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Many people have questions about human papillomavirus (HPV) and the vaccine that prevents it. Here, you can find a compilation of some common questions. Can't find what you're looking for? Ask your HPV questions here.
HPV infections can last up to 24 months before the immune system eliminates the infection. During this time, most people do not know they are infected. This is why it is difficult to stop transmission of the virus.
HPV virus can cause persistent infections. This means that when a person is infected, the virus is reproducing in the cells that line the infected area. It does not live silently inside of cells like herpes viruses. This means that when the immune system “clears” the infection, it is no longer present, and therefore it cannot be spread to someone else.
However, what is important to understand is that many people have HPV infections without symptoms; so they do not realize they are infected. Further, since a Pap test checks for cellular changes and not the presence of virus, a “negative” Pap test does not mean that no HPV infection is present. It only means that the cells that line the cervix do not currently show signs of damage caused by a persistent HPV infection. This is why it is important to get regular Pap tests.
HPV infects epithelial cells that line mucosal surfaces of the body. When HPV enters these cells, such in the throat, genital tract or anus, it causes the cells to produce HPV proteins. In most cases, the immune system recognizes the cells that are infected and eliminates them, clearing the infection. However, in some instances a persistent infection occurs causing the cells to mutate, or change. These mutations can ultimately lead to cancer.
HPV is spread through genital contact, most often, but not always, during sex. It can also spread through oral sex. Most people don’t know they have HPV, so they often don’t realize they are spreading the virus. Since HPV is so common, if you are intimate with anyone, the best way to reduce your chance of getting infected is to be vaccinated with the HPV vaccine.
HPV is one of the most common sexually transmitted diseases among both men and women in the United States. Currently, about 79 million Americans are infected with HPV and every year, about 14 million new infections occur.
HPV causes cervical cancer, one of the most common cancers in women. Every year in the United States, approximately 12,000 women get cervical cancer and about 4,000 women die from the disease. Worldwide, the total number of deaths from cervical cancer every year is about 300,000. HPV is also known to cause genital warts as well as cancers of the penis, vagina, vulva, anus and oropharynx.
Because most people do not develop symptoms of infection, they do not know they are infected. To avoid or decrease the chance of exposure, you can abstain from sexual activity, limit the number of sexual partners you have and use condoms. Unfortunately, other than abstinence, none of these methods offers complete protection.
Yes, in some people the virus causes changes in cells that lead to the development of potentially fatal cancers.
Yes, in fact, most people (9 of every 10) do clear the infection within two years, often never having symptoms. Those who don't clear the infection (the remaining 1 of every 10 people) may suffer from genital warts, cervical cancer or other cancers.
Yes, you can be infected with more than one type of HPV at a time.
If your boyfriend has an HPV infection (with or without symptoms), you can still be infected with HPV even when using a condom for two reasons. First, because condoms aren’t foolproof at containing the virus, you could still be infected and, second, while HPV is most often transmitted during sexual intercourse, it can also be transmitted during oral sex or during genital-to-genital contact.
People can be infected with HPV for years, or even decades, before they experience any symptoms of infection. This is why women should get regular Pap screenings. Because Pap screenings show early signs of changes in cells of the cervix (precancerous changes), treatment is often more successful than after physical symptoms, such as bleeding and pain, appear.
Yes. If a person has outward signs of infection, such as genital warts, he or she can transmit the virus. However, it is important to realize that people can also transmit HPV when they do not have any symptoms. Additionally, even if someone has genital warts removed, they may still be infected and able to transmit the virus.
Even if you had the HPV vaccine, you could still develop genital warts if you were infected with a strain of HPV not contained in the vaccine. You may want to consider visiting your healthcare provider to confirm the diagnosis of genital warts. If you do have genital warts, your doctor can go over treatment options with you depending on your particular situation. You can read the information about treating genital warts from the Centers for Disease Control and Prevention.
Regarding whether you will always have genital warts, it is difficult to say. In most people, their immune system will eventually clear the infection and the warts will go away, but for some, they may remain. We have no way of telling whether an individual’s immune system is likely to clear the infection or not.
