H uman

Papilloma
V irus and its
PREVENTION
To help protect you against
HPV-related cancers and diseases

Image for illustration purpose only HPV: Human papillomavirus.

 HUMAN HPV is the most commonly transmitted
PAPILLOMAVIRUS viral infection of the reproductive tract1

Around 8 out of 10 individuals can develop

an HPV infection in their lifetime2

MORE THAN 200 HPV

TYPES HAVE BEEN
IDENTIFIED3
Low-risk HPV types (6 and 11) are responsible for
genital warts3,4
High-risk HPV types (16, 18, 31, 33, 45, 52, and
58) are responsible for certain HPV-related
Image for illustration purpose only
cancers3,4
Source: https://www.shutterstock.com/image-illustration/human-papillomaviruses-hpv-viruses-which-causes-533717263

1. World Health Organization: WHO. Cervical cancer. www.who.int [Internet]. 2022 Feb 22; Available from: https://www.who.int/news-room/fact-sheets
/detail/cervical-cancer#:~:text=HPV%20is%20the%20most%20common,populations%20eventually%20clear%20the%20infection. Accessed on 31 August 2023
2.Frequently asked questions about HPV. Available at: https://www.hpv.org.nz/about-hpv/hpv-faq-questions. Accessed on: 22 August 2023. 3. Meites E, Gee J,
Unger E, et al. Human papillomavirus. In: Hall E, Wodi AP, Hamborsky J, et al. (eds). Centers for Disease Control and Prevention. Epidemiology and Prevention of
Vaccine-preventable Diseases. 14th edn. Washington D.C.: Public Health Foundation, 2021, pp. 165–178. 4. Data on File. HPV and HPV related diseases. MSD
REF-128791. HPV: Human papillomavirus.
 CANCERS & DISEASES CAUSED BY HPV

Anogenital warts1 Cervical

cancer1

Other anogenital
cancers1
Precancerous lesions1 Anal cancer, vaginal cancer,
and vulvar cancer

1. Meites E, Gee J, Unger E, et al. Human papillomavirus. In: Hall E, Wodi AP, Hamborsky J, et al. (eds). Centers for Disease Control and Prevention. Epidemiology and Prevention of Vaccine-preventable Diseases. 14th edn. Washington D.C.:
Public Health Foundation, 2021, pp. 165–178. Image for illustration purpose only HPV: Human papillomavirus.
 HOW ARE HPV-RELATED
INFECTIONS TRANSMITTED?

Sexual Contact1,2 Fomites and Mother-to-child2

(most common non-sexual
route of contact1,2
transmission)
For most people, HPV clears on its own. But for those who don’t
clear this virus, it could cause certain HPV-related cancers & diseases later in
life.3
1. Frequently asked questions about HPV. Available at: http://www.hpv.org.nz/about-hpv/hpv-faq-questions. Accesed on: 26 july 2022. 2. Petca A, et al. Exp Ther Med. 2020;20(6):186 3. Markowitz LE et al. Quadrivalent Human Papillomavirus Vaccine:
Recommendations of the advisory committee on Immunization practices (ACIP). MMWR recomm Rep. 2007 Mar 23;56(RR-2);1-24 HPV: Human papillomavirus.
HPV POSES A THREAT LARGER
THAN IT APPEARS GLOBALLY

~660 million cases of HPV-related

diseases are reported worldwide
annually1

More than 95% of cervical cancer

cases worldwide are attributed to
HPV2

Image for illustration purpose only

1. Report of the consultation on human papillomavirus vaccines: World Health Organization, Geneva, April 2005. Available at: https://apps. who.int/iris/bit-
stream/handle/10665/69150/WHO_IVB _05.16.pdf?sequence=1&isAllowed=y. Accessed on: 15 July 2022. 2.World Health Organization–Cervical cancer.
Available at: https://www.who.int/news-room/fact-sheets/detail/cervical-cancer. Accessed on: 12 June 2023. HPV: Human papillomavirus.
 HPV INFECTION IS A
MASSIVE THREAT IN INDIA

Every 5 minutes, nearly 1 patient dies

of HPV-related cancer in India1
1 out of 13 cancers reported in India are
HPV-related2

