Human papillomavirus (HPV)

HPV infection can cause cancer in men and women. Immunisation is free for everyone age 9 to 26 inclusive.

HPV stands for human papillomavirus, a group of very common viruses that infect about four out of five people at some time in their lives.  HPV causes cells to grow abnormally, and over time, these abnormalities can lead to cancer.



HPV immunisation protects against infection from the types of HPV that cause most cervical, anal and genital cancers, as well as some mouth and throat cancers.

For those aged 9 to 14 years, HPV vaccine is provided as two doses in the upper arm, spaced at least six months apart. This age group develops a stronger immune response than those vaccinated when they are older, which is why it is recommended for both boys and girls at age 11 to 12. Those beginning vaccination at age 15 or older will need three doses. The immunisation is expected to provide long-lasting protection, well into adulthood.

[Hinetaapora] Hi! I’m Hinetaapora. I’m going to talk to you about being immunised against HPV.

That's short for human papillomavirus.

A group of viruses that can live in skin cells

They’re passed on in different ways through skin to skin contact and they’re pretty common. Did you know, four out of five people get them in their teenage years? Most of the time you wouldn’t even know that they’re there and they usually go away on their own.

But sometimes they hang around, and then they can be really nasty.


[Ella] Oh, hi Hinetaapora, how can I help?

[Hinetaapora] I would like to know about the HPV immunisation.

[Ella] Well we give you this HPV immunisation, at school, about age 12 because we know that’s the best time for you to be protected. This is the age where you produce the best antibodies after your vaccinations.

Most people will be infected with HPV at some point in their lives. This can lead to genital warts, and for a few, this can cause cancer, especially cervical cancer.

More than 50 women in New Zealand die of cervical cancer every year, and lots more need hospital treatment.

[Hinetaapora] Right, so it’s pretty serious.

[Ella] It is.

[Hinetaapora] Is it just girls who can get HPV?

[Ella] No, boys get it too. They don’t get cervical cancer, but they can get cancer in other parts of their body if they get infected.

[Hinetaapora] So how does Immunisation work?

[Ella]  The immune system protects us against germs by making special blood cells and antibodies.

The first time your body meets a germ, your body takes time to make the blood cells and antibodies to fight off that germ.

It’s during this time that the germs can sometimes make you unwell. But a healthy immune system will eventually fight off the germs.

Once your immune system has encountered a germ, it can recognise it the next time it sees it. Your immune system is able to fight off the germs before you become unwell. This is called immunity.

HPV immunisation works by making your body recognise the most common kinds of HPV that can cause cervical cancer and genital warts. The HPV vaccine contains little particles that look the same as some of the particles on the outside of the real virus.

Because they are only particles and not the real virus you can’t get HPV from the vaccine. They’ll just help your immune system fight the HPV virus in the future.

[Hinetaapora] I’ve heard some kids can react badly to an injection.

[Ella] Hardly ever but it can happen.

You probably won’t have any side effects at all.

A few people feel a little dizzy, sick or get a fever or headache after their vaccination. This is normal, and should get better on its own.

[Ella]  There are things you can do to help.

Make sure you have breakfast or lunch before your injection. Even a snack before or afterwards will help stop you feeling faint. 

The injections are done in your upper arm, so wear a loose shirt, preferably with short sleeves.

Take things easy afterwards. Your nurse will keep an eye on you after the vaccination and will provide you with all the advice you need.

If you’ve reacted badly to an injection before, or even if you’ve just been ill lately, somebody in your family should ask the doctor or practice nurse if it’s OK for you to have the immunisation.

If you have asthma, allergies, or you’re getting over something not too serious like a common cold, you can still be immunised. Your parents can talk to the nurse if they would like more information.

But the important thing is that the benefits of immunisation are huge compared to the risks.

[Ella] It will take 2 injections a few months apart to be fully protected.

In very rare cases a problem can occur. But we nurses are trained to deal with it and, as I said, problems are very rare indeed.

They’re covered off in the form you will get to take home.

[Hinetaapora] So once you’ve been immunised. You’re covered right?

