Vaccination against cervical cancer: yes or no?

What is Human Papillomavirus (HPV)?

Human papillomaviruses consist of around 120 subtypes. In the event of an infection, they attack the cells of the upper skin layer or the mucous membrane cells and stimulate them to grow uncontrolled. Since infection is mainly possible through sexual intercourse, the sexual organs are affected by the consequences in most cases.

HPV infection can manifest itself in a number of ways, and both women and men can be carriers of the virus. The viruses often lie dormant in the cells for months or years before the first symptoms become noticeable. If the course is mild, only the upper layer of skin is affected by the infection. In most cases, so-called genital warts form in the genital area, which are contagious and can be transmitted to other people through direct skin contact, especially during sexual intercourse. Since the infection does not occur through contact with bodily fluids, a condom does not offer reliable protection in this case. However, genital warts can usually be treated well and heal after a while without any consequences.

Some of the virus types, the high-risk types, lead to longer-lasting infection, increasing the likelihood that affected cells will degenerate. Pathological cell changes usually affect the mucous membrane or deeper layers of tissue and initially lead to so-called dysplasia, a precursor to cancer. Here, too, both women and men can be affected, for example by diseases of the penis, the anus or the vagina. However, if the disease is detected at this early stage, it can in many cases be treated very effectively and often cured completely.

What is the benefit of cervical cancer vaccination?

If the HPV infection is not detected early, for example as part of regular gynecological examinations, women can develop manifest cervical carcinoma, i.e. cervical cancer . This is by far the most common cancer resulting from infection with HPV.

Cervical cancer is, after breast cancer , the second most common malignant change in the female genital organs. Every year around 7,000 women in Germany become ill. This means that the number of illnesses in Germany is one of the highest in a European comparison. For example, cancerous tumors in the cervix can lead to unwanted childlessness or problems with vaginal delivery. In the worst case, the disease is fatal. In Germany alone, around 1,800 women die of cervical cancer every year.

The cervical cancer vaccination or HPV protects against the two most common cancer-causing virus types 16 and 18 and can thus save lives. One of the existing vaccines also contains antigens against virus types 6 and 11, which are mainly responsible for the development of genital warts.

Timing and procedure of cervical cancer vaccination

Since infection with the virus usually occurs in adolescence, when those affected are more likely to have different sexual partners than at an advanced age, STIKO recommends vaccination for girls between the ages of 12 and 17, if possible before the first sexual intercourse. This should significantly reduce the incidence of cervical cancer. A cervical cancer vaccination at a later point in time is generally no less useful as long as an infection does not already exist. In the event of a deviation from the public vaccination recommendation, however, the assumption of costs depends on the respective health insurance company. Before getting a vaccination against cervical cancer, you should definitely ask about the benefits of your own health insurance company.

There are currently two different inactivated vaccines available for vaccination, which protect against two or four different types of virus. Both contain virus-like proteins produced by genetic engineering, the surface of which resembles that of the virus.

For complete immunization, three partial vaccinations within half a year are necessary. There should be an interval of four to eight weeks between the first and second vaccination. The third, final vaccination should be given six months after the first vaccination.

Vaccination against cervical cancer is a relatively new vaccine. The vaccine was first approved in 2006, so long-term studies on whether and when a booster is needed are still lacking.

This is also where the arguments of vaccination critics come in. Due to the lack of studies, in her opinion there is still too little knowledge about the long-term effects of vaccination against cervical cancer, the actual protection rate and the tolerability of the vaccine. It is also of concern that vaccination is only recommended for girls, although transmission by boys and men is no less likely. However, here too there is still no reliable data on whether vaccination of men would be effective in further reducing the rate of infection.

Who should not get the cervical cancer vaccine?

In certain cases you should, at least temporarily, refrain from vaccination against cervical cancer:

• Due to the lack of studies, pregnant women should not be vaccinated against HPV. There are no data on whether and if so what effects the vaccine can have on the unborn child.
• If the person to be vaccinated has an acute infection that requires medical treatment, vaccination should be postponed until the person is fully recovered. A simple cold usually does not stand in the way of a vaccination against cervical cancer.
• If severe physical reactions have occurred to a previous vaccination with the same vaccine, such as seizures or fainting, the serum should not be used again. The same applies to known allergies to an ingredient in the vaccine.

Important: Before each vaccination, have a detailed consultation with the doctor treating you so that he can point out any risk factors or circumstances that may speak against vaccination.

Possible side effects of cervical cancer vaccination

As with all vaccinations, vaccination against cervical cancer can also lead to slight vaccination reactions. Redness, swelling, and mild pain and bleeding at the injection site are common. The neighboring lymph nodes can also temporarily swell. These reactions can be increased with the second and third partial vaccination.

Fever and flu-like symptoms such as fatigue, shivering, headaches and body aches as well as gastrointestinal problems are often associated with the vaccination.

Following the vaccination against cervical cancer, breathing problems, such as acute shortness of breath, respiratory paralysis and asthma, have already occurred in some cases. However, a direct connection with the administration of the vaccination has not yet been proven. Unfortunately, there are no long-term studies in this area either, which is why no reliable statements can be made about the risk-free nature of the vaccine.