Vaccination against HPV

The aim of this leaflet is to inform patients about the nature of HPV and HPV vaccination.

Human papillomavirus (HPV) is a common virus transmitted from person to person. HPV can cause precancerous conditions and malignant tumours in the genital, oral and throat regions as well as genital warts (condylomas) and, very rarely, respiratory papillomatosis (benign tumours in the airways).

HPV is spread through skin-to-skin contact, including sexual intercourse, oral sex, anal sex or other contact in the genital area. Both women and men can become infected. 75–80% of sexually active adults will contract HPV in their lifetime. Most women and men are first infected with HPV between the ages of 15 and 25. In most cases, a HPV infection does not cause any symptoms and resolves on its own within two years.

Persistent HPV infection can cause cellular changes that can develop into malignant tumours. HPV can cause anal cancer and cancers of the mouth and throat, penile cancer in men and cervical, vulvar and vaginal cancers in women.

The most common cancer caused by HPV is cervical cancer.

In 10–20% of women, the HPV infection persists for more than two years, increasing the risk of cervical cell changes or dysplasia and cervical cancer. This is why it is important to regularly see a gynaecologist if you have cervical dysplasia.

You can get vaccinated against HPV. Vaccination does not eliminate the risk of HPV-related cancer but significantly reduces it.

There are more than 100 HPV types, about 15 of which cause cervical cancer.

About 90% of genital warts are caused by HPV types 6 and 11. These types are low risk and do not usually cause cervical cancer.

HPV types 16 and 18 are high-risk, causing the majority (around 70%) of cervical cancers, 90% of anal cancers and the majority (80–90%) of vaginal, vulvar, oral and throat cancers.

HPV types 31, 33, 45, 52 and 58 are also high-risk, causing around 19% of cervical cancers.

For HPV vaccination, we use the Gardasil 9 vaccine, which provides protection against nine types of HPV (6, 11, 16, 18, 31, 33, 45, 52 and 58).

HPV vaccination for 12–18 year olds is included in the national immunisation schedule and consists of one dose. The vaccine is nationally funded, meaning it is free of charge for young people. In most cases, young people aged 12 to 18 are vaccinated against HPV by school nurses, but it is also possible to receive the vaccine through a family doctor or at a midwife’s appointment at East Tallinn Central Hospital. Written parental consent is required for vaccination of a minor. When coming to a midwife’s appointment, the parent can sign the consent at the appointment.

For adults aged 18 and over, the HPV vaccine may be given in either two or three doses. A gynaecologist or midwife will advise on whether two or three doses are needed. In the three-dose schedule, the vaccine is injected into the muscle over six months. In the two-dose schedule, the second dose is given six months after the first.

For people over 18, HPV vaccination is a paid service according to the price list of the healthcare institution. To get vaccinated, you can go to a midwife at East Tallinn Central Hospital, to vaccination centres in other healthcare institutions or to your family doctor.

The vaccination does not require a gynaecological examination or cervical cancer screening (HPV or PAP test).

The vaccine is more effective if administered before sexual activity begins. Therefore, it is recommended to begin vaccination as early as possible, ideally at age 12.

HPV vaccination can cause mild redness, tenderness or swelling at the injection site, fatigue, fever, chills, headache, dizziness and nausea. HPV vaccines do not have any known long-term side effects. Vaccination is not recommended during pregnancy as its safety for the foetus has not been proven.

As no vaccine is 100% effective and does not protect against all types of HPV or pre-existing HPV infection, it is still important to undergo routine cervical cancer screening, either a HPV or a PAP test. HPV vaccines do not provide protection against other sexually transmitted infections. The vaccine does not treat existing HPV infections or HPV-induced cell changes in the cervix.

ITK1195

Approved by the decision of the Medical and Nursing Care Quality Commission of Aktsiaselts Ida-Tallinna Keskhaigla on 12.November 2025 (Protocol No. 2.2-8/8-25)