Community Immunisation Service IMPORTANT INFORMATION Human Papillomavirus (HPV) vaccination to protect against cervical cancer School year 8 GIRLS ONLY COMMUNITY IMMUNISATION TEAM IN SCHOOL TUESDAY, 13 TH SEPTEMBER
Please review the enclosed information and return the consent form to school within one week of receiving it using the envelope provided.
From: Community Immunisation Service Leicestershire Partnership NHS Trust, Families, Young People and Children s Services Bridge Park Plaza, Bridge Park Road, Thurmaston, Leicester, LE4 8PQ If you require help understanding the contents of this envelope, please telephone 0116 295 4743.
September 2016 Dear Young Person and Parent / Carer, Human Papillomavirus (HPV) vaccination to protect against cervical cancer As part of the national vaccination programme we are offering girls in school year 8 (aged 12 to 13 years) the Human Papillomavirus (HPV) vaccination in school. This vaccination offers protection against high risk HPV types 16 and 18, which can cause cervical cancer. Please find enclosed a leaflet with further information about the vaccination. For information about the national vaccination programme, visit: www.nhs.uk/conditions/vaccinations You will need to fully complete the enclosed consent form and return it to school using the envelope provided, within one week of receiving it. Forms not fully completed may result in the vaccination not being given. The HPV vaccination is a two dose course and is offered to girls aged 12 to 13 years (school year 8). It is important to receive the vaccinations at this age as it gives the best protection. The vaccine will be given as an injection in the upper arm. The vaccine has been found to be very effective and has been widely used worldwide. Leicestershire Partnership NHS Trust s Community Immunisation Service will be giving the vaccine in school. The team regularly deliver vaccinations in schools and in GP surgeries. You will be informed of the vaccination date by your school. These dates are also available on our website, visit: www.leicspart.nhs.uk/communityimms Where young people are absent, the team will revisit schools and will offer additional opportunities for vaccination. Please note this vaccine will not be routinely offered by your GP. The vaccine used in the HPV vaccination programme does not contain gelatine or alcohol. We have also developed a website for young people aged between 11-16 years. The website offers health advice through interesting articles, films and interactive content. This includes a short animation about the rumours and facts behind the HPV vaccine. You can watch this film by visiting: https://www.healthforteens.co.uk/health/immunisation/video-5- rumours-about-the-hpv-vaccine/ Should you have any questions you can contact the team, by telephone: 0300 300 0007, or by e-mail: communityimms@leicspart.nhs.uk, for further information visit: www.leicspart.nhs.uk/communityimms Yours faithfully, 2016-5-B-v1.0 Page 1 of 2
Dr Tim Davies Consultant Lead for Screening and Immunisation NHS England Central Midlands Helen McCreery Immunisation Service Manager Leicestershire Partnership NHS Trust NHS Choices website allows information to be translated into the following languages: Arabic, Bengali, Czech, Farsi, French, Greek, Gujarati, Italian, Kurdish, Pashto, Polish, Portuguese, Punjabi, Somali, Spanish, Tamil, Turkish and Vietnamese. NOTES ON COMPLETING THE CONSENT FORM Please discuss and complete the form fully with your daughter using BLOCK CAPITALS using black or blue ink. PART 1: Patient Information and Contact Details Your daughter s NHS number: If you are registered with a GP practice you will already have this number. It is a 10 digit number which is unique to every indivudal and can be found on their medical card. It can also be found on any letter from the NHS, any prescription and on every child s red book my personal child health record. PART 2: Consent Declaration Parents/Carers should complete the first section of the consent box, signing to give consent to the full course of HPV vaccinations. Your daughter should complete the second section of the consent box and sign to give consent to the full course of HPV vaccinations. Your daughter may be able to consent for herself to have this vaccination without your agreement and health professionals will assess her ability to make an informed decision. Sharing information: After our team has vaccinated your daughter at their school, the information will be added to their NHS health records. 2016-5-B-v1.0 Page 2 of 2