Genital warts typically develop four weeks to eight months after contracting one of the types of HPV that cause genital warts. However, HPV can also replicate without causing symptoms for several years before genital warts appear.
Progression from an initial HPV infection to cancer requires prolonged infection with one of the types of HPV that causes cancer. For this reason, cervical cancer typically develops 20 to 25 years after the initial HPV infection. Regular Pap tests and HPV tests will help your doctor monitor for precancerous changes to the cells of the cervix.
The HPV vaccine protects against nine types of HPV. Two earlier versions protected against two or four types. The types of HPV in the vaccine protect against the most common causes of cancer and genital warts. If, after being vaccinated, a person is infected with a type of HPV that was included in the vaccine, he or she is unlikely to be infected and, therefore, wouldn’t spread the virus. However, if a vaccinated person is exposed to an HPV type not in the vaccine, they could potentially be infected and spread the virus to others.
It is possible to spread the virus through intimate contact that does not include intercourse, such as genital-to-genital contact or oral-to-genital contact. So, it is possible that someone who has not had intercourse could be infected with HPV and spread it to others.
While the studies looking at HPV transmission orally are minimal, it is generally agreed upon by the scientific community that HPV is spread orally through more intimate forms of engagement, such as oral sex or "open-mouth" (French) kissing; so kissing your daughter would not be likely to spread the virus to her if you were infected with HPV orally.
No. HPV is not transmitted by simply being near or touching someone who has it. The reference to skin-to-skin contact refers to intimate interactions, such as genital-to-genital or oral-to-genital contact.
Recurrent respiratory papillomatosis, or RRP, is chronic infection of the vocal cords and lungs caused by passage through a birth canal infected with HPV. RRP is primarily caused by two types of HPV that also commonly cause genital warts, types 6 and 11. Because many people are infected with HPV and never have symptoms, they do not know they have an HPV infection. Therefore, unfortunately, it is possible that you could have had an undiagnosed HPV infection during pregnancy that led to your child’s infection.
Your question is a common one. Almost everyone who is sexually active will be infected with HPV at some point. For many, they may never know when or how they were infected for a few reasons. First, symptoms can appear years after the initial infection. Second, the disease can be transmitted without having intercourse. Skin-to-skin contact or oral sex can also transmit the virus. Finally, even people who do not know they are infected and those who do not have any symptoms may still transmit the virus.
Yes. A woman can be exposed to HPV if she has oral sex with a man who has an HPV infection (with or without current symptoms). If this happens, the infection will occur in the mucosal areas of her mouth, such as in cells in her throat. In most cases, the woman’s immune system will clear the infection without any symptoms. In very rare cases, the virus will persist and cause a condition known as recurrent respiratory papillomatosis (RRP). People with RRP develop warts in their throat which can become large enough that they cause hoarseness or trouble breathing.
Yes, in fact, most people do not know when they are infected with HPV. So, even if your partner does not have any symptoms of an HPV infection, he or she can still pass the virus to you.
Yes. Although most infections occur following intercourse, HPV may also be passed on during oral sex and genital-to-genital contact. Even more rarely, a mom can transmit the virus to her baby during birth.
Yes, a woman can pass the infection to a partner as well as to her baby during birth, although the latter is fairly uncommon. While the infection is most commonly transmitted through intercourse, the virus can also be passed to one's partner during genital-to-genital contact or oral sex.
In rare instances, mothers with genital HPV can pass the virus to their baby during vaginal delivery. A small number of these babies go on to develop recurrent respiratory papillomatosis (RRP), a condition in which tumors grow in the throat or lungs, sometimes causing hoarseness and difficulty breathing, talking and swallowing. While the tumors can be surgically removed, they tend to grow back. Some people with RRP require regular surgical intervention. RRP can also cause a disease of the lungs that resembles cystic fibrosis.
A link between HPV and miscarriage, premature delivery or other complications has not been found.
Consult your doctor if you have any concerns.
Although the HPV vaccine has not been found to cause harm to a woman or her fetus, it is recommended to wait until after delivery to start or continue with the series.