HPV-related cancers are the 2nd-most common

cancer in women aged 15-44 years in India
after breast cancer3,4

The prevalence of genital warts in India is

~1.07%5
1. Seth S, Malhotra N, Malhotra J. HPV vaccination—An update. In: Sekaran SK, Patel M, Suman A, et al. (eds.) FOGSIs Update in Obstetrics and Gynaecology. Volume 2. Evangel Publishing, 2022, pp. 165–174. 2. Ramamoorthy T, Sathishkumar K, Das P, et al. Epidemiology of human papillomavirus related cancers in
India: Findings from the National Cancer Registry Programme. Ecancermedicalscience. 2022;16:1444. 3. Human papillomavirus and related diseases report 2023, India. Available at: https://hpvcentre.net/statistics/reports/IND.pdf. Accessed on: 12 June 2023. 4. Bhatla N, Meena J, Kumari S, et al. Cervical cancer
prevention efforts in India. Indian J Gynecol Oncol. 2021;19(3):41. 5. Khopkar US, Rajagopalan M, Chauhan AR, et al. Prevalence and burden related to genital warts in India. Viral Immunol. 2018;31(5):346–351. HPV: Human papillomavirus.
 NEVER HEARD OF IT? BUT IT
DOES EXIST IN HUGE
NUMBERS IN INDIA 1

Cervical cancer-123,907 cases1

Vaginal cancer-5518

cases1 Anal cancer-2776

Image for illustration purpose only cases1 Vulvar cancer-3447

cases1
1. Bruni L, Albero G, Serrano B, Mena M, Collado JJ, Gómez D, Muñoz J, Bosch FX, de Sanjosé S. ICO/IARC Information Centre on HPV and Cancer (HPV Information Centre). Human Papillomavirus and Related Diseases in India. Summary Report 22 October 2021. Accessed on 25 August 2023.
 PERSISTENT HPV INFECTION IS THE MOST
IMPORTANT RISK FACTOR FOR DISEASE PROGRESSION 1

Viral persistence
& progression
Normal HPV-infected Precancerous Cancer
cervix cervix lesion
Regression Invasion
Clearance

Prevalance
HPV

Precancer Cancer

15 30 45
Age (in
years)
Adapted from Schiffman M, Castle PE. The promise of global cervical-cancer prevention. New England Journal f Medicine, 2005, 353(20): 2102-2103

Prevalence of HPV Infection, precancerous lesions and cervical cancer by age of

women.
1. Schiffman M, Castle PE. The promise of global cervical-cancer prevention. New England Journal of Medicine, 2005, 353(20): 2102-2103 HPV: Human papillomavirus.
HELP CONTROL THE INFECTION BEFORE IT HAMPERS LIFE

To help protect against HPV infections1

Ask the doctor Ask the doctor Take care of

for HPV for HPV sexual
vaccination1 screening and health and
testing1 wellness1
By being in a mutually monogamous
relationship & practicing safe sex.

1. Centers for Disease Control and Prevention. Genital HPV Infection—Basic Fact Sheet. Available at: https://www.cdc.gov/std/hpv/stdfact-hpv.htm. Accessed on: 12 July 2023. HPV: Human papillomavirus.
 ONLY SEXUAL MONOGAMY AND
USING CONDOMS DO NOT
GUARANTEE PROTECTION AGAINST
HPV!1,2

1 out of 2
women may be HPV-
positive even with one
male partner2

1. WHO–Talking with patients and parents about HPV vaccination for girls. Available at: https://cdn.who.int/media/docs/librariesprovider2/euro-health-topics/cancer/talking-with-patients-and-parents-about-hpv-vaccination-for-girls.pdf. Accessed on: 15 March 2023.
2. Winer RL, Feng Q, Hughes JP, et al Risk of female human papillomavirus acquisition associated with first male sex partner. J Infect Dis. 2008;197(2):279–282. HPV: Human papillomavirus.
 SO, DOES THIS MEAN THAT SEXUALLY ACTIVE
WOMEN DO NOT NEED HPV VACCINATION?

Data suggest that

More than 99% of
HPV serotypes only ~0.5% of
sexually active
16 & 18 are the sexually active
women can still get
most prevalent in women are
the benefit of HPV
India1,2 fully exposed to
vaccine3
prevalent HPV 16 &
183
1. Indian Academy of Pediatrics. Questions and answers for parents–Human papillomavirus vaccines. Available at: https://iapindia.org/pdf/vaccine-information/HPV-VACCINE.pdf. Accessed on: 20 March 2023. 2. Vora KS, Saiyed S, Joshi R, et al. Prevalence of
high risk HPV among marginalized urban women in India and its implications on vaccination: A cross sectional study. Int J Gynaecol Obstet. 2022. 3. Velicer C, Zhu X, Vuocolo S, et al. Prevalence and incidence of HPV genital infection in women. Sex Transm Dis.
2009;36(11):696–703. HPV: Human papillomavirus.
 DO NOT FRET
IF SHOT IS NOT TAKEN YET!

