Is it worth getting the HPV vaccine after 26?

Human papillomavirus (HPV) is a common sexually transmitted infection that will infect most people in their lifetimes. Like COVID-19, HPV has many different strains – most strains can clear on their own without treatment, but high-risk ones are linked to cancers of the cervix, anus, vagina and penis. 

In Singapore, one in 10 healthy women are affected by HPV. Half of them have strains associated with cervical cancer, the 10th most common female cancer in Singapore.

One way to protect yourself from contracting HPV, or to prevent more serious strains from harming your body, is through the HPV vaccine. While this vaccine is not compulsory in Singapore, it is recommended that all three shots be taken before the age of 26.

Is it still recommended to get vaccinated after 26, and should you still get vaccinated if you’ve already been infected with HPV? Let’s find out. 

What is the HPV vaccine, and how does it work?

The human papillomavirus (HPV) vaccine protects against sexually transmitted viruses such as HPV. It triggers your cells to produce antibodies that will bind to the virus and prevent further infections in your body. There are many different strains of HPV but only a small fraction is a cause for concern. High-risk strains can lead to illnesses such as cancer while low-risk strains can cause genital warts. It is important to check if you can get the HPV vaccine to prevent these conditions from occurring.

What can the HPV vaccine protect against?

The types of HPV vaccines that are currently available in Singapore are Cervarix, Gardasil-4 and Gardasil-9. They are effective in preventing cervical cancer and HPV-related infections.

In Singapore, 99%[2] of cervical cancer cases are linked to an HPV infection in the genitals. One example is repeated inflammation of the cervix due to the infection of squamous cells lining the area as well as harmful cell changes in the genitals. 

Studies[3] have shown that taking the HPV vaccine reduces the chances of developing cervical cancer by 70%. 

Some conditions that the HPV vaccine can protect against include:

• High-risk strains such as type 16, 18, 31, 33, 45, 52, and 58 (can cause cervical cancer)
• Low-risk strains such as type 6 and 11 (can cause genital warts)

Can I still get the HPV vaccine after 26?

The HPV vaccine is recommended for males and females from the age of 9 to 26. It is ideally administered before any type of sexual activity. It’s also been proven[4] that the vaccine is most effective for those who take either Cervarix or Gardasil by the age of 12.

That being said, you can still get the HPV vaccine after 26 years of age and after you become sexually active. It may be less effective as you may have already been exposed to HPV, but it nonetheless still provides some form of protection compared to not getting vaccinated at all. 

Recently, the U.S. Food and Drug Administration extended the approved age for getting the vaccine to 45 years old. So if you’re past 26 and have not yet been vaccinated against HPV – please discuss with your doctor to consider the pros and cons of doing so. Getting the vaccine even after the recommended age is likely to be beneficial as it can still protect you against the more serious HPV strains.

Can I still get the HPV vaccine if I already have HPV?

If you have already been diagnosed and infected with HPV, you may still be able to get the vaccine. This is because you can still be protected from HPV strains that are more harmful in future. However, it is important to note that the HPV vaccine does not cure you of HPV. For milder cases, the infection will be cleared up by your body’s natural immune response.

While the HPV vaccine is able to prevent serious conditions such as cervical cancer, it does not replace the need to undergo a pap smear or cervical cancer screening every three years. A pap smear is recommended for women above the age of 21 to check for abnormal (pre-cancerous) cell changes in the cervix. 

Who should not get the HPV vaccine?

The following persons are not recommended for the HPV vaccine:

• Pregnant women 
• Those who’ve had a life-threatening reaction to any ingredient of an HPV vaccine 
• Those with yeast allergies 

Is the HPV vaccine Medisave claimable?

You can use up to $500 of your Medisave to pay for the HPV vaccine – but this only applies to Cervarix and Gardasil 4. Currently, Gardasil 9 is not covered under Medisave but carries the most protection (protects against 9 HPV types) and can be found in most hospitals and private clinics. 

References

1. https://www.sgh.com.sg/news/research/sgh-study-on-prevalence-of-human-papillomavirus-infections-in-local-healthy-women
2. https://www.singaporecancersociety.org.sg/get-screened/cervical-cancer/hpv-vaccination.html
3. Basu, P., Banerjee, D., Singh, P., Bhattacharya, C., & Biswas, J. (2013). Efficacy and safety of human papillomavirus vaccine for primary prevention of cervical cancer: A review of evidence from phase III trials and national programs. South Asian journal of cancer, 2(4), 187–192. https://doi.org/10.4103/2278-330X.119877
4. Bednarczyk R. A. (2019). Addressing HPV vaccine myths: practical information for healthcare providers. Human vaccines & immunotherapeutics, 15(7-8), 1628–1638. https://doi.org/10.1080/21645515.2019.1565267