[Ella] Actually, that’s not the end of the story.

When girls become adults, they should get a smear test done every few years. This is another way to protect against the risk of cancer.

[Hinetaapora] So to get immunised, kids need to get the form signed, right?

[Ella] That’s right Hinetaapora. We can’t immunise any kid before the parents or guardians let the nurses know whether or not you can have the vaccines.

We’re handing these out to all kids to take home.

It has everything they need to know.

It has to be filled in, signed and brought back to school before we can do your immunisation.

Tell your parents to fill in Section A to get the immunisation done at school or Section B if they don’t want you to get it.

Either way, they must sign the form, and you have to bring it back to school.

But if your parents or guardians aren’t sure about anything, don’t worry.

They can talk to me or any school nurse, the doctor or the practice nurse.

They can even watch this video for themselves – online at

[Hinetaapora] You want to keep yourself healthy, right? Get your parents to sign the form so you can be immunised against HPV.


Four out of five people become infected with HPV at some time in their lives. The peak incidence of HPV infection is between the ages of 16 and 20. 

HPVs infect the deeper layers of the skin and internal passages such as the the cervix (at the lowest part of the uterus and at the top of the vagina), genital area and the mouth.

Usually HPV infections get better on their own.  Some HPV infections don’t get better and over time cause abnormal cells to grow. If these cells go undetected (for example, by cervical screening) and untreated, over time, usually many years, they can lead to cancer.

The types of HPV that can cause cervical cancer and genital warts are spread through intimate skin to skin contact (not just sexual intercourse).  Types 16 and 18 are responsible for around 70 percent of HPV-related cancers, and types 31, 33, 45, 52 and 58 are responsible for about a further 20 percent.

Genital warts are caused by low-risk types of HPV (6 and 11) and are not associated with cervical cancer. Genital warts are the most commonly reported sexually transmitted viral infection in New Zealand, but rates among young women and men have fallen significantly since HPV immunisation was introduced in 2008.


Immunisation, safer sex, and regular cervical screening are the most important ways to prevent diseases caused by HPV. Condoms may not completely eliminate the risk of HPV infection because the virus can be contracted through skin-to-skin contact beyond the covered area. 

Women who have had the HPV immunisation still need to have regular cervical screening. The vaccine doesn’t protect against all the types of HPV that can cause cervical cancer or other sexually transmitted diseases.

Where to get immunised


The HPV vaccine is provided to children in school year 8 through most schools. If the HPV vaccine is available through your school, a consent form will come home from school.  The HPV vaccine will only be given at school if the consent form is completed, signed and returned to school.

Participating schools may provide the district health board or public health nurse with specific information about their students (such as names, addresses, dates of birth, ethnicity and room numbers) to help with the administration of school based immunisation.

Information from the consent form and details of each immunisation given or declined will be recorded on the School-Based Vaccination System (or another system held by your district health board) and some of it will be passed to the National Immunisation Register.

Other places to get immunised

The vaccine is also available free from family doctors, local health clinics and some Family Planning clinics for those who are no longer at school, who do not attend a participating school or who do not want to have it at school.

If you are not eligible for free immunisation, you may be able to purchase the vaccine.  Your family doctor or local health clinic can advise about costs and whether the vaccine is clinically appropriate for you. 3 doses will cost about $500.00.

About the HPV vaccine

Gardasil 9 is the HPV vaccine included in the New Zealand Immunisation Schedule from 2017. 

Gardasil 9 was approved in New Zealand by Medsafe in 2016.  The Consumer Medicine Information and Datasheet are available to read on the Medsafe website.

How the HPV vaccine works


The vaccine has been shown to be very effective in preventing infection from the types of HPV it targets.

Length of protection

Protection is expected to be long lasting. As studies are ongoing, the exact period of protection is unknown. So far, they show that more than 10 years after immunisation, protection from HPV infection remains high with no sign of weakening.

Studies have also shown evidence of ‘immune memory’ which indicates protection may be life-long. Similar results were seen with studies of the hepatitis B vaccine, where long-term immunity is internationally accepted.