Human Papillomavirus (HPV) Vaccination Consent Form For girls aged 12-18 years old Important information: Please read the accompanying information before completing this form. It is important to receive the vaccinations at this age as it provides the best protection against cervical cancer. We aim to complete the full two dose vaccination course during school year 8. If your daughter is late in starting her vaccination course, i.e. 15 years of age or over, she will require a three dose course which is given within 12 months. This vaccination will not be routinely offered by your GP. Please discuss this vaccination with your daughter before completing this form and returning it to her school. Your daughter can consent for herself without your agreement and health professionals will consider her ability to make this decision. The vaccine used in the HPV vaccination programme DOES NOT contain gelatine or alcohol. Please complete this form fully using BLOCK CAPITALS and black/blue ink. PART 1: Patient Information and Contact Details Daughter s Surname: NHS Number: Daughter s First Name: Date of Birth: Home address: Name of School: Postcode: School year: Class: Contact number for parent: Has your daughter had the HPV vaccinations before? (delete as appropriate) Yes / No If yes, please provide dates and the vaccine name: Does your daughter have any needs or a disability that will require additional support during vaccination? If yes, please provide details: Yes / No PART 2: Consent Declaration (complete only ONE part below) I have read and understood the information given to me about the HPV vaccine. I understand that information provided will be added to my NHS health records. FOR PARENT / CARER TO COMPLETE YES, I CONSENT to my daughter receiving the full course of HPV vaccinations. FOR PARENT / CARER TO COMPLETE NO, I DO NOT CONSENT to my daughter receiving the full course of HPV vaccinations. OFFICE USE ONLY Parent s name:.... Parent s name:.... Parent s signature:.... Parent s signature:.... Date:..... FOR YOUR DAUGHTER TO COMPLETE Date:..... FOR YOUR DAUGHTER TO COMPLETE Daughter s signature:.. Daughter s signature:.. Date:..... Date:..... Reason for no consent: Gardasil Dose 1 Dose 2 Dose 3 if applicable Name of vaccinator, signature and date Batch no. Exp. date Site on arm left / right upper / lower left / right upper / lower left / right upper / lower Venue S C H S C H S C H Inputted Date Initials Date Initials Date Initials Scanned Date Initials Date Initials Date Initials 2016-5-C-v1.0
Your questions about the HPV vaccination answered I missed my vaccination, can I still have it? Yes. If you missed either of your vaccinations, for whatever reason, you should speak to your nurse or doctor about making another appointment. It s best to make your appointment as soon as possible after your original one. The most important thing is to have both doses it s never too late to catch up. My older sister had three doses, why am I only getting two? Since the HPV vaccination programme started in the UK in 2008, the vaccine has proved to be very effective. Studies conducted since then suggest that two doses of the HPV vaccine will provide excellent, long-lasting protection for young girls and so countries, such as Switzerland, have moved to this new schedule. From September 2014, the HPV vaccination programme in the UK will consist of two doses of HPV vaccine. What if I have not had my first HPV vaccine by the age of 15? If you have not had any HPV vaccine by the time you are 15 years old you will need three doses to have full protection. This is because the response to two doses in older girls is not quite as good, so to be on the safe side you should have three doses, with the second dose given around a month after the first dose, and a final dose given around six months after the first dose. You should speak to your nurse or doctor about making an appointment as soon as possible. What if I have had the first two doses of the old three dose HPV course, do I still need the third one now? Yes. If you have started the three-dose course of HPV you should complete it as originally planned. Now I ve had the injections, will I still need to go for cervical screening? Yes. All women are offered cervical screening (smear tests) when they are old enough (25 and over in England). The vaccine protects against the two human papillomavirus types that cause 70% of the cases of cervical cancer, so screening is still needed to try to pick up cervical abnormalities caused by other HPV types that could lead to cancer. Should girls who have already had sex bother with the vaccination? Definitely. If you ve had sex, and are in the relevant age group, you should still have the vaccine. Missed your appointment? Speak to your nurse to arrange another one. It is important that you have both doses at the right time to get the best protection. For more information about cervical screening visit www.cancerscreening.nhs.uk i mmunisation the safest way to protect your health Crown copyright 2014 2902473 1p 300k June 2014 (SLS) First published June 2014 DH Publications Orderline www.orderline.dh.gov.uk Tel: 0300 123 1002 Minicom: 0300 123 1003 (8am-6pm, Mon-Fri) Your guide to the HPV vaccination from September 2014 Beating cervical cancer