HPV vaccination can benefit

sexually active women as
well.1

HPV vaccine has demonstrated

effectiveness rates as high as ~89%
in adult women aged 18–45 years,
irrespective of prior HPV
exposure.2,3

HPV vaccine can help prevent new

vaccine HPV type infections that
one may have not been exposed
Image for illustration purpose only
to.1,4
1. Human Papillomavirus (HPV) Vaccination. Frequently asked questions. Available at: https://www.acog.org/womens-health/faqs/hpv-vaccination.
Accessed on: 26 July 2022. 2. Castellsagué X, Muñoz N, Pitisuttithum P, et al. End-of-study safety, immunogenicity, and efficacy of quadrivalent HPV (types
6, 11, 16, 18) recombinant vaccine in adult women 24–45 years of age. Br J Cancer. 2011;105(1):28–37. 3. Kjaer SK, Nygård M, Sundström K, et al. Final
analysis of a 14-year long-term follow-up study of the effectiveness and immunogenicity of the quadrivalent human papillomavirus vaccine in women from
four nordic countries. EClinicalMedicine. 2020;23:100401. 4. World Health Organization. Questions and answers about human papillomavirus (HPV).
Available at: https://www.euro.who.int/ data/assets/pdf_file/0003/427017/WHO-HPV-QA.pdf. Accessed on: 16 March 2023. HPV: Human papillomavirus.
DID YOU KNOW THAT DURING THE POSTPARTUM
PERIOD, WOMEN ARE MORE PRONE TO GET
HPV INFECTION? 1,2
Image for illustration purpose only
~3 out of 10 women are at
risk of an HPV infection after
childbirth.3
National & International organizations
like FOGSI, WHO, ACOG and CDC
support HPV vaccination in lactating
women.4-7
Evidence suggests that a high number of normal Pap
smear results are observed in postpartum HPV-vaccinated
women compared to unvaccinated women.2
1. Pandey D, Solleti V, Jain G, et al. Human papillomavirus (HPV) infection in early pregnancy: Prevalence and implications. Infect
Dis Obstet Gynecol. 2019;2019:4376902. 2. Lee CY, Tseng CJ, Chang CC, et al. Postpartum HPV vaccination rate and differences
in background characteristics between HPV vaccinated and unvaccinated postpartum women: Strict monitoring and follow-up of
postpartum HPV vaccination program. Front Immunol. 2021;12:626582. 3. Nobbenhuis MA, Helmerhorst TJ, van den Brule AJ, et
al. High-risk human papillomavirus clearance in pregnant women: Trends for lower clearance during pregnancy with a catch-up
postpartum. Br J Cancer. 2002;87(1):75–80. 4. FOGSI’s Update in Obstetrics & Gynecology. Vol.2. New Delhi. Evangel Publishing.
2022. Chapter 33. HPV Vaccination-An Update.p.166. 5. Human papillomavirus vaccines: WHO position paper, May 2017
https://www.who.int/immunization/policy/position_papers/hpv/en/ Accessed on 13 Jul 2022. 6. Maternal immunization. ACOG
Committee Opinion No. 741. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2018;131:e214–7. 7. CDC.
Vaccination Safety for Breastfeeding Mothers. Adapted from: https://www.cdc.gov/breastfeeding/breastfeeding-special-
circumstances/vaccinations-medications -drugs/vaccinations.html Accessed on 13 Jul 2022. HPV: Human papillomavirus.
 EARLY VACCINATION IS A KEY TO
HELP PROTECT AGAINST HPV INFECTION

HPV vaccine can help offer maximum protection when taken

early,
preferably prior to the first sexual contact.1–3

Early HPV vaccination before

Reduction in risk of 15 years may offer a ~2X
cervical cancer throughout higher immune response
life3 against
HPV infection than after 154,5

