Immunisations

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HPV

Girls and boys aged 12 to 13 years (born after 1 September 2006) are offered the human papillomavirus (HPV) vaccine as part of the NHS vaccination programme.

The HPV vaccine helps protect against cancers caused by HPV, including:

It also helps protect against genital warts.

In England, girls and boys aged 12 to 13 years are routinely offered the 1st HPV vaccination when they're in school Year 8. The 2nd dose is offered 6 to 24 months after the 1st dose.

It's important to have both doses of the vaccine to be properly protected.

If you’re eligible and miss the HPV vaccine offered in Year 8 at school, it’s available for free on the NHS up until your 25th birthday for:

  • girls born after 1 September 1991
  • boys born after 1 September 2006

HPV is the name given to a very common group of viruses.

There are many types of HPV, some of which are called "high risk" because they're linked to the development of cancers, such as cervical cancer, anal cancer, genital cancers, and cancers of the head and neck.

Other types can cause conditions like warts or verrucas.

High risk types of HPV can be found in more than 99% of cervical cancers.

There is also a significant association between HPV and some of the anal and genital cancers, and cancers of the head and neck.

HPV infections do not usually cause any symptoms, and most people will not know they're infected.

Find out more about HPV

What are the different types of HPV and what do they do?

There are more than 100 different types of HPV, and around 40 that affect the genital area.

HPV is very common and can be caught through any kind of sexual contact with another person who already has it.

Most people will get an HPV infection at some point in their lives and their bodies will get rid of it naturally without treatment.

But some people infected with a high-risk type of HPV will not be able to clear it.

Over time, this can cause abnormal tissue growth as well as other changes, which can lead to cancer if not treated.

High-risk types of HPV are linked to different types of cancer, including:

Infection with other types of HPV may cause:

  • genital warts – small growths or skin changes on or around the genital or anal area; they're the most common viral sexually transmitted infection (STI) in the UK
  • skin warts and verrucas – not on the genital area
  • warts on the voice box or vocal cords (laryngeal papillomas)

How does the HPV vaccine work?

Gardasil has been the HPV vaccine used in the NHS vaccination programme since 2012.

Sometime during the 2021 to 2022 academic year, the HPV vaccine used in the NHS programme will switch to Gardasil 9.

Gardasil 9 protects against 9 types of HPV: 6, 11, 16, 18, 31, 33, 45, 52 and 58. Between them, types 16 and 18 are the cause of most cervical cancers in the UK (more than 80%). Types 31, 33, 45, 52 and 58 cause an additional 15% of cervical cancers.

These types of HPV also cause most anal cancers, and some genital and head and neck cancers.

HPV types 6 and 11 cause around 90% of genital warts, so using Gardasil 9 helps protect girls and boys against both cancer and genital warts.

HPV vaccination does not protect against other infections spread during sex, such as chlamydia, and it will not stop girls getting pregnant, so it's still very important to practise safe sex.

Who can have the HPV vaccine through the NHS vaccination programme?

The 1st dose of the HPV vaccine is routinely offered to girls and boys aged 12 and 13 in school Year 8. The 2nd dose is offered 6 to 24 months after the 1st dose.

If you miss either of your HPV vaccine doses, speak to your school immunisation team or GP surgery and make an appointment to have the missed dose as soon as possible.

It's important to have both doses of the vaccine to be fully protected.

If you’re eligible and miss the HPV vaccine offered in Year 8 at school, it’s available for free on the NHS up until your 25th birthday for:

  • girls born after 1 September 1991
  • boys born after 1 September 2006

Find out more about who can have the HPV vaccine

Read more about HPV vaccination safety and the possible side effects.

How has the HPV vaccination programme changed?

In July 2018, it was announced that the HPV vaccine would be extended to boys aged 12 to 13 years in England.

This decision was based on advice from the Joint Committee on Vaccination and Immunisation (JCVI), the independent body that advises UK health departments on immunisation.

