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Reality of the HPV Vaccine and the Need for Vaccinations

Human Papilloma Virus (HPV) is a highly contagious virus which causes problems for both men and women, yet the vaccination rate for HPV is almost baffling. According to November's reports, the nation's Ministry of Health and Welfare released a statement that upon the public release of the HPV vaccination, there were roughly 500,000 vaccinations given, which is far too few considering the population of Korea. In addition, a large portion of the South Korean public believes rumors such as “Vaccinations cause side effects”, “It is okay to get vaccinated later in life”, or “There is no need for vaccinations at all”. Therefore, the SungKyun Times (SKT) now corrects the misconceptions and hoaxes made by the public in the hope of reestablishing the importance of vaccinations and containing HPV.

What Is Human Papilloma Virus (HPV)?
Causation of HPV and Infection

HPV is similar to the common cold and hepatitis. It infects a host through sexual contact and can later cause genital warts and cervical cancer. According to the Korean medical forum Naayo, men and women are equally capable of catching HPV, assuming that they are sexually active. With that said, sexually active men and women have up to a 50~80% chance of catching HPV. In addition, Korea has a higher number of HPV infections, which is 15 per 100,000 people, than the global average, which is eight per 100,000 people. HPV also has been known to be dormant in men, while women can suffer greatly. Studies show that 70~80% of the men infected by HPV have little to no symptoms and quickly recover from it. Regardless, men can still spread HPV through sexual contact as they are carriers of HPV, and therefore need to be vaccinated. HPV can be prevented through vaccinations and it is also acceptable to have sexual contact during the vaccination period. Doctors, however, advise the vaccination to be given at a young age, preferably before any sexual contact has been made, to maximize its effectiveness.
HPV also has numerous strands of viruses. Types 16, 18, and 35 are high risk viruses and can cause cervical cancer. Unfortunately, type 35 cannot be prevented by HPV vaccinations. The Journal of the Korean Medical Association (JKMA) released a statement that the second most common cancer across the world for women is cervix cancer. Since 70% of cervix cancer is caused by the HPV infection, many experts concluded that HPV is the leading cause of cervix cancer.


HPV Vaccinations and Regular Checkups of Cervix Cancer in Korea

Since June of 2016, the HPV vaccine has been newly added to the national immunization list, and it targets girls aged 12 and younger. To maximize the vaccine's effectiveness, it is advised to take the vaccinations two to three times before engaging in sexual activities. The cost per vaccination, however, is between \100,000 to \200,000, which can be expensive for many households. The Korea Center for Disease Control and Prevention (KCDCP) thus aimed to increase vaccination rates by providing free HPV vaccinations. Roughly 51% of girls born in 2004, who became 12 years old in 2016, were vaccinated, but soon after the free HPV vaccinations were announced, the vaccination rate of girls who were born in 2005 grew to 51.9%.

Even after getting HPV vaccinations, doctors still recommend getting daily checkups for cervix cancer. Cervix cancer checkups are also free in Korea, so there are no fiscal barriers. It is also advised to schedule a checkup for HPV to identify high risk HPV types. Last year, Gardasil 9, which is a type of HPV vaccine commonly used in the United States (US), Canada, and Australia, was released for public use in Korea. Gardasil 9 is a more effective HPV vaccine than Gardasil, which is the original HPV vaccine. Gardasil 9 has advantages such as a wider range of prevention and no side effects. Unfortunately, Gardasil 9 has not yet been accepted by insurance companies. The public, therefore, must pay the full price to get vaccinated. In addition, since only one third of Korea’s hospitals have Gardasil 9, the public must contact hospitals personally to see if they have Gardasil 9 available.

HPV’s Rumors and Truths
Through a survey regarding HPV recognition from 130 Kingos, many participants had little understanding of HPV itself and the need for vaccinations. The survey showed that 56.3% of participants knew very little about HPV. Of the 20 people who got HPV vaccinations, only five people were vaccinated between the ages of nine to 15, when the HPV vaccine has peak effectiveness. For those who have not been vaccinated, the most common response for not vaccinating was: “I do not know about the HPV vaccine well enough (26%)”, followed by “I don't think I need one (24%)”, and “I am worried about the side effects (9.5%)”. Kingos therefore seem to have a poor understanding of HPV. To prevent this, it is important to learn about the misconceptions of HPV.


HPV Infection, It Is Not Going to Happen to Me!

Globally renowned pharmaceutical company Roche Diagnostics Co. conducted a survey concerning HPV recognition. It revealed that 64.4% of respondents did not know what caused HPV, further proving that the public knows very little about HPV. It has also been statistically revealed that the younger the responder, the less understanding and interest they had with HPV. Disappointingly, 11.3% of the responders said, “HPV vaccines can wait until the responders reach adulthood.” HPV, however, has become more prevalent in the younger generation. HPV infections have decreased overall, but HPV infections diagnosed during the 20s and 30s have gone up. Recent westernized diets, imbalanced lifestyles, high levels of stress, and earlier ages of being sexually active, have all contributed to an increase in HPV infections and cervical cancers for those in their 20s and 30s. Of those infected by HPV, the percentage of those younger than 35 years old increased from 6% in the 1990s to 11% in the 2000s. This conveys an urgent need to vaccinate teens.