The Ministry of Health is continuing to monitor international research on the duration of protection from the vaccine.

What’s in the vaccine

The vaccine contains tiny virus-like protein particles that mimic HPV but cannot cause infection.

There is no virus in this type of vaccine – you cannot become infected with HPV when you have the vaccine.

Each 0.5 ml dose of the vaccine also contains a small amount of aluminium, which stimulates the immune response. Aluminium has been safely and effectively used in vaccines for more than 70 years.

The vaccine also contains tiny amounts of sodium chloride (salt), L-histidine (an amino acid), Polysorbate 80, sodium borate and sterile water.

The vaccine does not contain preservatives, antibiotics or any human or animal materials.

After vaccination, the body quickly starts making antibodies that protect against the types of HPV the vaccine targets.

People who should not receive the vaccine

The vaccine should not be given to anyone who has had a life-threatening reaction (hypersensitivity or anaphylaxis) to any component of the vaccine or has had a reaction to the previous dose of the vaccine. 

Anyone who has a bleeding condition or an immune disorder should talk to their doctor or nurse before having the HPV vaccine.

The safety of HPV vaccine in pregnancy is unknown. Published data has not found any safety concerns among pregnant women who have been inadvertently vaccinated.

Possible reactions

Reactions experienced following the HPV immunisation are similar to those from other vaccines.

As with all immunisations, people may have a sore arm and get redness, pain and swelling at the injection site.

Other less common reactions include vomiting or fainting. These can follow any immunisation and people should remain seated for 20 minutes (to reduce the risk of injury from falling if they faint).

It’s also a good idea for people to eat breakfast and lunch and avoid excessive exercise on the day they receive the immunisation.

Other possible reactions that can occur, usually within 1–2 days, include:

  • a fever (feeling hot)
  • headache
  • general discomfort (feeling unwell, aches and pains)
  • skin reaction, rash.

Very rarely, a serious allergic reaction (like a peanut allergy) called anaphylaxis occurs, usually within 10 minutes of immunisation. Anaphylaxis can occur with any medicine or vaccine.

Based on clinical studies and experience from overseas we can expect around 3 anaphylactic reactions per 1 million doses of vaccine administered. This is similar to the rates for other vaccines given to children and adolescents.

If anaphylaxis does occur, it can be treated. For this reason, children are asked to wait for 20 minutes after immunisation. Every vaccinator is trained and equipped to deal with such a reaction.

If you’re concerned about reactions

If you have concerns about reactions following the immunisation, contact the nurse or your general practice.

It is important you tell the nurse or doctor if there have been reactions to any previous immunisations, before having the HPV immunisation.

It is also important to report any unexpected side effects following immunisation as there is ongoing monitoring of the safety of the vaccine.

As vaccines are given to large numbers of people in a population, many events occur around the same time as a vaccine is delivered. This does not necessarily mean the vaccine was the cause of the events.

Both international and New Zealand safety monitoring databases record and monitor events to assess whether they are likely to have been caused by the immunisation or whether they were simply chance associations in time.

To date the only known very severe side effect associated with the HPV vaccine is immediate allergic reaction (anaphylaxis) in rare cases. International regulators are continuing to monitor and watch for any very rare possible events following immunisation.

Reactions that occur after being given a vaccine in New Zealand are reported to the Centre for Adverse Reactions Monitoring (CARM) at the University of Otago by health professionals, or members of the public can report directly.

If you are unsure whether a symptom is related to the vaccine, discuss this with the nurse or your doctor.


The vaccine’s safety profile is well documented.

The safety and effectiveness of the vaccine have been assessed against international guidelines and the requirements of the Medicines Act 1981.

HPV vaccines has been approved for use in more than 125 countries, including Australia, the USA, Canada and the European Union. More than 165 million doses of HPV vaccine have been distributed worldwide.

The World Health Organization’s Global Advisory Committee on Vaccine Safety has been reviewing the safety of HPV vaccines since they were first licensed in 2006, and have concluded that they have good safety profiles.

In this section

  • Information about the extension of HPV immunisation to boys and young men in 2017, and changes to the vaccine used. Read more
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