If you got the vaccine while you were pregnant, you do not need to take any special precautions. However, you or your doctor should report the exposure to the appropriate registry that has been established to keep track of these occurrences:
Receipt of Gardasil® should be reported to 877-888-4231
You should wait until after you deliver to get the remaining doses of vaccine. There is no indication that the vaccine causes harm to you or your unborn baby, but it is recommended to wait just to be safe. After you deliver, you can resume the process of getting the remaining doses.
The Centers for Disease Control and Prevention (CDC) has a helpful resource for understanding Pap and HPV tests.
Two tests for women are available:
The CDC has a great information page about the different test results and what they mean.
Although there is no approved test for men to know their "HPV status," most HPV infections resolve without causing any problems. The problems caused by HPV in men can include genital warts, anal and penile cancers, or cancers of the oropharynx. There are ways to check for those:
Although no specific treatments for HPV exist, supportive treatments for the health problems caused by HPV are available.
The CDC has an excellent fact sheet related to men and HPV that can provide you with a wealth of additional information.
No antiviral drugs are available to treat HPV. Most HPV infections, however, clear on their own in a few years without causing any health problems. While there are no treatments for the infection, there are supportive treatments for the health problems caused by HPV, such as genital warts and cancers.
No. A Pap test is one in which cells isolated from the cervix are examined under a microscope for precancerous changes caused by a persistent, or long-term, HPV infection. So, a negative Pap test is good news in that it means the cervical cells appear normal, but it does not give any information about a person’s HPV status.
A test that specifically detects HPV is also available. Although this test does measure the presence of HPV virus in the cervical cells, it does not provide information about whether that infection will remain long term or eventually cause cancer. Because many younger women get an HPV infection that is cleared by their immune systems, the HPV test can often be positive, causing unnecessary concern; therefore, it is not recommended for most women younger than 30 years of age.
Pap tests identify changes to cervical cells that could lead to cervical cancer; however, the types of HPV that cause cervical cancer are rarely associated with recurrent respiratory papillomatosis (RRP). Therefore, you could have had an infection with one of the types that cause RRP and continue to have normal Pap tests. Also, HPV can infect cells without causing the types of precancerous changes that lead to an abnormal Pap smear.
The types of HPV that cause genital warts typically differ from those that cause cervical cancer. Since a Pap test is meant to identify potential cellular changes that could lead to cervical cancer, it does not provide information about HPV infections with types that cause genital warts. For this reason, your Pap test results do not mean that you did not get infected with HPV when your boyfriend had it. The good news is that for many people, the infection will clear without any symptoms, so you may never experience genital warts like your boyfriend did.
If you have an abnormal Pap test, an HPV test may be suggested to determine if human papillomavirus DNA is present in the cells of the cervix. If the results of the HPV test are positive, your doctor will determine how frequently you should be tested. In addition to HPV and Pap tests, a colposcopy or biopsy may be suggested. A colposcopy visualizes the cells of the cervix and a biopsy takes a sample of cervical cells.
For more information about understanding your test results, see the CDC’s information, “What do my cervical cancer screening test results mean?”
Women are recommended to get their first Pap test at age 21, and then once every three years until they turn 29. Women who are 30 to 65 years old should have both Pap and HPV tests performed every five years, or a Pap test alone every three years. Women who have an irregular Pap test or who are at risk due to other factors, such infection with Human Immunodeficiency Virus (HIV) or previous diagnosis of cervical cancer, may be required to get tested more frequently.
Find out more on the CDC’s page, “What should I know about screening?”
Find out if you qualify for free or reduced cost screening through the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) and where near you offers the program.
No, HPV tests should not replace routine Pap tests for two reasons:
Yes. The HPV test is used to determine if HPV DNA is present in the cells of the cervix. Positive results mean that your cervix has the types of HPV commonly linked to cervical cancer; however, a positive result does not mean you have cervical cancer. Based on the results, your doctor will determine how frequently you should be tested and whether other tests should be performed. Currently, HPV tests are recommended for all women 30 years and older and any woman 21 to 29 years old who has had an irregular Pap test.
