Up to the age of 18, anyone can get the HPV vaccinations free of charge through the National Immunisation Programme. People over 18 can be vaccinated at their own request.

What is the HPV vaccination?

The HPV vaccination protects against various forms of cancer caused by human papillomavirus (HPV). In addition, it can protect against genital warts.

Two or three injections

HPV vaccination is most effective when you receive two vaccine doses. You will receive the second dose at least six months after the first one, and preferably within a year. People who are less resistant to infection need three doses. Talk to your doctor about whether this applies to you.

Best time for HPV vaccination

The HPV vaccination works best if someone has not yet been in contact with the virus, so before someone becomes sexually active. That is why children are offered the HPV vaccination around the age of 10 through the National Immunisation Programme. This provides them with timely protection against HPV.

Studies show that vaccination provides protection if the first vaccination is given before their 27^th birthday. However, the level of protection is lower if someone started the vaccination when older. The protection is better if someone started the vaccinations at the age of 10 than if they started at the age of 20. Over the age of 26, there is no good evidence that the HPV vaccination provides protection. Most people have already been infected with HPV by that age, and the vaccine has no effect on pre-existing HPV infections or pre-existing HPV-related disease. If you are aged 26 or older and would like to be vaccinated against HPV, it is recommended to have three doses instead of two.

Which adults could benefit from HPV vaccination?

For some people, vaccination at a later age may be useful because they have an increased risk of HPV infection. For example:

• people with HIV or a weakened immune system
• people with inflammatory bowel disease
• people with inflammatory rheumatic diseases
• people with Fanconi anaemia

If you want to know whether HPV vaccination could be beneficial for you, discuss this with your GP or treating physician.

Is the HPV vaccination free?

The HPV vaccination is free for children up to the age of 18 through the National Immunisation Programme.

Adults who want to receive the HPV vaccination pay for this themselves.

Where can I get the HPV vaccination?

• Children can get the HPV vaccination through the National Immunisation Programme.
• Adults can get the HPV vaccination at their GP or a vaccination centre.

Which HPV vaccine can I get?

In the Netherlands, two HPV vaccines have been registered.

• Gardasil 9 (see package leaflet): protects against virus types 6, 11, 16, 18, 31, 33, 45, 52 and 58 (including two types of HPV that cause genital warts).
• Cervarix (see package leaflet): protects against virus types 16 and 18. These two types cause most forms of HPV-related cancer.

How effective is the HPV vaccine?

The HPV vaccine protects well against (precursors of) HPV cancer and (in the case of Gardasil 9) against genital warts. The vaccination allows the body to recognise HPV when it comes into contact with it. Your body then cleans up the virus so that you do not get a long-term HPV infection. This can reduce the risk of HPV cancer by up to 90% after vaccination.

Possible side effects of HPV vaccination

Studies show that the HPV vaccine is safe. However, the HPV vaccine may cause mild side effects for a few days. This is normal and can be expected after all vaccinations. The most common side effects are:

• redness, pain and swelling at the injection site
• stomach pain
• nausea
• tiredness
• headache
• fever

Most of the symptoms are mild and clear up after one to three days. There have never been serious, permanent side effects reported as caused by the HPV vaccine. For a complete overview of the side effects, see the vaccine package leaflet. Or visit the website of the Pharmacovigilance Centre Lareb for more information.