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My daughter's school wants to vaccinate against STIs, is she too young?


Dr Nina Byrnes

Dr Nina Byrnes

Dr Nina Byrnes

My daughter is due to get vaccinated against the human papilloma virus in school soon. I don't fully understand what this vaccine is for.Why does she need it? Is it necessary to give it now and is it important to have?

DR NINA: Human Papilloma Virus (HPV) is a group of viruses that cause infection of certain parts of the body. These include the throat, anus, cervix, vagina and external genitalia. HPV is one of the most common sexually transmitted infections we know and it is estimated that most people come in contact with this virus within 18 months of commencing sexual activity.

There are over 100 different types of HPV. Most are harmless but certain types are known to be associated with cancers of the area they infect. Types 16 and 18 are considered high risk and are known to increase the risk of cancer of the cervix and throat. Types 6 and 11 are low risk and are associated with the development of warts.

Most people are not even aware they have been infected with the virus and 90pc of those infected will clear the virus within two years. It isn't clear why some clear the virus and others don't but smoking definitely increases the risk of prolonged infection.

Those who are infected with the virus can pass it on even if they have no symptoms. The virus is spread through direct contact with the infected area, usually through skin to skin contact, kissing or oral, anal or genital sexual contact. You can have the HPV virus for years and be unaware of this.

It isn't unusual for someone to develop changes or warts years after being in touch with the virus. This can cause upset in a relationship as some are concerned there has been a recent infidelity. This isn't necessarily the case.

The only way the virus can be diagnosed is through direct testing or if genital warts appear. Women who are found to have HPV with abnormal smears are at a higher risk of developing cancer of the cervix and do need closer screening. Until recently the only way to prevent cervical cancer was through regular cervical screening. A national screening programme was introduced in 2008. This invites all women aged 25 to 60 to attend for smears every three years from the age of 25 to 45 and every five years from 45 to 60.

Since 2010 we also can give vaccines which can prevent infection with certain strains of the HPV virus which will further reduce the incidence of cervical cancer in Ireland.The vaccine is currently offered to girls in first year in secondary school. The vaccine is most effective when given to those who are not yet sexually active which is why this age group have been selected.

Vaccination is currently only offered to girls in Ireland but in other countries it is also offered to boys in school as it is felt it will help reduce transmission of the virus and prevent against genital warts. International recommendations also recommend vaccination of men who have sex with men.

The vaccine can prevent seven out of 10 cases of cervical cancer. It is safe and well tolerated. The most common side effect is soreness at the injection site which is usually mild and short lived.

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There aren't many cancers that we can vaccinate against and unfortunately cancers of the throat, cervix, anus and genitalia are still a cause of death in our country. In this instance it is certainly true that vaccination saves lives.

My child's crèche informed me that they have had an outbreak of winter vomiting bug

I've only ever heard of this before in hospitals. Is it a serious illness, what do I need to watch for?

DR NINA: Winter vomiting bug is caused by a group of viruses called noroviruses. They are more common during winter months but can occur any time of year. Norovirus are the most common cause of vomiting bugs in Ireland. It is thought to affect up to 20,000 people a week here during peak season.

Norovirus causes inflammation of the stomach, intestines or both. This results in abdominal pain, nausea, vomiting and diarrhoea which often comes on quite suddenly. You may also have a fever, headache and body aches and pains. Most people recover within one to three days. Those with severe illness are at risk of dehydration. Children and the elderly or those with other illnesses are especially at risk. Signs of dehydration include dark or reduced urine, dry mouth and lips, dizziness, headache, unusual tiredness.

There is no need to seek medical treatment for a mild norovirus. The most important thing to do is to ensure you stay hydrated. Drink plenty fluids in order to replace those lost through diarrhoea and vomiting. Take paracetamol if you have fever. If you feel like eating, try bland easily digested foods. If symptoms are going on more than three days, you are unable to consume fluids or have any symptoms of dehydration you will need to seek medical help.

Norovirus is extremely contagious and spreads easily among those in close contact. Those who are infected should stay out of work, school or crèche until at least 48 hours after the last vomiting or diarrhoea episode. As the virus can remain present in stool for up to two weeks after infection, it is also important to remain extremely vigilant about hand hygiene and to avoid swimming pools for this time.


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