Sexually transmitted disease (STD) testing is not the same for every person as it depends upon individual risk factors. For HPV, there is no test for males. For females, HPV can be detected by either Pap tests or an HPV test. The Mayo Clinic has a good discussion regarding how to determine what STD tests you may need and what is available.
Yes. The HPV vaccine does not contain all of the types of HPV that can cause cervical cancer; therefore, it is important to continue getting Pap tests.
Yes. You should still get the HPV vaccine even if you have had an abnormal Pap test because even if you have been infected with HPV, it is not likely that you have been infected with all of the types that the vaccine protects against. So, you can still benefit from protection afforded by the HPV vaccine.
The HPV vaccine is recommended for adolescents between 11 and 12 years of age, and all teenagers and adults between 13 and 26 years of age who did not get the vaccine when they were younger. Children as young as 9 years old can also receive the HPV vaccine.
Two doses of the HPV vaccine are recommended for those younger than 15 years of age, with the second dose administered six months after the first one. Those 15 years and older should receive three doses of HPV vaccine with the second dose given one to two months after the first, and the third dose given six to 12 months after the first.
Learn more about why this is the recommended age group by watching the short video below.
View this video with a transcript
You should talk with your healthcare provider to see if they know whether you were vaccinated and if so, what type of HPV vaccine you received and how many doses were given. However, if that is not an option and you are uncertain, you can still get the vaccine. Extra doses are not likely to have negative effects.
No, people who have been vaccinated against HPV do not need to be revaccinated after giving birth.
Yes. Typically, people with HPV have not been infected with all of the strains contained in the vaccine, so the vaccine could protect them from strains to which they have not been exposed previously. However, the vaccine will not help treat or protect against types of HPV to which the person has already been exposed.
For those 15 years of age and younger, the HPV vaccine is now given in two doses. So, depending on your age, you may not need a third dose:
The HPV vaccine protects against nine types of HPV (Gardasil 9®). The CDC does not recommend giving this vaccine to people who already had the earlier HPV vaccines (Cervarix® or Gardasil®-4). However, because the vaccine protects against additional types of the virus, individuals may still reasonably get the vaccine. In this case, the person should speak with his/her healthcare provider regarding the relative benefits associated with this choice.
The newer version, Gardasil 9®, is the only version currently available, so you can be protected against more types of the virus by getting the vaccine. The 9-valent vaccine can be used in place of either of the previous two HPV vaccines (Gardasil® and Cervarix®) to complete a vaccination series, so, you do not need to start over again. You would just get the last dose with the current vaccine option. Cervarix is no longer available in the United States.
If you are younger than 15 years old and your first two doses were separated by five months or more, you do not need any additional doses.
You should start by checking with your primary healthcare provider. If you cannot get the vaccine from their office, you should also check with your gynecologist, the local health department or a local pharmacy. The manufacturer, Merck, also has an adult vaccine locator on their website that might be of help.
Yes. A few studies have looked at this and none have found that receiving the HPV vaccine causes girls to become promiscuous or engage in sexual activity at an earlier age. One such study by Robert Bednarczyk and colleagues, published October 2012 in Pediatrics, compared the medical records of 493 girls who received the HPV vaccine and 905 who didn’t. The study found no differences between the two groups in regards to incidence of pregnancies, tests for or diagnosis of sexually transmitted diseases (STDs), and contraceptive counseling. Based on these results, the authors of the study reported that the HPV vaccine “was not associated with increased sexual activity-related outcomes.”
The HPV vaccine was introduced in 2006, and according to an article published in the July 2012 issue of Pediatrics, use of the HPV vaccine has resulted not only in lower rates of infection among those who were vaccinated, but also, to some degree, in those who have not been vaccinated. This phenomenon is commonly known as herd immunity.
You should still consider getting the vaccine for two reasons. First, additional studies are needed to reproduce these findings. Second, while herd immunity might lessen your chance of coming into contact with the virus, the vaccine will significantly decrease your chance of infection if you do come into contact with it.
