Can a person with CIN1 still receive the nine-valent vaccine?
Hello Dr.
Tsao, I received the quadrivalent vaccine 7-8 years ago and I am now 32 years old.
I just had my first Pap smear, which showed abnormalities, and I tested positive for HPV type 58.
A biopsy revealed CIN1, with some areas showing mild CIN2.
The doctor advised me to have another Pap smear in three months to monitor the situation before deciding whether to proceed with a larger biopsy.
I would like to know if my current condition makes me a suitable candidate for the 9-valent vaccine.
Additionally, since my partner and I have not had children yet and we plan to conceive in the next couple of years, will a cone biopsy affect my future pregnancy?
Jiegeng, 30~39 year old female. Ask Date: 2016/10/29
Dr. Cao Guotao reply Obstetrics and Gynecology
Hello, the primary function of vaccines is preventive; their effectiveness is reduced if administered after infection.
Wishing you good health.
Reply Date: 2016/10/29
More Info
When considering the safety and appropriateness of receiving the 9-valent HPV vaccine (Gardasil 9) in the context of a diagnosis of CIN1 (cervical intraepithelial neoplasia grade 1), it is essential to understand both the nature of the vaccine and the implications of your current cervical health status.
Firstly, the 9-valent HPV vaccine is designed to protect against nine types of HPV, including those most commonly associated with cervical cancer (types 16 and 18) and genital warts (types 6 and 11). The vaccine is most effective when administered before any HPV exposure, which is why it is typically recommended for preteens and young adults. However, it can still provide benefits even after exposure to HPV, as it can protect against types of HPV that the individual has not yet encountered.
In your case, since you have already been diagnosed with CIN1 and have a history of HPV infection (specifically type 58), the vaccine may still be beneficial. While it won't treat existing lesions or infections, it can help prevent further HPV infections and potentially reduce the risk of progression to higher-grade lesions or cervical cancer in the future. The vaccine is generally considered safe for individuals with a history of HPV-related conditions, including those with CIN1. However, it is crucial to discuss this with your healthcare provider, who can consider your specific medical history and current health status.
Regarding your concern about future pregnancies and the impact of a cone biopsy (if it becomes necessary), it is important to note that while cone biopsies can affect the cervix, many women go on to have healthy pregnancies afterward. The extent of the procedure and individual health factors will influence outcomes. Your healthcare provider will monitor your cervical health closely and can provide guidance on the best course of action to minimize risks to future pregnancies.
As for the likelihood of progression from CIN1 to cervical cancer, it is generally low, especially in the absence of persistent high-risk HPV types. Many cases of CIN1 resolve on their own without treatment, particularly in younger women. Regular monitoring through Pap smears and HPV testing is essential to ensure that any changes in cervical health are detected early.
In summary, receiving the 9-valent HPV vaccine while diagnosed with CIN1 is generally considered safe and may provide additional protection against other HPV types. It is crucial to maintain regular follow-up appointments with your healthcare provider to monitor your cervical health and discuss any concerns regarding future pregnancies and treatment options. Always consult with your healthcare provider for personalized advice tailored to your specific situation.
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