Since the 2019 to 2020 school year, both 12- to 13-year-old boys and girls in school Year 8 (born after 1 September 2006) have been eligible for the HPV vaccine.

The HPV vaccination programme has been extended to prevent more boys and girls getting HPV-related cancers, such as head and neck cancers and anal and genital cancers.

A catch-up programme for older boys is not necessary as evidence suggests they're already benefiting greatly from the indirect protection (known as herd protection) that's built up from 10 years of the girls' HPV vaccination programme.

Why is the HPV vaccine given at such a young age?

HPV infections can be spread by any skin-to-skin contact and are usually found on the fingers, hands, mouth and genitals.

This means the virus can be spread during any kind of sexual activity, including touching.

The HPV vaccine works best if girls and boys get it before they come into contact with HPV (in other words, before they become sexually active).

So getting the vaccine when recommended will help protect them during their teenage years and beyond.

Most unvaccinated people will be infected with some type of HPV at some time in their life.

The virus does not usually do any harm because the person's immune system clears the infection.

But sometimes the infection stays in the body for many years, and then it may start to cause damage.

HPV vaccination for men who have sex with men (MSM)

Gay, bisexual and other men who have sex with men (MSM) have not benefitted in the same way from the longstanding girls' programme, so may be left unprotected against HPV.

Since April 2018, MSM up to and including 45 years of age have been eligible for free HPV vaccination on the NHS when they visit specialist sexual health services and HIV clinics in England.

Ask the doctor or nurse at the clinic for more details.

Find out more about HPV vaccination for MSM in this NHS leaflet (PDF, 93kb)

HPV vaccination for transgender people

Trans women (people who were assigned male at birth) are eligible in the same way as MSM if their risk of getting HPV is similar to the risk of MSM who are eligible for the HPV vaccine.

Trans men (people who were assigned female at birth) are eligible if they have sex with other men and are aged 45 or under.

If trans men have previously completed a course of HPV vaccination as part of the girls' HPV vaccine programme, no further doses are needed.

How is the HPV vaccine given?

The HPV vaccine is given as 2 injections into the upper arm spaced at least 6 months apart.

It's important to have both doses of the vaccine to be properly protected.

If you missed the HPV vaccine offered in school Year 8, you can get it for free up until your 25th birthday.

Men who have sex with men (MSM), and trans men and trans women who are eligible for the vaccine, will also need 2 doses of the vaccine given 6 months apart.

MSM who are HIV positive or have a weakened immune system (immunosuppressed) need to have 3 doses of the HPV vaccine.

If you need 3 doses of the vaccine:

  • the 2nd dose should be given at least 1 month after the 1st dose
  • the 3rd dose should be given at least 3 months after the 2nd dose

It's important to have all vaccine doses to be properly protected.

Find out more about how the HPV vaccine is given

How long does the HPV vaccine protect for?

Studies have shown that the vaccine protects against HPV infection for at least 10 years, although experts expect protection to last for much longer.

But because the HPV vaccine does not protect against all types of HPV that can cause cervical cancer, it's important that all women who receive the HPV vaccine also have regular cervical screening once they reach the age of 25.

Read more about cervical screening

Further information

Find out more about the safety of the HPV vaccine

Find out more about HPV vaccination in this NHS leaflet (PDF, 157kb)

You can also read more about the human papillomavirus (HPV).

Teenage booster

The teenage booster, also known as the 3-in-1 or the Td/IPV vaccine, is given to boost protection against 3 separate diseases: tetanus, diphtheria and polio.

It's a single injection given into the muscle of the upper arm.

Learn more about immunisations for young people

The 3-in-1 teenage booster is free on the NHS for all young people aged 14, as part of the national immunisation programme.

It's routinely given at secondary school (in school year 9) at the same time as the MenACWY vaccine.

Schools will send a letter to parents shortly before the vaccinations are planned to ask for their or their child's consent.