1. Hoes J, Pasmans H, Schurink-van 't Klooster TM, et al. Review of long-term immunogenicity following HPV vaccination: Gaps in current knowledge. Hum Vaccin Immunother. 2022;18(1):1908059. 2. Nicoli F, Mantelli B, Gallerani E, et al. Effects of the age of vaccination on the humoral responses to
a human papillomavirus vaccine. NPJ Vaccines. 2022;7(1):37. 3. Burger EA, Kim JJ, Sy S, et al. Age of acquiring causal human papillomavirus (HPV) infections: Leveraging simulation models to explore the natural history of HPV-induced cervical cancer. Clin Infect Dis. 2017;65(6):893–899. 4. Giuliano
AR, Lazcano-Ponce E, Villa L, et al. Impact of baseline covariates on the immunogenicity of a quadrivalent (types 6, 11, 16, and 18) human papillomavirus virus-like-particle vaccine. J Infect Dis. 2007;196(8):1153–1162. 5. Bednarczyk RA. Addressing HPV vaccine myths: Practical information for
healthcare providers. Hum Vaccin Immunother. 2019;15(7-8):1628–1638. HPV: Human papillomavirus.
 HPV VACCINATION
IS A BASIS
OF HPV-RELATED
CERVICAL CANCER
PREVENTION 1

1. Diaz M, Kim JJ, Albero G, et al. Health and economic impact of HPV 16 and 18 vaccination and cervical
Image for illustration purpose only cancer screening in India. Br J Cancer. 2008;99(2):230–238. HPV: Human papillomavirus.
 HPV VACCINATION IS ONE OF THE
KEY INTERVENTIONS AGAINST HPV

A first line of defense

against HPV infection and related
diseases1

Can help reduce the risk of HPV-related genital warts & certain HPV
related cancers by 80%–90% when all recommended doses have
been given2
HPV
VACCINATION
A cost-effective strategy in the long term to help
reduce the incidence of cervical cancer & related
mortality3

1. Kombe Kombe AJ, Li B, Zahid A, et al. Epidemiology and burden of human papillomavirus and related diseases, molecular pathogenesis, and vaccine evaluation. Front Public Health. 2021;8:552028. 2. American College of Obstetricians and Gynecologists. Human Papillomavi-
rus (HPV) Vaccination. Frequently asked questions. Available at: https://www.acog.org/womens-health/faqs/hpv-vaccination. Accessed on: 8 August 2022. 3. Arora S, Tuffaha H. Cost-effectiveness analysis of human papillomavirus vaccines for the prevention of cervical
cancer in India. Asia Pac J Clin Oncol. 2023;1–8. HPV: Human papillomavirus.
 HPV VACCINATION IS RECOMMENDED IN GIRLS
AGED 9 YEARS AND OLDER BY MAJOR NATIONAL AND
INTERNATIONAL MEDICAL ORGANIZATIONS

National Technical Advisory NTAGI WH

World Health
Group on O Organization6
Immunization1

Indian CDC
Centers for Disease
IAP
Academy of Control &
Pediatrics2 Prevention5

Federation of
American College of
Obstetric & FOGSI ACOG
Gynecological Obstetricians &
Societies of Gynecologists4
India3
1. Minutes of the Meeting of the National Technical Advisory Group on Immunization. Available at: https://main.mohfw.gov.in/sites/defaul/t/files/Approved%20Minutes%20of%20NTAGI%20meeting%20held%20on%20December%2019%202017.pdf. Accessed on: 12 September 2022. 2. Kasi SG, Shivananda S,
Marathe S, et al. Indian Academy of Pediatrics (IAP) Advisory Committee on Vaccines and Immunization Practices (ACVIP): Recommended immunization schedule (2020–21) and update on immunization for children aged 0 through 18 years. Indian Pediatr. 2021;58(1):44–53. 3. Bhatla N, Meena J, Gupta K, et
al. Human papillomavirus vaccination: Good clinical practice recommendations from the Federation of Obstetric and Gynecological Societies of India. J Obstet Gynaecol. 2020;46(9):1651–1660. 4. American College of Obstetricians and Gynecologists. Human papillomavirus vaccination: ACOG Committee
Opinion, Number 809. Obstet Gynecol. 2020;136(2):e15–e21. 5. Centers for Disease Control and Prevention. Human papillomavirus. Available at: https://www.cdc.gov/vaccines/pubs/pinkbook/hpv.html. Accessed on: 17 August 2022. 6. Human papillomavirus vaccines: WHO Position Paper 2022 update.
Available at: https://www.who.int/teams/immunization-vaccines-and-biologicals/policies/position-papers/human-papillomavirus-(hpv). Accessed on: 15 March 2023. HPV: Human papillomavirus.
 HPV VACCINES CURRENTLY AVAILABLE IN INDIA

QUADRIVALENT NINE-VALENT
HPV VACCINE1,2 HPV VACCINE1–3
(Contains HPV serotypes (Contains HPV serotypes
6, 11,16 6, 11,
and 18)1 16, 18, 31, 33, 45, 52
Quadrivalent HPV vaccine and 58)1
(4vHPV) is expected to help
prevent ~ 83% of cervical Nonavalent vaccine (9vHPV) is
cancers. expected to help prevent ~ 98%
of cervical cancers.