No. You can just resume where you left off.
The HPV vaccine is recommended before the start of sexual activity for two reasons:
Yes. The reason to get the HPV vaccine even if you are already sexually active is that you will not have been exposed to all of the types of HPV that are contained in the vaccine.
Although HPV is a known cause of cervical cancer, the virus can also cause other cancers of the reproductive tract, anal cancer, penile cancer, genital warts, and on occasion, cancers of the head and neck. In fact, about 1 of every 3 cases of HPV-related cancers are in boys or men. Because vaccinating boys will also decrease the spread of the virus, they will not only protect themselves, but also their sexual partners.
Yes. The HPV vaccine can be given at the same time as other vaccines recommended at this age, including the vaccine for tetanus, diphtheria, and pertussis (Tdap) and the one for meningococcus. If it is influenza vaccine season, this vaccine can be given as well.
Yes, you can still get the HPV vaccine even if you have had sexual intercourse. While you may have been exposed to one or more types of HPV, it is unlikely that you would have been exposed to all of the types that the vaccine protects against, so it may still be of benefit for you.
In October 2018, the vaccine became licensed for people up to 45 years of age, so inquire with your provider.
Because the HPV vaccine does not protect against all types of HPV, it is possible that a fully vaccinated person could be infected with a type of HPV that is not contained in the vaccine. Most people will clear any type of HPV infection— but it may take months to do so. In a few people, however, HPV infection will persist and possibly become cancerous. We have no way of knowing who will be affected over the long term. That said, the vaccine protects against the most common types that cause cancer or genital warts.
Vaccine safety is studied by many, many groups not just those who manufacture vaccines. The FDA reviews all data associated with studies completed by vaccine manufacturers as well as visiting manufacturing sites and continuing to monitor the vaccine as long as it is being made. Additionally, the CDC has systems in place to monitor vaccine safety including the Vaccine Adverse Events Reporting System (VAERS) which allows anyone to report side effects, allowing CDC scientists to watch for trends. Two additional systems provide a controlled way to test whether the trends are causally associated and to study vaccine safety. The first, the Vaccine Safety Datalink (VSD), is a collaboration with eight large healthcare organizations from various parts of the United States. Health records are monitored for vaccine receipt and illnesses to study vaccine safety. The second, the Clinical Immunization Safety Assessment Project (CISA), is a national group of vaccine experts from the CDC, seven medical research centers, and other experts who conduct research around specific vaccine safety concerns, provide consultations for individual healthcare providers on specific patients, and review adverse event data. Vaccine manufacturers do not have a role in these studies.
Additionally, the National Academy of Medicine (NAM), previously called the Institute of Medicine (IOM), periodically conducts comprehensive reviews of the literature to monitor vaccine safety. The NAM completed a review related to adverse effects of vaccines, which included HPV, in 2012. Their findings are available online.
More than 200 million doses of HPV vaccine have been given safely throughout the world. More than 100 million of these have been given in the U.S. What we know from all of these data is that the vaccine is safe and it is working to decrease transmission of HPV, genital warts, cervical changes that cause cancer, and juvenile-onset recurrent respiratory papillomatosis.
No. Because the HPV vaccine is made using only a single protein from each type of the virus, it can’t cause HPV infection, and, therefore, it can’t cause cervical cancer or other cancers.
It is not likely that your son’s symptoms were the result of his HPV vaccination for a couple of reasons. First, the length of time between the dose and the appearance of symptoms is not what one would expect if the vaccine was the cause. Second, of the three symptoms you mentioned, the only one that was consistently reported in HPV vaccine recipients was headache, and that was typically reported within 15 days of the first dose.
No. HPV infections do not cause infertility, except indirectly in cases when they progress to cervical cancer, so it is not biologically plausible that the HPV vaccine would lead to infertility. To the contrary, since the HPV vaccine decreases the number of cases of cervical cancer, it may indirectly decrease the number of women unable to have a baby.
