(When) should I have the vaccine?

At my LLETZ on Monday, my nurse colposcopist said that she was unable to give me any information about the HPV vaccination as it's not available to me on the NHS, or on private HPV screening - if I wanted to know about these things I'd have to research them myself. So I have :-) Firstly, a disclaimer - I do have an undergraduate biology degree which means I'm comfortable reading the primary literature, but I'm not a medical professional. I've tried to look for authoritative sources of information but have not conducted an exhaustive search: this is very much my own view and you should consult your own healthcare providers with regard to your own treatment.

The first question is whether it's worth getting the Gardasil 9 HPV vaccine when I know I've already been exposed to at least one strain of HPV. A talk by Maria Kyrgiou on 'Prophylactic HPV vaccination in women with previous cervical disease' at the British Society for Colposcopy and Cervical Pathology Annual General Meeting 2019 suggests that following treatment for abnormal cells it may be - the talk can be found here https://www.bsccp.org.uk/colposcopy-resources/prophylactic-hpv-vaccination-in-women-with-previous-cervical-disease/.

The second question is when to get the vaccine - this paper was published in the International Journal of Cancer in 2017 and is a systematic review which means that it looks at the findings from a number of other scientific papers and tries to draw conclusions: Patterns of persistent HPV infection after treatment for cervical intraepithelial neoplasia (CIN): A systematic review (https://onlinelibrary.wiley.com/doi/full/10.1002/ijc.30623). This says that for most strains of HPV, the percentage of people showing post-treatment persistence decreases from 3 to 24 months (unless you're over 35 years old and have HPV-16, in which case after 6 months the percentage of people with post treatment persistence begins to increase again). I'm assuming you'd want to get the vaccine when the viral load is lowest, but I don't know what that means in terms of potentially being re-infected by a partner. Note that the NOVEL trial that Maria Kyrgiou references in her talk above plans to give the vaccine with treatment - I don't know the reason(s) for this.

And the last question - different strains of HPV are known to have different oncogenic potential. I was told that it's not possible to find out via the NHS which strain of HPV I have, but I have found a private test that apparently will tell you which strain you have if the result is positive (https://www.check4cancer.com/private-cancer-tests/cervical-cancer) - note that I've not yet used this service so can't vouch for it.

So, I plan to take the private HPV test shortly before my 6 month test-of-cure, to determine whether I'm HPV negative or, if I'm still positive, which strain I have. Then I'll likely get the vaccine (especially if the HPV test is negative).

I'm having my second dose Saturday 

lied about my age. I looked at the research too, and am about to read your post again.

my lletz is Monday. I feel I am quite high risk and was/ am poly and kinky ( slowed under Covid). I didn't really think about HPV or know about it.

I asked about my type and was told ' others'

Ha 

I just remembered 

there was case study research where they gave the vaccine at the same time as lletz and it improved outcomes. I suppose that's kind of what I'm doing by default. My age increases risk somewhat though possibly my ' others' diagnosis decreases it. Not sure if I'm ' others' or ' other'. She wrote type others 

 

Hi
Firstly, thank you so much for this post, it really spoke to me, you know what you are looking at when doing research which is something I have struggled with. I had a positive PAP in the UK just before moving to Switzerland. Here I found out straight away I have HPV 31 after my first appointment. My first biopsy found no cell changes, but my second CIN3, and a week ago I had a cone biopsy and waiting on results. Im 33 and was told by Swiss Doctors to have the Vaccine now that i’m going through surgery. They advised in line with what you said, it will help combat the HPV (assuming now because the viral load is lower) but also protect me from catching any other HPV types, so was highly recommended. I’m guessing at this point also, we know my body cant fight it and my cervix is weakened, so worth a try to protect me. Unfortunately, I cant start the vaccine treatment in Switzerland (leaving at the end of the month back to UK) but the doctors here said it wasn’t so time precious, I didn’t need it immediately. Im guessing because the course of vaccinations are over a fair few months anyway, so the actual protection point could for some time. Im booking my first set in July.

Your other point about partner reinfection really struck me, this is something I regularly concern myself with. Why am I going through all this just to (potentially) be continually reinfected by my partner? I really haven’t found much information about this side of things. I don’t want to shut down on my husband, i’m not even sure if his body has the virus still (as no testing option) but is that the only answer to avoid virus transmission after my cone biopsy? Any of your thoughts on this would be appreciated. Thank you

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Hello Jodz just an idea you could get 1 vaccine in Switzerland and do other 2 in Uk just in case you just want to get started as far as I know you pay individually for each one . Good luck :grin:

Hello Jodz my doctor advised for my husband to also have the vaccine so I am making him do it also. but yes the issue about keep giving the hpv to each other is something doctors still not sure about they advised me to use condoms also to lower the risk.

Hi, Thank you, yes that’s a good idea, I’ll get him to do the vaccines with me - makes sense - thank you! :smiley:

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@Jodz @Hop1 - thank you, I’ve learned today that men can get the HPV vaccine privately in England. I really appreciate hearing your experience and that my conclusions agree with the medical advice that you were given abroad.

I also learned from another helpful forum user that the Superdrug HPV test will report subtype if positive (16/18/other high risk strain), and is half the cost of the test that I found and linked to above. I’ll likely be using this Superdrug test when the time comes.

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