HPV Vaccine, Scary Due to Side Effects?

Even with the great level of prevention, HPV is not being vaccinated enough because of unwarranted fears of potential side effects. Many parents are misguided about the side effects of the HPV vaccine and thus are deterred from vaccinating their children. The KCDC released a survey on HPV recognition showing that 73% of the respondents were not vaccinating because of a fear of side effects. These people have picked up rumors from online communities that people who received HPV vaccinations experienced rashes, paralysis, and even death as side effects. The HPV vaccine’s safety, however, has been proven numerous times. The World Health Organization (WHO), the US, Sweden, and the Center for Disease Control and Prevention (CDC) have all proven the safety of HPV vaccines. Of the 2,084 women who completed three trials of HPV vaccinations, none showed serious side effects related to HPV types 16 and 18. Reports in Korea also had no major side effects. Rather, they only had minor side effects like fainting and slight pain in the vaccinated area.


Is HPV Vaccine Useless After Sexual Activity?

A misconception about the HPV vaccine is that the vaccine becomes useless after engaging in sexual activity. The truth is that HPV vaccines prevent HPV regardless of sexual activity. Since HPV is spread through sexual activity, the HPV vaccines reduce this chance. Even when infected with HPV, the HPV vaccine can still prevent other types of HPV. Therefore, it is recommended to consult a gynecologist and get regular checkups since a prolonged exposure to HPV can cause cervix cancer.

Proper Prevention Measures Against HPV
Since HPV’s processing speed is slower than other viruses, a full recovery is possible if it is discovered and treated early enough. Vaccinations and regular checkups, therefore, are necessary at the appropriate times.


Vaccinations at the Appropriate Times

In Korea, the average age of one’s first sexual experience is getting younger and the infection rate of HPV in those in their 20s and 30s is increasing. Thus, people at the age of 12 are provided free vaccinations against HPV to reflect this situation. Recently, many countries including the US and Australia encourage vaccinations when they are teenagers at the latest, regardless of sex.


Men Need to Get Vaccinated

Today, HPV vaccinations are called “vaccinations against cervical cancer” so the improper belief that cervical cancer is related to only women and that men do not need to get vaccinated is rampant. In fact, HPV causes many diseases and cancers like condyloma acuminatum, anal cancer, or penis cancer for men. Not only are women afflicted with HPV, but men can also be harmed. Since HPV is transmitted through sexual intercourse, if men are HPV carriers, they need vaccinations to prevent transmitting the virus and giving fatal diseases to women. According to the CDC, it is common to recommend HPV vaccinations to men in major developed countries. Sixty-five countries have a designated HPV vaccination national immunization program and the United Kingdom (UK) and Australia’s rate of vaccination is over 80%.


Women Need Regular Checkups

After Getting Vaccinated There are two examinations for cervical cancer provided as part of the national health care plan: Papanicolaou (Pap) smears and HPV examinations. Pap smears are used as the primary test, but it has a false negative rate of 30~45%, meaning that the examination tests negative when it is actually a positive result. In fact, both Pap smears and HPV tests are recommended to be administered together for a more effective diagnosis and supplementation. In Korea, free HPV examinations are implemented for women over 20 years old, so they need to get regular checkups for early discovery. In the US and Germany, their guidelines say that existing Pap smears and HPV examinations for discovering causative viruses should be administered together on women over 30 years old to enhance the sensitivity of checkups.


Proper Prevention Measure Guidance Against HPV

The vaccinations are inoculated with intramuscular injections, and second vaccinations are needed six months after the initial one. All vaccinations should be done within one year for higher efficacy. Although teenagers at 12 to 13 need only two inoculations, people over this age should get three for sufficient effect. There have been no other serious side effect cases recently, but people need to recognize that side effects can occur. There are some common symptoms after getting the vaccinations. Inoculated areas can become red and hard or painful, but they are mostly temporary and do not need treatment. Although serious allergies are not common, hypersensitivity reactions could occur in people at a chance of one in 600,000, so people need to be observed in hospital conditions for a while.

In Korea, girls at the age of 12 have been provided free HPV vaccinations since last year, but for boys or children of other age groups, free vaccinations have not yet been offered. Free checkups for HPV infections are also conducted only for women. As mentioned above, HPV causes many diseases and cancers regardless of sex, and the importance of HPV vaccinations continues to grow as the fatality rate of cervical cancer is increasing. Therefore, active support by the government and the KCDC is needed to protect the health of citizens. They need to expand the range of test subjects and increase the immunization rate by promoting guidance and education about HPV vaccinations.

박신영, 김대한  sgtlsdud@naver.com, arnoldd.kim76@gmail.com

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