Human papillomavirus (HPV) vaccinations can provide protection to both men and women against specific types of HPV. These HPV types can cause certain cancers (cervical, vaginal, penile, anal & mouth/throat) as well as genital warts. 

We can provide prescriptions for the Gardasil 9 vaccine via our online HPV vaccination service.

Is this vaccination service suitable for me?

This service is suitable for you if you:

• Are aged 17- 45 years old. You must be younger than 45 years at the time of the first vaccination in the course.
• Would like to request a prescription for Gardasil 9 (HPV 9) vaccination.

This service is not suitable for you if you:

• Are requesting this prescription for someone else (adult or child)
• Are younger than 17 years of age
• Are older than 45 years of age (at the time the first vaccination will be administered)
• Are pregnant, possibly pregnant or planning to become pregnant in the next 6 months
• Have had an anaphylactic reaction to any previous vaccination
• Have already completed a full course of HPV vaccinations
• Have a known bleeding disorder 
  • Examples include Haemophilia, Von Willebrand disease, Factor V/VII/X deficiency and Idiopathic thrombocytopenic purpura (ITP). If you are not sure, send us an email to info@careoncall.ie and we can advise you.

How does this service work?

When you complete the medical questionnaire, it will be reviewed by one of our Irish-registered doctors. Sometimes, further medical information is required by the doctor based on your answers. In this situation, the doctor will send you a message on your secure patient profile.

• You will receive a message on your profile to let you know if your prescription has been approved or declined.
• If your prescription is approved, it will be sent to your selected pharmacy via Healthmail (secure email) and you will be notified once your prescription has arrived in your pharmacy.
• You will then be sent a link to make an appointment at your pharmacy for the initial vaccination consultation.
  
  
  

Where can I get the HPV vaccine?

We can send your prescription to one of the pharmacies below:

*Please note: unfortunately, we cannot send prescriptions to a pharmacy that is not listed above at this time.

What will happen when I attend the pharmacy for my vaccination appointment?

This contains important information - please ensure you read this prior to making your appointment.

• You will need to bring valid photographic identification to all of your vaccination appointments. This will be checked by the pharmacist to ensure the details on your ID match the details on the prescription issued via this service.
• Your pharmacist will go over the specifics of the service with you and go over any relevant medical history.  They will discuss how the vaccination will be given and will give you the opportunity to ask any questions.
• If you have a fever on the day of your appointment, you may be asked to return when you’re feeling better.
• If everything is medically sound and you are willing to proceed, you will be given your vaccination. As it will be administered in your upper arm, please wear loose-fitting clothing or short sleeves.
• You will need to stay in the pharmacy for 15 minutes after your vaccination in case you experience any immediate side effects.

What happens next?

Your pharmacist will advise you on when to make your next appointment, depending on how many vaccinations you require.

Please ensure the information you provide is accurate so that we can ensure safe and appropriate prescribing. 

The information that you provide is treated with the same patient-doctor confidentiality as in a normal face-to-face consultation.

How much does the HPV vaccine typically cost?

Please find an approximate price guide below. Please note that prices may vary between pharmacies. Please also note that payment for your vaccinations is made when you attend your chosen pharmacy for administration of the vaccinations.

Vaccination Name: Gardasil 9
Price Per Dose (approx.): €185
Usual No. of Doses: Between 1 to 3*

*The number of vaccinations that you need to complete the vaccination course will be decided by your doctor

What is HPV?

Human papillomavirus (HPV) is very common and there are over 200 different types. We will all be exposed to it at some time or another. It affects the skin and mucous membranes i.e. mouth, throat, vagina, cervix, penis, anus. Most infections with HPV will not cause any harm.

HPV affects people in various ways and this is largely determined by the type of HPV virus they have been exposed to and if they have any significant medical conditions. HPV causes many conditions from benign skin lesions (verrucas and warts), to some cancers. Most infections do not cause any symptoms. HPV spreads very easily via skin-to-skin contact.

What exactly is genital HPV?

Genital HPV is the most commonly sexually transmitted infection (STI) in the world and can be passed between partners of any sex. If you are sexually active you can contract a HPV infection. This risk is present from the time of your first sexual encounter. 

Genital infection is usually spread via:

• Vaginal, anal or oral sex
• Touching the genital area
• Sharing sex toys
  
  
  

What is the difference between high-risk and low-risk genital HPV infections?

