Practice 10 Minute Consultation

Discussing human papilloma virus vaccination

BMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j2730 (Published 22 June 2017) Cite this as: BMJ 2017;357:j2730
  1. Yan Ling Quah, resident physician1,
  2. Ieera Madan Aggarwal, consultant2
  1. 1Singhealth Polyclinics, Singapore
  2. 2Department of Gynaecological Oncology, KK Women’s and Children's Hospital, Singapore
  1. Correspondence to: I M Aggarwal Ieera.aggarwal{at}singhealth.com.sg

What you need to know

  • HPV vaccination protects against infection with oncogenic human papilloma viruses responsible for up to 70% of all cervical cancers

  • Offer vaccination to adolescent girls in line with the recommended schedule in your country

  • Explain that vaccination is not a substitute for routine cervical screening, which continues to be an important strategy for prevention of cervical cancer

A mother and her 15 year old daughter come to your clinic. The mother’s other daughter, who is 12 years old, recently received the human papilloma virus (HPV) vaccine at school. The mother wants to know whether her 15 year old daughter who missed her HPV vaccination should receive it now.

HPV is sexually transmitted. Infection is often asymptomatic. In some people, however, HPV infection persists and over time leads to genital warts or cancer, mainly cervical, but also anal, penile, oral, and throat cancers (fig 1). The HPV types 16 and 18 together cause 70% of cervical cancers.1234

Fig 1 Sequelae of HPV infection and preventive strategies

Prophylactic vaccines against HPV are offered as part of the national immunisation programme in many countries including in the UK.1 These vaccines generate HPV-specific antibodies that bind to the virus and prevent cervical infection. Table 1 shows the three types of vaccines available.

View this table:
Table 1

Types of HPV vaccines2

Vaccination coverage globally has been variable. Surveys among parents find that the most common reasons for not vaccinating their child include lack of knowledge about the vaccine, a belief that it is not needed, their child is not sexually active, and concerns about safety.678 A healthcare provider’s recommendation is an important factor in parents’ …

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