Almost 75% of all sexually active adults are likely to be infected with at least one type of the Human Papillomavirus (HPV) (1). That is how common it is for a person to be infected with the virus as a result of any sexual activity, be it vaginal, oral or anal sex as well as intimate skin-to-skin contact. This commonality, however, should not be a cause of concern in itself because for most people who become infected with the HPV the infection clears up within two years on its own and does not manifest in the form of any serious health condition. But this does not mean that an HPV infection can never turn into something that is dangerous and calls for medical intervention.
Is doctor’s prescription needed for HPV vaccine?
Yes, doctors prescription is needed.
In India, the HPV vaccine is available only under prescription, privately, for individuals from the age of 94. Both the quadrivalent vaccine Gardasil and the bivalent vaccine Cervarix are licensed for prescription in India1. Additionally, the indigenous quadrivalent vaccine Cervavac is also available in the country5.Therefore, a doctor’s prescription is required to obtain the HPV vaccine in India.
In India, the available HPV vaccines are Cervarix (bivalent) and Cervavac (quadrivalent). Cervavac is India’s first indigenous HPV vaccine, launched in January 2023, and has been developed and manufactured by the Serum Institute of India. It targets the same four HPV types as Gardasil, which are HPV 16, 18, 6, and 11. The government of India has announced plans to promote HPV vaccination for girls aged 9-14 to prevent cervical cancer, and some states have already included free HPV vaccination in their routine immunization programs. The introduction of Cervavac in India is a significant advancement in public health, offering a preventive measure that can save countless lives135.
What is HPV ? What is the link between HPV and genital warts and certain cancers?
HPV is the most common sexually transmitted infection in the world. There are over 100 strains or types of the virus and more than 40 of these can be transmitted through skin-to-skin contact during sexual activity. Certain types of the virus can cause genital warts, warts in the throat and cancers of the cervix, mouth, throat, anus, vagina, vulva and penis.
The presence of genital warts caused by an HPV infection does not necessarily mean that one will have cancer. In most cases of HPV where there are no genital warts, there are no noticeable symptoms to indicate that the person is infected. For timely diagnosis of cancers that may be caused by HPV, regular screening procedures, such as the Pap smear test for detecting cervical cancer in women and HPV DNA tests, are of vital importance as any symptoms of the cancers mostly appear in the later stages.
Availability and price of HPV vaccine in India
In India, two HPV vaccines, Gardasil, marketed by Merck, and Cervarix, marketed by GlaxoSmithKline, are commercially available in the private medical sector. These have been approved by the Drug Controller General of India (DCGI), US Food and Drug Administration, European Medicines Agency and prequalified by the World Health Organization. The major challenge faced by the HPV vaccination in India is its high cost and subsequent lack of accessibility. The HPV vaccine is expensive, costing between Rs 2000 and Rs 3000 for a single dose (2)
When is the HPV vaccine given?
The HPV vaccine can be administered to girls starting from the age of 9-12 years. This age bracket is recommended so that they are protected against the virus before the onset of sexual activity in their lives. If a woman has not been vaccinated earlier, she can get the vaccine upto the age of 26 years old. The vaccine has lesser benefits for women older than 26 years as they are more likely to have already been exposed to the virus. In India, the HPV vaccine cannot be administered to boys and men.
HPV and cervical cancer in India
HPV types 16 and 18 account for 80–85% of cervical cancers in India (3). The incidence of cervical cancer cases among women in India is alarming and this makes the administration of the HPV vaccine all the more important. It is the women of lower socioeconomic status who suffer the most from this health problem (3), which is because of both a lack of awareness about the vaccination as well as the lack of affordability of the vaccine. The vaccines, Gardasil and Cervarix, prevent infection by types 16 and 18 of the HPV in girls and women who have been administered the vaccine.
Indeed, the only way in which we can safeguard ourselves against the virus is by being completely sexually inactive. This, however, is not a solution that many people would be willing to embrace. Sexual intimacy and sexual pleasure are important parts of people’s lives regardless of whether or not they are engaged in romantic relationships with a partner. This makes it important for girls and women to get the HPV vaccine, accompanied by regular screenings for any signs of genital cancers that might develop due to HPV. This is the best they can do to protect themselves against a possible infection and any serious health hazards such as cervical cancer that the HPV might cause.
1^ Roy, Shubham et al. “HPV Vaccination of Girl Child in India: Intervention for Primary Prevention of Cervical Cancer.” Asian Pacific Journal of Cancer Prevention, vol. 19, no. 9, 2018, pp. 2357-58, www.ncbi.nlm.nih.gov/pmc/articles/PMC6249453/
2^ Narayanan, Nayantara. “Efficacy, safety, cost: India’s decade-old debate on the cervical cancer vaccine erupts again.” scroll.in, 17 Jan. 2018, scroll.in/pulse/865284/
3^ Sankaranarayanan, Rengaswamy et al. “Current status of human papillomavirus vaccination in India’s cervical cancer prevention efforts.” The Lancet, Oncology, Policy Review, vol.20, no. 11, 2019, pp. 637-44, www.thelancet.com/journals/lanonc/article/PIIS1470-2045(19)30531-5/fulltext
About the Author: Navya Dawar
She is a second-year student pursuing BBA LLB Honours at Jindal Global Law School, Sonipat, Haryana. She aspires to, one day, be a part of something that helps people believe in themselves and cherish themselves for who they are while simultaneously becoming aware of their own potential for personal growth and exploiting this potential to become better versions of themselves. She loves drinking tea, playing tennis and is fond of working out. She likes to sing and read and aspires to go on long-distance solo hikes at some point in the future.
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