Genital HPV types are categorised according to their association with cervical cancer into low-risk and high-risk.

Low-risk HPV infection may cause warts around the genitals, anus, mouth or throat.

• These types of HPV are common sexually transmitted infections and are very contagious. The virus is passed on via skin contact even if there are no visible lesions. The virus remains for life and can flare intermittently. 90% of these infections are caused by HPV types 16 & 18.

Here is useful some information on genital warts.

High-risk HPV can cause certain cancer including:

• Cervical (most common cancer caused by HPV)
  • HPV is responsible for 99% of cervical cancers.
  • Seven types of HPV cause 89% of cervical cancers (These are 7 of the 9 HPV types in the Gardasil vaccine).
  • These cancers take many years to develop after first exposure to the virus. 

Here is some useful information on cervical cancer.

• Anal, oral/throat, vaginal/ vulval, penile (these are rare).
  • High-risk, persistent HPV infection can cause other cancers in men and women. Thankfully, these cancers are not as common as cervical cancer and there are often other risk factors involved.

There are 13 high-risk types of HPV for which you are tested when you get your smear test. These types are more likely to become persistent infections which means they are not cleared by your immune system.

As these infections usually cause no symptoms, you can be infected for years without knowing. When a high-risk HPV infection persists for many years, it can lead to the formation of abnormal cells. If these cells are not treated, they can get worse over time and may develop into cancer.

Is there a cure for HPV?

No, unfortunately a cure for HPV does not exist. If there was, there would still be the issue that most individuals are unaware they have it because there are no symptoms. Fortunately, the majority of HPV infections are managed by your natural immune defences; over 90% are cleared within 2 years. In some cases, your immune system may not be able to clear the HPV infection within this time. This is referred to as a “persistent infection”.

If your immune system is not working properly (immunocompromised) it may be more difficult to clear this virus. 

What increases my risk of getting HPV? 

Risk factors for developing HPV infection include:

• Having sex for the first time at 16 years or younger
• A higher number of sexual partners
• Your partner’s prior sexual history
  
  
  

What vaccine is available to protect against HPV infection?

The HPV vaccine is called Gardasil 9. It protects both males and females against 9 types of HPV infection (types 6, 11, 16, 18, 31, 33, 45, 52, & 58).

The vaccine works by triggering the immune system to produce antibodies to these types of HPV so that any potential infection can be managed effectively by the individual, but it also helps to prevent viral spread. The greater the numbers of people vaccinated, the greater the impact on potential exposure and spread. 

Gardasil 9 is an inactive vaccine (there are no live viruses in this product). It does not cause HPV infection. 

Can I get this vaccination at any time? 

For maximum benefit, it is advised that Gardasil 9 vaccine is administered before any type of  sexual encounter happens. However, you are likely to benefit from vaccination if you are sexually active, even if you have already been exposed to HPV, as it is unlikely you will have been exposed to all types 9 of HPV in the vaccination, so you will gain protection against these. 

Can I protect myself against HPV infection?

• If you have close contact with other people, it is impossible to completely protect yourself against getting HPV infection, but there are precautions you can take to decrease your chances of developing a persistent infection.  
• Get vaccinated: the Gardasil 9 vaccine protects against 9 of the high-risk HPV infections.
• Practice safe sex: barrier protection (e.g. condoms, dental dams) reduces the chance of contracting HPV infection. However, this is not completely effective at reducing viral transmission as the virus can be present on all areas of skin, not just the area covered, It is spread by close contact of all types, not just sexual intercourse.  
• Stop smoking: it reduces your ability to fight infection making it harder to clear any HPV infections. 
  
   

Can I get this vaccine from the HSE?

The HPV vaccination is included in the National School Immunisation programme. Gardasil 9 is offered to all children aged 12-13 years of age.

If a child declined or missed the vaccination at that time, there is a catch-up vaccination programme. This is for unvaccinated people less than 25 years of age. It is also available through the HSE for men who have sex with men (MSM) less than 45 years of age.

You may be eligible for a free vaccination through your local sexual health clinic if you:

• Have HIV and are  26 years old or younger (male and female)
• Are a man who has sex with other men (MSM) and are 45 years old or younger

See here for additional information on HPV.

How many doses of vaccine do I need to be considered fully vaccinated? 

