3.1.5 HPV NSCH

Learning Outcomes

  • The student should be able to tabulate HPV information using the following headings:
    • Age
    • Abbreviation of vaccine
    • Full name of vaccine
    • Definition of disease that the vaccine protects against
    • Dose
    • Preferred route
    • Recommended site
    • General and specific contraindications
    • General and specific side effects
    • Applicable health education on managing side effects at home.

Study Material

  • Clarke, 2016 (Vlok), Chapter 13
  • Vaccinators’ Manual, 2015
  • Vasuthevan & Mthembu, 2016, Chapter 11
  • Primary Health Care Level (EDL), 2020, Chapter 13
  • Road to Health Booklet, 2012
  • New Road to Health Booklet, SideBySide, 2018
  • IMCI Manual, 2019

Human Papillomavirus (HPV)

  • HPV Infection Effects:

    • Causes multiple reproductive tract cancers, especially cervical cancer.
    • Leads to genital warts.
    • May cause recurrent respiratory papillomatosis.
    • Associated with rare oropharyngeal cancer.

  • Transmission:

    • Sexual contact.
    • Direct contact with infectious body fluids or blood.
    • From mother to baby during delivery (Clarke, 2016:190; EDL, 2014:13.11).

HPV Vaccine Information

  • Brand: Cervarix
  • Type: Human Papillomavirus (rDNA) vaccine (AS04 adjuvanted, adsorbed)
  • Form: Suspension for intramuscular injection.
  • Regulatory Information: Reg No 41/30.1/0366
  • Dosage: 0.5 ml (one dose)
    • Administered in a prefilled syringe with a needle for intramuscular use.

Vaccine Details

  • Abbreviated Name: HPV (DOH, 2015:36)

  • Full Name: Human Papillomavirus Vaccine (DOH, 2015:36)

  • Age Administration:

    • First dose at age 9 (Grade 4) and second dose 6 months later (DOH, 2015:29; 36)

  • Disease Prevention:

    • Protects against HPV serotypes 16 and 18 (EDL, 2018:13.12).
    • Can cause genital warts, recurrent respiratory papillomatosis, and a rare form of oropharyngeal cancer (Clark, 2016:190).

  • Dosage and Schedule:

    • 0.5 ml with two doses scheduled 6 months apart, delivered via the Integrated School Health programme to Grade 4 girls (≥ 9 years) in public schools (EDL, 2018:13.12).

  • Preferred Route: Intramuscular (IM) (DOH, 2015:36; EDL, 2018:13.12)

  • Recommended Site: Administered into the deltoid of the non-dominant arm (EDL, 2018:13.12)

Storage and Handling

  • Cold Chain Requirements:
    • Do not freeze; vaccine is damaged by freezing.
    • Store between 2°C – 8°C on the middle shelf, in original packaging, protecting it from light.
    • Use immediately once withdrawn from a syringe (DOH, 2015:19; 32; EDL, 2018:13.12).

Contraindications

  • General Contraindications:

    • Severe hypersensitivity to any vaccine component.
    • Serious allergic reaction to a previous dose.
    • Postpone if temperature ≥ 38.5°C (DOH, 2015:54; 101).

  • Specific Contraindications:

    • Previous anaphylaxis.
    • Known hypersensitivity/allergy to vaccine components.
    • Current febrile illness (≥ 38.5°C).
    • Not recommended for pregnant girls/women (DOH, 2015:31-32; EDL, 2018:13.12).

Side Effects

  • General Side Effects:

    • Mild fever for 1-2 days.
    • Redness, swelling, and pain at injection site for 3-4 days, with a possibility of small abscess (DOH 2015:85, 87, 110, 148-149).

  • Specific Side Effects:

    • Common: Injection site pain, arm swelling.
    • Occasional: Itching, rash, redness, urticaria, nausea, diarrhea, abdominal pain, headache, myalgia, fever (38°C).
    • Rare: Syncope, dizziness, lymphadenopathy, anaphylaxis.
    • Precautions: Observe for 15 minutes post-vaccination for fainting (DOH, 2015:31-32; EDL, 2018:13.12).

Health Education for Parents

  • General Management:

    • For fever: provide extra fluids, tepid sponge, and paracetamol based on age and weight.
    • For injection site issues: do not apply ointments; use cooling cloths; and apply dry dressing for any abscess.

  • Specific Management:

    • Educate on handling mild fever.
    • Monitoring for worsening symptoms post-vaccine.

  • Other Considerations:

    • Vaccine is safe for girls on hormonal contraceptives and can be administered during menstruation (DOH, 2015:32, 110).

References

  • Clarke, M. 2016. Vlok's Community Health. Revised 6th ed. Cape Town: Juta & Company.
  • Department of Health (DOH). 2015. Vaccinators Manual: Immunisation that Works. 4th ed.
  • Standard Treatment Guidelines and Essential Medicines List for South Africa Primary Health Care Level (EDL), 2020 Edition.