancers – these HPV types are included in the HPV 9 vaccination.

These cancers usually take years to develop after first exposure to the virus. Here is useful information on cervical cancer.

Other Cancers
High-risk, persistent HPV infection can cause other cancers in men and women (see above). Thankfully, these cancers are not as common as cervical cancer and there are often other risk factors involved.

Genital Warts
These are a common sexually transmitted infection and are very contagious. The virus is passed on via skin contact even if there are no visible lesions. The virus remains for life and can flare intermittently. 90% of these infections are caused by HPV types 16 & 18.

Here is useful information on genital warts.

• First having sex at a younger age.
• Number of sexual partners.
• Sexual history of your sexual partners (how many previous sexuals have they had?).

You cannot completely protect yourself against HPV infection but there are things that you can do to reduce your risk of persistent infection (this is what causes most of the associated cancers).

• Consider getting the HPV vaccine if you are eligible: HPV 9 vaccine protects against 9 of the high-risk HPV infections.
• Stop smoking: smoking weakens your immune system, making it more difficult for your body to clear the HPV infection.
• Practice safe sex: using condoms and dental dams can decrease your risk of getting HPV infection, but it does not eliminate the risk of transmission. This is because HPV can be present on the skin of the entire genital area (penis, vagina, anus) and can be spread via close sexual contact without having sexual intercourse. These will also protect you against other sexually transmitted infections.

The more young people that are vaccinated, the better we can control the spread of this virus.

It is not a live vaccine – it is an inactivated vaccine that does not contain any live bacteria or viruses and it cannot cause the diseases against which it protects.

You will still benefit from this vaccine if you are already sexually active and have been exposed to HPV, as you will get protection from the other types of HPV covered by the vaccine. Infection with one type of HPV virus does not prevent infection with another type.

A HSE HPV vaccination catch-up programme is available for unvaccinated females and males under the age of 25 years, with priority being given to second level students and females. Men who have sex with men (MSM) HPV9 vaccine is recommended for MSM aged ≤45 years.

You may be eligable for a free vaccination through your local sexual health clinic if you:

• Have HIV and are ≤ 26 years old (male and female)
• Are a man who has sex with other men (MSM) and are ≤ 45 years old

The guidance on this was updated in November 2022, and so it may be different to previous information you have been given by a healthcare professional.

Current guidelines:

• If you are less than 25 years old, a single vaccination is required to complete the vaccination course
• If you are 25 years or older, 2 doses of vaccination are required to complete the vaccination course (The 2nd vaccine is to be given 6-12 months after the 1st vaccination)
• If you are immunocompromised, regardless of your age, you will require 3 vaccinations to complete the vaccination course

To get the best protection, it is important that the full course of vaccination is completed.

If there is any disruption or delay to this vaccine schedule, please contact your pharmacist or this service for advice.

If you have already started your HPV vaccination course before these guidelines were updated, you can:

• Complete the vaccination course that you started*
• Use the new guidelines to guide your vaccination requirements**

*Previously the guidance for full vaccination was as follows:

• If you received your first dose of the vaccine before 15 years of age, you needed a total of 2 vaccination doses
• If you received your first dose of the vaccine at 15 years or more, you needed a total of 3 vaccination doses

**You are considered fully vaccinated if you are:

• Under 25 years of age and have received one dose of the vaccine
• 25 years of age or older and have received 2 doses of the vaccine

If you are immunocompromised, the guidance has not changed, you require 3 doses of the vaccine regardless of your age.

If you are immunocompromised, you should consider getting the HPV vaccination, as your ability to clear the HPV infection may be impaired. This could put you at risk of developing a persistent HPV infection.

The decision should be made based on your potential risk of acquiring this infection, and the possibility that you may not develop an adequate protective response from the vaccination.

If you have any questions about this, please speak to your doctor or one of our GPs via online video consultation.

The only serious adverse event that has been reported is anaphylaxis and this is very rare (one per million vaccinations administered).

Common side HPV vaccine side effects (these will resolve within 1-2 days):

• Localised (at the injection site):
• Tenderness/ redness/ swelling at the injection site.
• Generalised:
• Fever (>38°)
• Headache
• Dizziness
• Nausea
• Fatigue

There is no scientific evidence linking HPV vaccination to long-term medical conditions, such as Chronic Fatigue Syndrome, postural orthostatic hypotension or chronic regional pain syndrome.

Here is more detailed information on the HPV Vaccine.

If you feel unwell or have any concerns after receiving your vaccination, please contact a healthcare professional for advice.

• Sodium Chloride
• L-histidine
• Polysorbate
• Sodium borate

You cannot have this vaccine if you are allergic to any of the above ingredients.

Yes! It is very important to continue to have cervical smear tests when you have completed the vaccination course:

• No vaccination is 100% effective as some people will not develop an adequate immune response to provide protection against the HPV types in the vaccine, even if they have completed a full vaccination course.
• 10-30% of cervical cancers are caused by HPV types not included in this vaccination.
• You may already have been exposed to certain high-risk HPV infections, so the vaccine will not provide protection against these HPV types.
• When you have a smear test in Ireland, high-risk HPV types are tested for and if identified, you will be monitored more frequently for persistent infection and abnormal cell changes.

If you have any symptoms that you are worried about, such as bleeding after intercourse or unexpected bleeding between periods, please speak directly with a doctor.

Here is more information on smear tests and HPV testing.

It is important to be aware that this vaccination:

• Will only protect against the specific types of HPV in the vaccine.
• Is to prevent infection with HPV; it has no effect on active infection or existing disease.
• Is similar to all vaccines and is not 100% effective in all recipients.

Here is more information on HPV and the vaccine, HPV (human papillomavirus), and the HPV vaccine.

• You will receive a message on your secure patient record to let you know if your prescription has been approved or declined.
• If your prescription has been approved, your prescription will be sent to your selected pharmacy via Healthmail (secure email) and you will be notified once your prescription has arrived in your pharmacy.
• You should then make an appointment at your pharmacy for the initial vaccination consultation.

• You will need to bring valid photographic identification (ID) to all of your vaccination appointments. This will be checked by the pharmacist to ensure the details on your ID match the details on the prescription issued via your online account.
• Your pharmacist will tell you more about the service and review relevant parts of your medical history. They will discuss how the vaccination will be given and will give you the opportunity to ask any questions.
• If you have a fever on the day of your appointment, you may be asked to return when you’re better.
• If everything is ok from a medical perspective, and you are happy, you will receive your vaccination. It will be given in your upper arm, so please wear loose-fitting clothing or short sleeves.
• It will be necessary for you to resin in the pharmacy for 15 minutes after your vaccination, just in case you have any immediate side effects.

What happens next?

Your pharmacist will advise you on when to make your next appointment, depending on how many vaccinations you require.

The accuracy of the information you provide is very important for the safe prescribing of the most suitable type of medication.

The information that you provide is treated with the same patient-doctor confidentiality as in a normal face-to-face consultation.