What is cervical cancer? Cervical cancer develops in the cervix (the entrance to the womb see diagram below). It is caused by a virus called the human papillomavirus or HPV. Cervical cancer can be very serious. After breast cancer, it is the most common women s cancer in the world. In the UK, around 3000 cases of it are diagnosed every year and about 1000 women die from it. Fallopian tube Ovary Uterus (womb) Cervix Vagina HPV and how it spreads The human papillomavirus is very common and you catch it through intimate sexual contact with another person who already has it. Because it is so common, most people will get infected at some point in their lifetime. In most women, the virus does not cause cervical cancer. But having the vaccine is important because we do not know who is at risk. Having this vaccine will also protect you against the two types of HPV that cause the majority of cases of genital warts. It won t protect you against any other sexually transmitted diseases such as chlamydia and it won t stop you getting pregnant. The HPV vaccine There are many types of human papillomavirus. The HPV vaccine protects against the two types that cause most cases (over 70%) of cervical cancer. Because the vaccine does not protect you against all of the other types, you will still need to have cervical screening (tests that pick up early signs of changes in the cervix) when you are older. Please don t forget that cervical screening (smear tests) will continue to be important whether you have had the HPV vaccination or not. Having the vaccination You will need two injections. When you are in year 8 you will be offered the first injection. You will be called for the second injection six to 12 months after the first, but it can be given up to 24 months after. Your school or GP will inform you when you will actually have the second dose. It s important that you have both doses to be fully protected. The nurse will give you the vaccination in your upper arm. The HPV vaccine is offered routinely to all girls starting in school year 8 (aged 12-13 years). The vaccine is recommended for all girls from the age of 12 years up to their eighteenth birthday. Adolescent girls who have the vaccination will reduce their risk of getting cervical cancer by over 70% Side effects Like most injections, the side effects of the HPV vaccination are quite mild. Soreness, swelling and redness in the arm are common but wear off in a couple of days. More serious side effects are extremely rare. The vaccine meets the rigorous safety standards required for it to be used in the UK and other European countries. See www.nhs. uk/hpv or see the patient information leaflet (PIL) if you d like more information on side effects. Giving consent You will probably want to share information about the vaccine with your parents and discuss it together. If you are being offered the vaccination at school, you may be given a consent form that your parent/guardian or you should sign giving permission for you to have the vaccination. Information about your vaccinations will be added to your NHS records. The nurse or doctor will discuss the HPV vaccination with you at your appointment and will be able to answer any questions you may have. More information Visit www.nhs.uk/hpv where you can download a question-and-answer sheet that gives more detailed information on the topics covered in this leaflet. A complete list of ingredients for the vaccine is given in the: Patient Information Leaflet (PIL) www.medicines.org.uk/emc/medicine/19033/ pil/gardasil and the Summary of Product Characteristics (SPC): www.medicines.org.uk/ emc/medicine/19016/spc/gardasil/
IMPORTANT NOTICE This envelope contains CONFIDENTIAL MEDICAL INFORMATION and should only be opened by the COMMUNITY IMMUNISATION SERVICE. Return this to the school Young Person s Name: School Year: Class/Form: HPV
Have you signed the form? Before returning the form to the school, please ensure that you have completed the form fully.