There are three HPV vaccines available in Italy:

1. The bivalent vaccine is indicated for females age 9 and up for the prevention of precancerous genital lesions (of the uterine cervix, vulva and vagina) and uterine cervical cancer. It is effective against two types of HPV, 16 and 18, which are responsible for over 70% of cases of cervical cancer;
2. The quadrivalent vaccine (protection against HPV strains 16, 18, 6 and 11) is indicated for both sexes age 9 and up for the prevention of precancerous genital lesions (of the cervix, vulva and vagina ), precancerous anal lesions, cervical cancers, anal cancers and genital condylomas.
3. The nonavalent vaccine, which is the most recent, protects against nine types of HPV: 6, 11, 16, 18, 31, 33, 45, 52 and 58. This vaccine guarantees the highest coverage. In addition to providing protection against cervical cancer, it also protects against other HPV-related cancers. It protects against precancerous lesions and tumors that affect the cervix, vulva, vagina, anus, penis and oropharynx, and also protects against genital condylomas. It is the only one to offer protection against HPV-related vulvar and vaginal infections.
   The nonavalent vaccine is particularly effective in males, adult women and women already treated for HPV-related precancerous lesions, since it extends immunity against nearly all the papillomaviruses involved.

HPV vaccines are immunogenic, effective, safe and well tolerated up to 45 years of age, even though have the maximum effect if administered before becoming sexually active.
It is important for youngsters to get vaccinated at an early age because the response of the immune system -and therefore the production of protective antibodies --is greater than that observed in older people. Considering also that the HPV vaccine is a means of prevention and to act with maximum efficiency it must be administered before exposure to the HPV virus, getting vaccinated before becoming sexually active is recommended. The vaccine has however been shown to be effective even in sexually active men and women. So having already become sexually active is not a contraindication to HPV vaccination, but by getting vaccinated before the benefit is greater.

HPV vaccines, and in particular the most recently developed, the nonavalent HPV vaccine, administered before exposure to the HPV virus, prevents precancerous genital lesions and thus significantly reduces the future possibility of developing a malignant neoplasm.

The nonavalent vaccine has been available in Italy since February 2017, and offers wider protection against the 9 most dangerous types of Papilloma viruses for men and women. The nonavalent vaccine is administered by 14 years of age in accordance with a program that calls for 2 doses. The second dose should be administered between 5 and 13 months after the first dose. After 15 years of age, those who get the vaccine can follow a 3-dose program (0, 2, and 6 months). The second dose should be administered at least one month after the first dose and the third dose at least three months after the second. All three doses should be administered within a 1 year period.

Millions of people have already been vaccinated against HPV and the safety profile of vaccines is good. Most reactions are mild and local reactions (redness, tenderness at the injection site), with muscular or joint pains, or rather, all the transient manifestations common to most vaccines. The risk/benefit ratio is greatly in favor of the benefits for future health in women that have tested positive for HPV during screening.

The theory of a possible association between vaccines and autism is entirely without foundation, so much so that the English doctor who circulated this hypothesis was removed from the Royal College (the prestigious society for British doctors) because of the documented (and admitted to by the same doctor himself) falsifying of data for the sole purpose of gaining fame! Always look for reliable sources when searching through online news, and even better, ask your gynecologist.

The nonavalent HPV vaccine is a papillomavirus vaccine which is unique of its kind. The nonavalent vaccine offers the chance to broaden HPV vaccine prevention, giving a greater protection against HPV-related diseases, in both sexes.
To date, it is the human HPV vaccine with the widest cover: there is no other vaccine that protects against 9 types of HPV (6, 11, 16, 18, 31, 33, 45, 52 and 58).

The nonavalent HPV vaccine is the best means of prevention currently available for HPV-related disease in both sexes: its implementation is consistent with the new public health objective for HPV vaccination to offer adolescents of both sexes maximum protection against all HPV-related diseases which can be directly prevented by vaccination, as expressed in the new National Prevention Plan 2017-2019.

