1. Vaccinations against human papillomavirus (HPV) for girls born in 2002, 2003 and 2004 inhabiting the Poviat of Kwidzyn.

2. Project entitled „ Equal in health – prevention and early detection of cancers as well as health promotion in the Poviat of Kwidzyn”  co-financed by Norwegian Financial Mechanism 2009-2014 and State budget within the Programme PL13 Reducing social inequalities in health  implemented by the Poviat of Kwidzyn  performed by Non-Public Health Care Unit Sanmed in Kwidzyn.

3. HPV – human papillomavirus is widely spread among the people  there are over 100 types of virus known  Circa 40 types of HPV triggers an infection in the area of urinogenital organs of men and women,  The majority of infections have no clinical meaning, do not give any symptoms and remit spontaneously, Some types of HPV cause the changes in skin and mucous of genital area - warts of external reproductive organs or genital warts,  Some types of HPV so-called high-risk might contribute to the development of cervical cancer (c.15 types)  It is estimated that type 16 and 18 of HPV is responsible for over 70% of cervical cancer cases.

4. HPV – human papillomavirus is widely spread among the people  there are over 100 types of virus known  Circa 40 types of HPV triggers an infection in the area of urinogenital organs of men and women,  The majority of infections have no clinical meaning, do not give any symptoms and remit spontaneously, Some types of HPV cause the changes in skin and mucous of genital area - warts of external reproductive organs or genital warts,  Some types of HPV so-called high-risk might contribute to the development of cervical cancer (c.15 types)  It is estimated that type 16 and 18 of HPV is responsible for over 70% of cervical cancer cases..

5. Vaccinations against human papillomavirus available in Poland :  Silgard – against types 16 and 18 of HPV as well as 6 and 11 of HPV– has been used since 2006.  Cervarix – against types 16 and 18 of HPV, has been used since 2007,

6. Four-valent vaccination against HPV type 6,11,16,18 – registered recommendations Silgard is a vaccination used from patients who are 9 year-old so as to prevent the appearance: - Cervical cancer – connected casually with the infection with oncogenic types of the human papillomavirus (HPV); - warts of reproductive organs (genital warts) connceted casually with the infection with certain types of human papillomavirus. The Characteristics of Therapeutic Product 2014

7. Counter-indications The vaccine cannot be used by persons oversensitive to any component of the vaccine. The date of vaccination should be postponed if there are any acute cases of ilnesses with fever (>38oC).

8. The schedule of vaccinations A complete vaccination consists of 3 doses applied by intramuscular injection in an arm. Second dose should be applied 1-2 months after the first one, and the third dose after 6 months from applying first dose. The schedule of vaccinations accepted in the Poviat of Kwidzyn: 1 st dose September/October 2015 2 nd dose November/December 2015 3 rd dose March/April 2016

9. Is the vaccination safe and well tolerated? The vaccination does not contain any alive viruses and only some of their protein – antigens which cannot cause the vaccinated person to become ill. As in case of every drug it is possible that some of the vaccinated persons may experience some side effects known as vaccine injuries. An attachment number 1 containing the list of vaccine injuries was attached to the Regulation of the Minister of Health of 21 December 2010 concerning vaccine injuries and the criteria of its diagnosis (Journal of Laws 2010 number 254 position 1711)

10. The examples of vaccine injuries: 1. mild: Swelling, pain, stiffening in the site of injection, swollen lymph nodes, injection site abscess, fever, alergic reaction, joint pain, headaches, general tiredness, faint 2. severe Convulsion, brain inflammation, meningitis, Guillain-Barre syndrome. 12,4 thousand vaccine injuries has beed reported after the application of 23 millions doses of the vaccination against HPV, 6% of those vaccine injuries was severe. The risk of severe vaccine injury is minor and is estimated as 1:31000

11. 624 doses of Silgard vaccinations were applied to girls born in 1999 and 2000 within an action preventing cervical cancer financed by the Municipality of Kwidzyn budget in 2013-2014 Not even one vaccine injury has been reported (the data from Poviat Sanitation and Epidemic Station in Kwidzyn)

12. THE SUMMARY The prevention of cervical cancer  Primary 1. The prevention of HPV infection through: The modification of lifestyle Vaccination  Secondary 1 Cytological screening examination

13. SUMMARY The vaccination against HPV is recommended by: WHO (World Health Organisation) European Centre for Disease Prevention and Control Polish Paediatric Society Polish Society of HPV prevention Polish Gynaecological Society Polish Coalition Against Cervical Cancer Recommend the application of vaccine against HPV to all the girls of 11-12 years old. The vaccination applied before potential exposure to the danger of infection, that is before sexual initiation or just after it, is the most effective.

