Sexual activity
The vaccine is most effective when administered before the onset of sexual activity but benefit may still be
derived after this as the woman may not have been exposed to the HPV types that the vaccine protects against (subtypes
6, 11, 16 & 18).
Young women will not be asked if they are sexually active before receiving the vaccine.
Research in other countries has not found that the vaccine is linked to sexual activity occurring at a younger age.1
Non-funded vaccine use
Women born before January 1st 1990 and males may still receive the vaccine but it is not funded. It would normally
cost approximately $450 for the three doses, in addition to any consultation fee that may apply.
Safety concerns
Clinical trials have shown that Gardasil is not associated with serious adverse events. Since the vaccine has
been licensed the most common reports to the Vaccine Adverse Events System (VAERS) have been local injection site reactions
and some cases of fainting after vaccination. As with all vaccines a 15–20 minute post-vaccination waiting period is
advisable.3
Vaccine effectiveness
Cervical cancer develops over ten or more years and HPV subtypes 16 and 18 are implicated in approximately 70%
of cervical cancers. Gardasil vaccine targets these HPV subtypes and current evidence from clinical trials suggests that
it provides immunity for at least five years with no evidence of reducing effectiveness. Continued monitoring of longevity
of immunity is underway. If boosters are needed in the future this would not change any recommendation for initial vaccination.3
Gardasil is expected to reduce future cervical cancer rates by up to 70% if young women are vaccinated before their
first sexual intercourse. It is estimated that Gardasil has the potential to prevent cervical cancer in the future for
approximately two women per week in New Zealand saving 30 lives per year.1 In the shorter term, it is expected
to reduce the incidence of genital wart infection (HPV subtypes 6 and 11 are implicated in 90% of genital warts) and abnormal
cervical changes.
Cervical smears are still required
Gardasil will not replace the cervical cancer screening programme as approximately 30% of cervical cancers are
caused by HPV subtypes not present in the vaccine. In addition, women with exposure to HPV prior to vaccination still
need to be monitored.
see BPJ 12 (April
2008) for more information about HPV vaccines.