What Is the HPV Vaccine? How Does It Work and Provide Protection?

HPV vaccines do not contain the disease-causing virus itself. Instead, they contain virus-like particles (VLP – Virus-Like Particles) that mimic only the proteins on the virus’s outer surface. These VLPs cannot cause a real infection or disease in the body.

Mechanism of Action: When the vaccine is administered, the body’s immune system recognizes these VLPs as foreign and mounts a strong antibody response against them. If the person later encounters one of the actual HPV types contained in the vaccine, these pre-formed antibodies quickly recognize the virus, bind to it, and prevent the infection from developing or the virus from establishing itself in cells.

Efficacy: HPV vaccines have been proven to be over 90%, even close to 100%, effective in preventing infections caused by the HPV types they contain, as well as the precursor lesions of cervical cancer (CIN 2/3), cervical cancer itself, and genital warts caused by these types. This efficacy is highest when the vaccine series is completed and when the vaccine is given at the ideal age (before the onset of sexual activity).

Which HPV Vaccines Are Available? What Are the Differences Between Them?

There are different HPV vaccines approved and used worldwide and in Turkey (as of April 2025):

• Gardasil® 9 (9-Valent / Nonavalent Vaccine): The most up-to-date vaccine, providing the most comprehensive protection. It protects against nine different HPV types:
  
  • High-Risk (Cancer-Associated) Types: 16, 18, 31, 33, 45, 52, 58 (these 7 types are responsible for approximately 90% of cervical cancers).
  • Low-Risk (Genital Wart–Associated) Types: 6, 11 (these 2 types are responsible for approximately 90% of genital warts). It is the most widely used vaccine in Turkey and worldwide.
• Gardasil® (4-Valent / Quadrivalent Vaccine): Provides protection against four HPV types (6, 11, 16, 18). Its use has declined since Gardasil 9 became available, but it may still be found in some locations.
• Cervarix® (2-Valent / Bivalent Vaccine): Provides protection against only the two high-risk types (16 and 18) that most commonly cause cancer. It offers no direct protection against genital warts.

Prof. Dr. Nuray Bozkurt generally recommends Gardasil 9, which provides the most comprehensive protection, to her patients in Ankara.

Who Should Receive the HPV Vaccine and When? Ideal Age and Dosing Schedule

The primary goal of the HPV vaccine is to prevent infection and related diseases from the outset by vaccinating individuals before they encounter HPV through sexual activity.

• Ideal Age Group: The World Health Organization (WHO) and health authorities in many countries recommend that the vaccine be routinely given to girls and boys aged 9 to 14. In this age group, the immune response generated by the vaccine is generally stronger and fewer doses are needed.
• Dosing Schedule:
  
  • Ages 9-14: A total of 2 doses, usually given 6 to 12 months apart, is generally sufficient. (The second dose should be given at least 5 months after the first dose).
  • Age 15 and Older: In this age group, or in individuals with a suppressed immune system (regardless of age), 3 doses are generally recommended. Dosing intervals are typically at months 0, 1-2, and 6 (Example: first dose, second dose 1 or 2 months after the first dose, third dose 6 months after the first dose).
• Vaccination at Older Ages:
  
  • Women and Men Aged 15-26: Routine vaccination is recommended for those who have not previously been vaccinated or have not completed the vaccine series (usually 3 doses).
  • Women and Men Aged 27-45: People in this age group have likely already encountered some HPV types, so the benefit provided by the vaccine may be lower. However, it can still offer protection against other types contained in the vaccine that have not yet been encountered. In this age group, the decision to vaccinate should be made individually together with a doctor (shared decision-making), taking into account the person’s risk factors (new partner, etc.), previous HPV status, and expectations from the vaccine.
• Gender: HPV is a virus that affects not only women but also men. In men, it can cause genital warts as well as cancers of the penis, anus, and throat. Vaccinating men protects them from these diseases and also helps protect women by reducing the circulation of HPV in the community (herd immunity). For this reason, the vaccine is recommended for both girls and boys.

What Are the Benefits of the HPV Vaccine? Why Is It So Important?

The HPV vaccine provides very important benefits for both individual and public health:

• Cancer Prevention: It largely prevents cancers caused by HPV, especially cervical cancer, as well as cancers of the vulva, vagina, anus, penis, and oropharynx. This is the most vital benefit of the vaccine.
• Prevention of Precancerous Lesions: It significantly reduces high-grade lesions such as CIN 2/3 detected in the cervix, which have the potential to progress to cancer, as well as precancerous lesions in other genital areas (VIN, VAIN).
• Reduction of Diagnostic and Therapeutic Procedures: By reducing precancerous lesions, it decreases the need for follow-up and treatment procedures such as colposcopy, biopsy, LEEP, and conization. This eliminates the physical and psychological burden these procedures bring.
• Prevention of Genital Warts: Gardasil and Gardasil 9 vaccines provide over 90% protection against the HPV types that most commonly cause warts, preventing the development of these uncomfortable and recurrent lesions.
• Contribution to Public Health: High vaccination rates reduce the spread of HPV in the community, which also lowers the risk of infection even for unvaccinated individuals (herd immunity).