Children who are home educated will also be offered the vaccine, provided they're in an eligible school age group.

Read answers to the common questions parents ask about the 3-in-1 teenage booster jab

How safe is the 3-in-1 booster vaccine?

The 3-in-1 teenage booster is a very safe vaccine.

As with all vaccines, some people may have minor side effects, such as swelling, redness or tenderness where the injection is given.

Sometimes a small painless lump develops, but it usually disappears in a few weeks.

The brand name of the 3-in-1 teenage booster vaccine given in the UK is Revaxis.

Read the patient information leaflet for Revaxis

Read more about possible side effects of the 3-in-1 vaccination

Men ACWY

"Fresher" students going to university for the first time should make sure they've had the MenACWY vaccine to prevent meningitis and septicaemia, which can be deadly.

The MenACWY vaccine is also routinely offered to teenagers in school Years 9 and 10.

This page covers information for England. If you live in, or are going to university in, other areas of the country, choose from the links below:

MenACWY in Wales
MenACWY in Scotland
MenACWY in Northern Ireland

Important

If you're starting college or university you should make sure you've already had:

  • the MenACWY vaccine – which protects against serious infections like meningitis. You can ask a GP for this vaccine until your 25th birthday, if you missed having it at school or before coming to the UK to study
  • 2 doses of the MMR vaccine – as there are outbreaks of mumps and measles at universities. If you have not previously had 2 doses of the MMR vaccine, you can ask a GP for the vaccine

The MenACWY vaccine is given by a single injection into the upper arm and protects against 4 strains of the meningococcal bacteria – A, C, W and Y – which cause meningitis and blood poisoning (septicaemia).

The MenACWY vaccine is called Nimenrix.

At what age should teenagers and young people have the vaccine?

Children aged 13 to 15 (school Years 9 or 10) are routinely offered the MenACWY vaccine in school alongside the 3-in-1 teenage booster.

Young people

Anyone born on or after 1 September 1996 who was eligible but missed their teenage MenACWY vaccine can still have the vaccine up to their 25th birthday.

If they're still at school, they should talk to their school nurse.

If they've left school (including people who have started apprenticeships or joined the armed forces), they should make an appointment with their GP practice.

University students

Any university student born on or after 1 September 1996 who was eligible but missed their teenage MenACWY vaccine can still have the vaccine up to their 25th birthday.

Students going to university or college for the first time, including overseas and mature students, who have not yet had the MenACWY vaccine remain eligible, as freshers (first-year students), up to their 25th birthday.

Students should contact their GP to have the MenACWY vaccine before starting university or college. If that's not possible, they should have it as soon as they can after they begin university.

Find out if you can have the MenACWY vaccine with the Meningitis Research Foundation's eligibility checker.

Why teenagers and students should have the MenACWY vaccine

Meningococcal disease (meningitis and septicaemia) is a rare but life-threatening disease caused by meningococcal bacteria. 

Older teenagers and new university students are at higher risk of infection because many of them mix closely with lots of new people, some of whom may unknowingly carry the meningococcal bacteria at the back of their nose and throat.

Anyone who is eligible for the MenACWY vaccine should have it, even if they have previously had the MenC vaccine.

The MenACWY vaccine is highly effective in preventing illness caused by the 4 meningococcal strains, including the extremely harmful MenW strain.

The dangers of meningococcal disease

Meningococcal disease can cause both meningitis and septicaemia (blood poisoning). Septicaemia and meningitis can trigger sepsis, which is a life-threatening response to infection.

Meningococcal disease is rare but very serious. It requires urgent hospital treatment.

It can lead to life-changing disabilities, such as amputations, hearing loss and brain damage.

The MenACWY vaccine was previously recommended only for people at increased risk of meningococcal disease, including people who have had their spleen removed, or have a spleen that does not work properly, for Hajj pilgrims, and for travellers to countries with high rates of meningococcal disease, including parts of Africa and Latin America.