1. Indian Academy of Pediatrics. Questions and answers for parents–Human papillomavirus vaccines. Available at: https://iapindia.org/pdf/vaccine-information/HPV-VACCINE.pdf. Accessed on: 20 March 2023. 2. Cheng L, Wang Y, Du J. Human papillomavirus vaccines: An updated review.
Vaccines. 2020;8(3):391. 3. Oyouni AAA. Human papillomavirus in cancer: Infection, disease transmission, and progress in vaccines. J Infect Public Health. 2023;16(4):626–631.
Image for representation purpose only HPV: Human papillomavirus.
 IT IS ALWAYS SAID THAT PREVENTION IS
BETTER THAN CURE…
DID YOU KNOW THAT PREVENTION CAN
ALSO COST LESSER THAN CURE?

Cost of HPV
Cost of HPV
vaccination is less
vaccination is lower
than the current HPV- than nearly 1%
related cervical of the HPV-related
HPV-related cancer therapy cost3 cervical cancer
cervical treatment cost#,*
cancer
treatment
can cost in
lakhs.1,2

#vaccination before 15 years of age with Quadrivalent vaccine require only 2 dose compared to 3 dose after 15 years. *The cost of cancer treatment provided here is indicative only. Information provided herein is for information purpose only. Please consult
your doctor. 1. Elbasha EH, Dasbach EJ, Insinga RP. Model for assessing human papillomavirus vaccination strategies. Emerg Infect Dis. 2007;13(1):28–41. 2. Hu D, Goldie S. The economic burden of noncervical human papillomavirus disease in the United
States. Am J Obstet Gynecol. 2008;198(5):500.e1–e7. 3. Denny L, Prendiville W. Cancer of the cervix: Early detection and cost-eective solutions. Int J Gynaecol Obstet. 2015;131(Suppl 1):S28–S32. HPV: Human papillomavirus.
 HOW EFFECTIVE IS HPV VACCINATION?

HPV vaccination
can help reduce
the risk of HPV-related
genital warts and
certain HPV-related
cancers by ~80%-
90%1

1. Centers for Disease Prevention and Control. CDC CDC Reasons to get HPV Vaccine. Available at https://www.cdc.gov/hpv/parents/vaccine/six-reasons.html(Assessed on June 2023) HPV: Human papillomavirus.
 IS THE VACCINE SAFE?

The HPV vaccine is generally well

HPV tolerated.1
HPV Vaccination has helped save
Vaccinatio millions of lives from many HPV related
cancers & diseases in India over nearly 15
n HPV
VACCINE
years.2
No serious vaccine-related adverse experiences
have been reported in individuals receiving the HPV
vaccine.3
Some of the most commonly occurring side effects
are: injection site adverse events such as redness,
pain and swelling, headache and fever.3
However, these adverse events were mostly mild
Image for representation purpose only. to moderate in intensity.3
1. United Nations International Children's Emergency Fund. UNICEF. Closing the gap: UNICEF bolsters country efforts to increase HPV
vaccination. Available at http://www.nicef.org/supply/stories/cosing-gap-Unicef-bolsters-country-efforts-increase-hpv-vaccnation
(Accessed on June 2023) 2. MSD Data on file 3. Macki M, Dabaja AA Literature review of vaceine related adverse events reported from
HPV vaccination in randomized controlled trial. Basic Clin Androl. 2016 Nov 21;26:16. doi: 10.1186/s 12610.016-0042-7, PMID:
27895921; PMCID: PMCS5116857. Available at https://www:ncbi.nlm.nih.gov/pme/articles/PMC5116857/ (Accessed on June 2023) HPV: Human papillomavirus.
 WHY WAIT? VACCINATE TODAY!

HPV PREVENTION AND HPV VACCINATION

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Image for illustration purpose only HPV: Human papillomavirus.