Is the HPV Vaccine Safe? Does It Have Side Effects?

Yes, HPV vaccines are extremely safe. Hundreds of millions of doses have been administered worldwide, and their safety profiles are continuously and closely monitored by independent international health authorities such as the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC), and the European Medicines Agency (EMA). Extensive scientific research has shown that the vaccines do not cause serious side effects.

Most Common Side Effects: As with many other vaccines, these are generally mild and short-lived:

• Mild pain, redness, or swelling at the injection site (80-90%).
• Mild fever (10-15%).
• Headache or fatigue (30-50%).
• Nausea, muscle or joint pain (rare).
• Fainting (Syncope): A rare occurrence, particularly in adolescents, after vaccination. For this reason, it is recommended that the person be kept under observation, sitting or lying down, for about 15 minutes after vaccination. This is related not to the vaccine’s contents but to the vaccination procedure itself (fear of needles, anxiety).

Serious Side Effects: Very rare. The risk of serious allergic reactions (anaphylaxis), which can occur with any vaccine or medication, also applies to the HPV vaccine, but this rate is very low (approximately one in a million). There is no scientific evidence whatsoever that vaccines cause infertility, autoimmune diseases (MS, Lupus, etc.), Guillain-Barré syndrome, or other chronic diseases. Claims to this effect lack scientific basis and stem from anti-vaccine rhetoric.

Other Important Points and Misconceptions About the HPV Vaccine

• The Vaccine Does Not Treat: The HPV vaccine is preventive; it does not treat an existing HPV infection, genital warts, or HPV-related cellular changes (CIN, etc.).
• Screening Must Continue: Even if you have been vaccinated, since the vaccine does not cover all cancer-causing HPV types, it is absolutely necessary to continue with cervical cancer screening (Pap smear and/or HPV test) at the recommended intervals.
• Sexual Activity and the Vaccine: It is ideal to be vaccinated before sexual activity begins. However, those who are already sexually active can also benefit from the vaccine to protect against HPV types they have not yet encountered (especially up to age 26, sometimes up to age 45).
• Pregnancy and Breastfeeding: The HPV vaccine is not recommended during pregnancy. However, if the vaccine was administered before pregnancy was noticed, there is no need to terminate the pregnancy. The vaccine can be safely given during breastfeeding.
• Cost and Accessibility: The HPV vaccine is not yet included in Turkey’s national vaccination schedule and is paid out of pocket (as of April 2025). This may limit access to the vaccine. It is important to obtain information about current pricing and reimbursement conditions.

HPV Vaccine in Ankara: Consultation and Administration with Prof. Dr. Nuray Bozkurt

Aware of the importance of protecting against HPV infections and preventing HPV-related cancers, Prof. Dr. Nuray Bozkurt provides comprehensive consultation and services regarding the HPV vaccine to her patients in Ankara:

• Personalized Assessment: She determines suitability for vaccination by evaluating the patient’s age, sexual activity status, previous screening results, and risk factors.
• Detailed Information: She provides detailed information about which vaccine (usually Gardasil 9) is suitable, the vaccination schedule (number and timing of doses), the protection the vaccine will provide, potential side effects, and precautions to take after vaccination.
• Accurate Information and Addressing Concerns: She corrects misinformation about vaccines, answers patients’ questions, and addresses any concerns they may have.
• Vaccine Administration: She safely administers the vaccine at her clinic or at partner institutions.
• Screening and Follow-up: Emphasizing that the vaccine does not replace screening, she reminds vaccinated patients not to neglect their regular gynecological check-ups and screenings.
• Accessibility: You can easily reach her clinic with any questions about the vaccination process and follow-up (0538 983 18 78)(0312 284 00 12).

One of the most important steps you can take to protect yourself and your loved ones (your children, your partner) from HPV-related cancers and genital warts is to get the HPV vaccine. To learn more about the vaccine, find out whether it is suitable for you or your child, plan your vaccination schedule, and ask any questions you may have, you can consult Prof. Dr. Nuray Bozkurt at our clinic in Ankara. To take this important preventive step for your health, please book an appointment by calling 0538 983 18 78.