Broader vaccination with the new nonavalent HPV vaccine will enable prevention of the development of cancer in both sexes and precancerous lesions of the cervix, vulva, vagina, anus and the external benign ano-genital lesions (genital warts) caused by the 9 HPV types present in the vaccine. The nonavalent vaccine has shown, in the numerous trials during its clinical development, clinical efficacy ranging from 96 to 100% in the prevention of such lesions. The protection provided by the nonavalent vaccine will lead to a substantial reduction of HPV-related diseases.

People who have previously been vaccinated with a 3-dose regimen vaccine for HPV types 6, 11, 16, and 18 should still receive 3 doses of the nonavalent vaccine to obtain the corresponding vaccine coverage against Papillomavirus.

The new nonavalent vaccine has added value because it protects against 9 HPV serotypes.

WHAT SHOULD WOMEN OF FERTILE AGE DO?

Those who already have one or more children can get re-vaccinated without problems, but it is not advisable to do so during pregnancy, as the gynecologist has likely already informed them. Because of obvious ethical reasons, there is no research data on the possible risks of vaccination during pregnancy, although the effects highlighted in animal studies so far have not shown any direct or indirect hazardous effect to the future mother of the baby, embryonic and fetal development, childbirth or postnatal development of the newborn. Once the baby is born, even a woman who breastfeeds may get the nonavalent vaccine for adequate HPV protection.

In order with keeping yourself informed, it is good to remember that even males should be vaccinated. The nonavalent vaccine protects them from several serious types of cancer that affect the anus and penis.
Additionally, vaccination helps decrease virus circulation and transmission to unvaccinated individuals (herd effect or indirect effect), which reduces the overall risk of infection for couples and all partners involved. The same benefits apply to gay people, especially since the virus can also be transmitted just by contact with the genital area.

An excellent choice. The HPV vaccination is safe and long lasting. The data available so far shows how both the bivalent and the quadrivalent vaccines can currently offer protection for more than 10 years. This figure was recently further confirmed for the quadrivalent vaccine in all age groups, males and females aged up to 45.

Those who already have one or more children can get re-vaccinated without problems, but it is not advisable to do so during pregnancy, as the gynecologist has likely already informed them. Because of obvious ethical reasons, there is no research data on the possible risks of vaccination during pregnancy, although the effects highlighted in animal studies so far have not shown any direct or indirect hazardous effect to the future mother of the baby, embryonic and fetal development, childbirth or postnatal development of the newborn. Once the baby is born, even a woman who breastfeeds may get the nonavalent vaccine for adequate HPV protection.

In order with keeping yourself informed, it is good to remember that even males should be vaccinated. The nonavalent vaccine protects them from several serious types of cancer that affect the anus and penis. Additionally, vaccination helps decrease virus circulation and transmission to unvaccinated individuals (herd effect or indirect effect), which reduces the overall risk of infection for couples and all partners involved. The same benefits apply to gay people, especially since the virus can also be transmitted just by contact with the genital area. The vaccine stops the circulation of the virus and the viral contamination chain.

The nonavalent HPV vaccine is more effective if administered before becoming sexually active, however its protective cover is still high up to 45 years of age, so up to that age it's still a good idea to get vaccinated.

It is important to remember that for sexually active adult women there is always a risk of infection by cancerous HPV strains not yet discovered. It's good to know that using a condom does not offer full protection from HPV infection since the virus can also be caught from parts of the body which are in any case exposed but not protected, like lips, scrotum, perineum.

An equally important thing for women is to understand the importance of going for screening up to 65 years of age, even if no longer sexually active at an older age (i.e. widows, divorcees), since the virus may be latent for many years.

Reassure your aunt, her doctor gave her good advice especially to monitor possible relapses and worry less. The HPV vaccine does not have a therapeutic effect but greatly reduces (although not eliminating it entirely) the risk that the infection will return. The primary objective of a vaccination is to keep a healthy woman healthy, and not to treat a sick woman.