Read about having the MenACWY vaccine before travelling on our page about travel vaccinations.

MenACWY vaccine effectiveness

The MenACWY vaccine is highly effective against serious infections caused by 4 different strains of meningococcal (A, C, W and Y).

The vaccine contains only the sugar coating found on the surface of the 4 types of meningococcal bacteria. It works by triggering the body's immune system to develop antibodies against these sugar coatings without causing disease.

MenACWY vaccine side effects

Like all vaccines, the MenACWY vaccine can cause side effects, but they are generally mild and soon pass.

The most common side effects seen in teenagers and young people are redness, hardening and itching at the injection site, a high temperature (above 38C), headache, feeling sick (nausea) and tiredness (fatigue). These symptoms should last no longer than 24 hours. 

Sometimes a small, painless lump develops, but this usually disappears after a few weeks.

Who should not have the MenACWY vaccine?

You should not have the MenACWY vaccine if you are allergic to the vaccine or any of its ingredients.

You should also check with the doctor or nurse before having the MenACWY vaccine if you:

  • have a bleeding problem, such as haemophilia, or bruise easily
  • have a high temperature
  • are pregnant or breastfeeding

How do meningococcal bacteria spread?

Meningococcal disease is caused by 13 different groups of meningococcal bacteria.

In the UK, the disease is almost always caused by 1 of 4 meningococcal groups commonly known as MenB, MenC, MenW or MenY. These can be prevented with vaccination.

MenA disease is rare in the UK, but it's more common in other parts of the world. It can also be prevented by vaccination.

The meningococcal bacteria live in the back of the nose and throat in about 1 in 10 people without causing any symptoms or illness.

Older teenagers are most likely to carry and spread the meningococcal bacteria.

The bacteria are spread from person to person by prolonged close contact – such as coughing, kissing or sneezing – with someone who is carrying the bacteria.

Very occasionally, the meningococcal bacteria can cause serious illness, including meningitis and septicaemia, which can rapidly lead to sepsis.

Meningococcal infections can happen at any age, but babies, young children and teenagers are especially vulnerable.

Babies, older people and the MenACWY vaccine

The MenACWY vaccine is currently recommended for teenagers as they are most likely to carry the meningococcal bacteria at the back of their noses and throats. 

The MenACWY vaccine protects teenagers when they're most at risk of meningococcal disease. It also stops them carrying and spreading the bacteria to other people. 

Vaccinating teenagers should also help protect other people, including babies and older people, against meningococcal disease, including the extremely harmful MenW strain.

How to spot meningococcal disease

Symptoms of meningococcal disease (meningitis and septicaemia) can start like a bad case of flu but they get worse very quickly. Early treatment can be lifesaving.

Other symptoms of meningococcal disease can include:

  • a headache
  • vomiting
  • a stiff neck
  • muscle and joint pain
  • a high temperature
  • cold hands and feet
  • drowsiness or difficulty waking up

A rash may also appear that can develop into a purple, bruise-like rash that does not fade under pressure – for instance, when gently pressing a glass against it (the "glass test").

If you, or a child or adult you know, has any of these symptoms, get urgent medical help. Do not wait for the rash to develop. Early diagnosis and treatment with antibiotics are vital.

Although meningococcal disease commonly causes meningitis and septicaemia, which can trigger sepsis, it can also more rarely cause other illnesses. These include pneumonia and joint infections (septic arthritis).

Find out more about meningitis.

Other vaccines against meningococcal disease

Several bacteria can cause meningitis and septicaemia, some of which can be prevented through vaccination.

The Hib/MenC vaccine is offered as part of the NHS vaccination programme to all babies after their 1st birthday.

The MenB vaccine (Bexsero) is offered as part of the NHS childhood vaccination programme to all babies at 8 and 16 weeks, with a booster after their 1st birthday.

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