HPV or human papillomavirus is a kind of virus that is transmitted by sexual contact. Sexual contact can mean any form of sexual activity, not only sex penetration but also skin-to-skin genital contact. Why do we need to know about the HPV virus? There are hundreds of kinds/ strains of the HPV virus, and the two most common types are HPV 16 and HPV 18, which causes 70% of pre-cancerous and cervical cancer. Cervical cancer is one of the leading death causes in women, particularly before the vaccination program. Moreover, HPV infection can cause other types of HPV-associated cancers and genital warts both in men and women. It is important for us to know about the vaccination program to protect ourselves against the HPV virus.
Why do you need HPV Vaccination?
In principle, the purpose of vaccination is to boost the body’s immune system to acquire protection against the infection. The vaccine could give around 90% protection against HPV in certain types depending on what kind of vaccine is taken by a person. However, vaccination is not to cure the diseases. If you are already infected by one of the HPV strains, you could still get the vaccination to protect you from other strains.
As you might know that HPV is related to cervical cancer, you might think that the vaccination is only for girls or women. However, men can also develop genital warts after infected, and they pass the infection to their sex partner. In order to stop the spread of HPV, I personally think that vaccination is also important for men.
Furthermore, It is preferable to get the vaccination before sexually active, meaning that the risk of getting the sexually transmitted infection is lower. If you have been sexually active, you still could ask for vaccination as well and another program such as pap smear is highly recommended for women.
A pap smear is aimed to check whether there is any abnormality of cells from the cervix or not. Pap smear test can be done easily since there are many gynecologists in Sweden (either in the clinic or Vardcentral). You just need to book an appointment with the gynecologist and it costs around 350SEK (depending on which area you live). Also if you have personnummer, you will receive an invitation for a pap smear test. You do not need to book since the hospital already gives a schedule for you to do the test.
Illustration: HPV vaccine
The general program for HPV vaccination in Sweden
This information is accessible on the 1177.se website. From autumn 2020, the vaccination program covers both boys and girls in Sweden (previously it is only for girls). 2 doses of vaccine will be given to the person before 14 years old (first injection and the second will be given after 6 months. For those above 14 yo, 3 doses of vaccine will be injected (0, 1-2, and 6 months). As part of the general vaccination program, the vaccination is free of charge for children (usually given in the fifth grade).
HPV vaccine types
There are three kinds of HPV vaccine including 2-valent HPV vaccine, 4-valent HPV vaccine, and 9-valent HPV vaccine. Recently, the most common types of vaccines given to people are 4vHPV or 9vHPV. The differences between 4vHPV and 9vHPV are the number of virus strains that are covered by the vaccine. the 9vHPV vaccine protects someone from 9 different strains of the virus such as 16, 18, 31, 33, 45, 52, 58, 6, and 11 types which offer protection from several strains causing cervical cancer and anogenital warts. While the 4vHPV vaccine only protects someone from 4 different HPV strains.
Both of them are good, you can consult and ask for a doctor’s recommendation. Besides, the advisory committee on immunization practices (ACIP) does not state one type of vaccine as the best vaccine over others  (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6411a3.htm). Both 4vHPV and 9vHPV show high efficacy in a long-term study of vaccine usage and there are many studies about it.
Now, to choose which one is better for you, it really depends on your finances and preferences. I personally think that it would be beneficial if you could get the 9vHPV while you are living in Sweden since as far as I know the 9vHPV is not available yet in Indonesia. The 9vHPV will protect you from more strains, yet it will cost you more money.
Tips to get HPV vaccination for adult
By referring to 1177.se and www.folkhalsomyndigheten.se website, it said that “4vHPV is included in the high-cost protection for women up to the age of 26. Older women, boys born before 2009 and men have to pay for the vaccination themselves. The 9-valent HPV vaccine is not included in the high-cost protection”. One of the benefits if you have a personnummer is getting into the high-cost protection program. In Sweden, you can access your electronic prescription and buy a vaccine in a pharmacy. Afterwards, you get the injection in Vardcentral.
Here is my personal suggestion to you who want to get an HPV vaccination.
- For you who are younger than 26yo and already got your personnummer :
- Make an appointment with the doctor in Vardcentral and ask for a prescription to get the vaccine. You make your own decision about which kind of vaccine you want. If you choose 9vHPV, it is not covered by high-cost protection. Each vaccine costs around 1600SEK and the injection (in Vardcentral) costs 100-200SEK. In total, you need 3 injections meaning that it will cost you around 5100SEK to get the 9vHPV injection in Vardcentral. While the cost of 4vHPV for each injection is around 900SEK and you will get the cost-protection after you reach the high cost-limit.
- Order the vaccine in the pharmacy. You can order it online through the pharmacy website (check apotekhjartat.se, apotea.se, or others) and then pick it up.
- If your vaccination time is in the upcoming days, store your vaccine at the appropriate temperature (e.g. put it in the fridge).
- Make an appointment to get the injection in Vardcentral. An appointment with the doctor costs 200SEK, and the nurse costs 100SEK. The vaccine is administered intramuscularly. It is usually injected into your arm.
- Bring your vaccine when your vaccination time is coming.
- For you who are older than 26 years old. You can get the vaccination (without the high-cost protection). For women, I personally suggest you do a pap smear test instead, if you are sexually active. Visiting a gynecologist costs around 350SEK but a pap test is free as far as I know.
- If you are turning into 26yo in several months. You still could get the high-cost protection as long as you buy all your vaccines (for 3 injections) before your 26 birthday. You can buy all 3 syringes and store them at the appropriate temperature and place (e.g., the fridge).
- I think vaccination in Vardcentral costs less than the drop-in vaccine in the clinics.
To conclude, everyone is responsible for his/her own health including maintaining the health condition, preventing diseases, and getting the best treatment. I personally think that getting HPV vaccination is beneficial as a way to prepare your body ready in case you get an infection and to prevent getting the diseases (e.g. cervical cancer, anogenital warts). My personal recommendation is to take the vaccine that you preferred. As I mentioned, both 4vHPV and 9vHPV showed high efficacy. Taking the 9vHPV would protect you from more virus strains. Moreover, since the vaccine is not available yet in Indonesia, it would give more reason to take the vaccine in Sweden. Lastly, it is also important to plan your vaccination. Make sure that you will stay in Sweden at least for 7 months since the vaccination needs to be done in 3 doses. To get more information about vaccination, please go to the 1177.se website.
Master in Biomedicine
Editor: Badai Kesuma
- Use of 9-Valent Human Papillomavirus (HPV) Vaccine: Updated HPV Vaccination Recommendations of the Advisory Committee on Immunization Practices [Internet]. Cdc.gov. 2021 [cited 1 February 2021]. Available from: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6411a3.htm
- [Internet]. Google.com. 2021 [cited 7 February 2021]. Available from: https://www.google.com/imgres?imgurl=https%3A%2F%2Fupload.wikimedia.org%2Fwikipedia%2Fcommons%2Fthumb%2Ff%2Ff7%2FMaria_beroendecentrum.jpg%2F250px-Maria_beroendecentrum.jpg&imgrefurl=https%3A%2F%2Fsv.wikipedia.org%2Fwiki%2FMaria_beroendecentrum&tbnid=1pMP4ZgO56Sn2M&vet=10CAsQxiAoAWoXChMIiMSPz_DY7gIVAAAAAB0AAAAAEAI..i&docid=GFMvX30L94i8jM&w=250&h=188&itg=1&q=capio%20vardcentral%20sodermalm&ved=0CAsQxiAoAWoXChMIiMSPz_DY7gIVAAAAAB0AAAAAEAI