14. The president signed an act redirecting the financing from the Ministry of Health to National Health Fund. The National Health Fund and not the Ministry of Health will finance the purchase of vaccines for the insured persons from 2017 – the act signed by the President assumes. The change should enable public financing of the vaccinations against i.a. HPV, meningococcus, pneumococcus.

15. HE IMPLEMENTATION OF THE PROGRAMME – 1ST DOSE The schedule of informative-educational meetings in the schools of Kwidzyn Poviat. Kwidzyn 1. Primary School number 2- Piotr Maciejewski 2. Primary School number 5- 09.09.2015 Elżbieta Żak-Maciejewska 3. Primary School number 4- 09.09.2015 Elżbieta Żak-Maciejewska 4. Primary School number 6 14.09.2015 Elżbieta Żak-Maciejewska 5. Secondary Social School 08.09.2015 Elżbieta Żak-Maciejewska 6. Secondary School number 2 08.09.2015 school nurse 7. Secondary School number 3 08.09.2015 school nurse 8. Primary School number 7 school nurse Sadlinki 1. Primary and Secondary School in Nebrowo 17.09.2015 Elżbieta Żak-Maciejewska 2. Primary and Secondary School in Sadlinki 22.09.2015 Piotr Maciejewski Ryjewo 1. Primary School in Straszewo 08.092015 school nurse 2. School Complex in Ryjewo - 10.09.2015 Paweł Maciejewski

16. Gardeja 1. Primary and Secondary School in Gardeja 10.09.2015 Elżbieta Żak-Maciejewska 2. Primary School in Cygany -10.09.2015 Elżbieta Żak-Maciejewska 3. Primary School in Czarne- P. Donata Dzwonkowska 4. Primary School in Morawy- P. Donata Dzwonkowska 5. Primary School in Otłowiec - 10.09.2015 Elżbieta Żak-Maciejewska 6. Primary School in Trumieje- P. Donata Dzwonkowska 7. Primary School in Wandowo-P. Donata Dzwonkowska The Commune of Kwidzyn 1. Primary School in Janowo 10.09 2015 Paweł Maciejewski 2. Primary School in Korzeniewo 10.09.2015 Paweł Maciejewski 3. Secondary School in Licze -nurse 4. Secondary School in Nowy Dwór - 16.09.2015 Paweł Maciejewski 5. Primary School in Rakowiec 08.09. 2015 Paweł Maciejewski 6. Primary School in Tychnowy 09.09.2015 Paweł Maciejewski Prabuty 1. Primary School in Obrzynowo -11.09.2015 Elżbieta Żak-Maciejewska 2. Primary School number 2 and Secondary School in Prabuty 08.09.2015 Elżbieta Żak- Maciejewska 3. Primary School and Secondary School in Rodowo 11.09.2015 Elżbieta Żak-Maciejewska 4. Primary School and Secondary School in Trumiejki 09.09.2015 Paweł Maciejewski Barcice Primary School and Secondary School-11.09.2015 -school nurse

17. Project entitled “Equal in health – prevention and early detection of cancers as well as health promotion in the Poviat of Kwidzyn” co-financed by Norwegian Financial Mechanism 2009-2014 and State budget within the Programme PL13 Reducing social inequalities in health THE IMPLEMENTATION OF THE PROJECT – 1ST DOSE The number of declarations issued 1722 The number of girls born in 2001, 2002, 2003, 2004 whose parents agreed to vaccinate 1210 The number of girls born in 2001, 2002, 2003, 2004 whose parents did not agree to vaccinate 296 The number of declarations not returned 216

18. Project entitled “Equal in health – prevention and early detection of cancers as well as health promotion in the Poviat of Kwidzyn” co-financed by Norwegian Financial Mechanism 2009-2014 and State budget within the Programme PL13 Reducing social inequalities in health THE IMPLEMENTATION OF THE PROJECT – 1ST DOSE The number of vaccinated girls born in 2001, 2002, 2003 and 2004 1138 The number of girls born in 2001, 2002, 2003 and 2004 who did not attend the vaccination though the parents agreed 70 The number of girls born in 2001, 2002, 2003 and 2004, who were not vaccinated due to doctor's counter-indications 2

19. Project entitled “Equal in health – prevention and early detection of cancers as well as health promotion in the Poviat of Kwidzyn” co-financed by Norwegian Financial Mechanism 2009-2014 and State budget within the Programme PL13 Reducing social inequalities in health THE IMPLEMENTATION OF THE PROJECT – 1ST DOSE The number of vaccinated boys born in 2003 157 The number of vaccinated adult women 205

20. Thank you for your attention