All three types of HPV prevention vaccines are safe because they do not contain viral genetic material. The nonavalent vaccine is no exception: it contains no viral particles, either attenuated or killed, but is made up of a protein synthesized in the lab (VLP = Virus Like Protein) that is normally present on the "cap" of the virus. The host's immune defense system recognizes and immunizes the body against the virus carrying this "cap," producing specific antibodies against the specific virus type, neutralizing it's action at all levels. In the HPV vaccine, there are also so-called "adjuvants," which are intended to enhance the effect of the immune system response . This way, a very small amount of vaccine can be used to obtain a large immune defense response from the body, including the genital cells.

Therefore, if naturally exposed to the virus, the immune system of the vaccinated subject is not caught off guard, but is able to react immediately and quickly produce specific antibodies that neutralize the types of HPV viruses included in the administered vaccine. Vaccination is a forward-thinking choice.

The administration of the HPV vaccine may in rare cases cause fever, pain, swelling and redness at the injection site. Sometimes it may cause headaches and muscle aches. These are all transient, short-lived effects, and there is no need to worry.

In December 2015, the IPVS (the International Papillomavirus Society) published a statement on the safety of HPV vaccines, reaffirming its good safety profile based on international ratings and recommendations. In addition, the number of documents published on the safety of vaccines by the World Health Organization (WHO) and by the extremely strict Food and Drug Administration (FDA) is by now numerous.

Yes, HPV vaccination is also very useful for males. If you did not know this, now you do – spread the word among your friends. It is important to be aware of it and to know why it is useful to do it. HPV is transmitted between males and females: the male, therefore, in addition to contributing to the spread of the virus, may be suffering from HPV-related illnesses and may thus benefit from vaccination-induced protection. Also, unlike cervical cancer, for HPV tumors that affect males, there are no organized screening programs aimed at early diagnosis as there are for women. These tumors are often diagnosed at an advanced stage, and are associated with high mortality.

The new nonavalent vaccine is particularly effective in males because it protects them from certain serious types of cancer that also affect men, such as anal and penile cancer. Experts have estimated that vaccination protects against 90-95% of anal cancers.

The vaccine against Papillomavirus also protects against condylomas, which are very annoying genital warts that can affect both males and females.

HPV vaccination also ensures a lower rate of the HPV virus in circulation (herd effect), which in turn helps reduce the overall risk of Papillomavirus infection for all subjects.

It is true, the new National Prevention Plan 2017-2019 has included HPV vaccination in the vaccination calendar for all female and male adolescents to be administered after their 11th birthday. The recent publication by the Agenzia Italiana del Farmaco (Italian Medicines Agency) of the report on alleged adverse reactions after vaccination shows that – as regards HPV vaccines, the data are consistent with those of all other vaccines and belie in a clear and decisive manner the unjustified catastrophism which derives from a prejudice – today considered scientifically unacceptable-against vaccines in general.

The strategy of also including boys in the vaccination campaigns aims to reduce the circulation of the virus (herd-effect) and the transmission of the Papillomavirus infection between the sexes but – above all – to counteract the emergence of numerous and often severe HPV-related diseases that affect men too.

Parents are obliged to ensure the best protection against diseases when safe and effective vaccines are available to prevent them, falling in line with the National Vaccination Schedule approved by the Ministry of Health. At the same time, parents must observe the current laws providing for obligatory vaccinations.

Doctors have a duty to abide by the code of ethics and, for those employed by public administrations, to actively promote the vaccinations included in the national vaccination schedule approved by the Ministry of Health. They also have a duty to properly inform parents about the risks and benefits of vaccination and non-vaccination.

The only contraindication to administering the nonavalent HPV vaccine is hypersensitivity to one or more of the active substances or to any of the excipients listed in the data sheet.

Vaccination should be postponed in subjects suffering from acute severe febrile illness. However, the presence of a minor infection, such as a mild upper respiratory tract infection or low fever, is not a contraindication to the administration of the vaccine (immunization).