To get the best protection, it is very important that the full course of vaccination is completed.

Current guidelines for full vaccination (updated November 2022):

• One dose of vaccine if you are under 25 years old
• Two doses of vaccine if you are 25 years of age or older (The 2nd vaccine is to be given 6-12 months after the 1st vaccination)
• Three doses of vaccine if you have a weak immune system,regardless of your age
  
  
  

If I have already started a course of HPV vaccinations, can I still complete the course?

If you have already started your HPV vaccination course before these guidelines were updated, you can:

• Complete the vaccination course that you started*
• Use the new guidelines to guide your vaccination requirements**

*Previously the guidance for full vaccination was as follows:

• If you received your first dose of the vaccine before 15 years of age, you needed a total of 2 vaccination doses
• If you received your first dose of the vaccine at 15 years or more, you needed a total of 3 vaccination doses

**You are considered fully vaccinated if you are:

• Under 25 years of age and have received one dose of the vaccine
• 25 years of age or older and have received 2 doses of the vaccine
• If you are immunocompromised, the guidance has not changed, you require 3 doses of the vaccine regardless of your age
  
  
  

I have been fully vaccinated with a different HPV vaccine. Can I have a course of Gardasil 9?

If this is something you are interested in, please speak to your doctor or local sexual health clinic. Revaccination (with Gardasil 9 vaccine) of those who have completed a series with another HPV vaccine is not routinely recommended and this decision is made on a case by case basis.

Can I get Gardasil 9 vaccine if I’m immunocompromised?

If you are immunocompromised, you should consider getting the HPV vaccination, as your ability to clear the HPV infection may be impaired. This could put you at risk of developing a persistent HPV infection.

The decision should be made based on your risk of acquiring this infection, and the possibility that you may not develop an adequate protective response from the vaccination.

If you have any questions about this, please speak to your doctor or one of our GPs via online video consultation.

What are the  potential side effects of Gardasil 9 vaccine?

Gardasil 9 vaccine is considered to be a very safe vaccine. Side effects are not common, and when they do occur are usually mild.

Anaphylaxis is a potentially very serious side effect but thankfully this is considered to be very rare (one case for every 1 million vaccinations administered).

These common side effects will usually resolve within 1-2 days:

• Localised : 
  • Sore/ red/ swollen at the site of injection 
• Generalised:
  • Fever (>38°)
  • Headache
  • Dizziness
  • Nausea
  • Fatigue

There is no scientific evidence linking HPV vaccination to long-term medical conditions, such as Chronic Fatigue Syndrome, postural orthostatic hypotension or chronic regional pain syndrome.

Here is more detailed information on the HPV Vaccine.

If you feel ill or have any concerns after receiving your vaccination, you should seek medical attention immediately.

Does this vaccine provide life-long protection?

Studies to date have shown HPV vaccination is effective for at least 14 years. There is no evidence of decreasing immunity over time. It is anticipated  that Gardasil 9 vaccine will provide long-term protection.

Do I need to continue to have my smear test if I am fully vaccinated?

Yes! It is extremely important to attend your cervical smear tests when they are due even if you have been fully vaccinated. This is because: 

• No vaccination is 100% effective. Not everyone will have an appropriate immune response to the vaccine.10-30% of cervical cancers are caused by HPV types not included in the vaccine.
• If you were exposed to one of the 9 high risk HPV types in the vaccine before you were vaccinated, you will not gain any protection against this type from the vaccination. In Ireland, the cervical check smear programme tests for high risk HPV types. If these are present, then you will be monitored more frequently. If you have any symptoms that you are worried about, such as bleeding after intercourse or unexpected bleeding between periods, please speak directly with a doctor.

Here is more information on smear tests and HPV testing.

Important information about the HPV vaccination

• You will only gain protection against the 9 types of HPV in Gardasil 9. This vaccine is being given to protect against specific high risk types of HPV. It is not a treatment for active infection or existing disease. Like all vaccinations, it is not 100% effective. 

Here is more information on HPV and the vaccine, HPV (human papillomavirus), and the HPV vaccine.

What does the HPV Gardasil 9 vaccine contain?

The following ingredients are contained in the Gardasil 9 HPV vaccine:

• Sodium Chloride
• L-histidine
• Polysorbate
• Sodium borate

You cannot have this vaccine if you are allergic to any of the above ingredients.