The known side effects of the HPV vaccine include pain, redness or swelling at the injection site. In addition, because teens tend to faint more easily, fainting has been associated with vaccines given to this age group. Because of this, vaccine recipients should remain seated or lying down at the doctor’s office for about 15 minutes after getting the vaccine.
Reports of blood clots, strokes, heart attacks, chronic fatigue syndrome, infertility or premature ovarian failure, and even death have occurred after receipt of this vaccine; however, reviews of individual cases as well as controlled studies looking at groups of people who did and did not get the vaccine have shown that none of these problems were caused by the HPV vaccine.
The HPV vaccine contains higher concentrations of salt than other vaccines, so they may hurt a bit more when they are administered. However, you can suggest one of the following to make your daughter more comfortable while getting the shot:
The HPV vaccine may cause redness, swelling and tenderness at the site of the injection. Some people may faint when they get the vaccine, so people are advised to stay at the doctor's office for 15-20 minutes after getting the vaccine.
Because vaccines are given to healthy children, they are held to a strict standard of safety. What that means for us as consumers is that before a vaccine is ever recommended for the general population it has been tested in thousands and thousands of children through carefully controlled scientific studies. So while they are “new” recommendations, the vaccines have often been studied for years.
For example, HPV vaccines were tested in more than 30,000 women whose health was monitored for about seven years before the vaccine was approved and recommended. Long-term studies continued to monitor vaccine safety in about 190,000 women after the HPV vaccine was licensed. Similarly, the Centers for Disease Control and Prevention (CDC) has networks that continue to monitor all vaccines in real time, so that any safety concern would come to attention quickly. At this point, millions of HPV vaccines have been given.
Some teens are more prone to fainting after getting the vaccine; therefore, all teens are recommended to wait at the doctor's office for 15 minutes to be sure they are okay.
While you may have some protection after receiving the first dose of HPV vaccine, your best level of protection will occur after you receive all recommended doses.
The HPV vaccine will not protect you against types of HPV to which you may have already been exposed; however, it will protect you against types to which you were not previously exposed. Since the vaccine protects against nine types of HPV, it is likely that you can still benefit from receiving the vaccine. For this reason, knowing your sexual activity status is not a requirement for deciding whether or not you should get the HPV vaccine.
We do not know for sure whether immunity will last a lifetime; however, the data are reassuring. First, the vaccine has been studied for more than 10 years at this point, and immunity doesn’t appear to wane. Second, the immune responses generated by the vaccine are stronger than those invoked after natural infection. Finally, the hepatitis B vaccine, which is made using a technology similar to the HPV vaccine, induces a memory response that lasts at least 30 years.
Yes, it is possible. Although the HPV vaccine protects against the two strains of HPV that most commonly cause genital warts, it will still only prevent about 9 of every 10 cases of genital warts. Therefore, someone could still get genital warts if they are infected with a type of HPV that causes genital warts but was not in the vaccine.
The strains of HPV included in the vaccine will prevent about 9 of 10 cases of cervical cancer. However, because a possibility of getting cervical cancer from one of the types of HPV not contained in the vaccine still exists, women should continue to get regular Pap tests. In addition, the vaccine does not protect against other sexually-transmitted diseases, so practicing safe sex is also important.
As with other vaccines, the immune response will take about one to two weeks to develop and will become more complete after each dose. Best protection may not be realized until all doses of the HPV vaccine are completed.
Also realize that the HPV vaccine does not protect against all types of HPV or all STDs. Therefore, it will be important to continue practicing safe sex and, if you are a female, getting regular Pap tests.
Yes. The HPV vaccine does not prevent all types of HPV or other types of sexually-transmitted diseases. The Centers for Disease Control and Prevention (CDC) has a helpful fact sheet about the use of condoms.
HPV booster doses are not expected to be necessary; however, public health officials will continue to monitor rates of disease to watch for waning immunity.
If you already have genital warts, the HPV vaccine will not treat them. However, the vaccine may still protect you against other types of HPV to which you were not previously exposed. Consult your doctor about medicines and procedures that may be used to treat genital warts.
No. The HPV vaccine is made using a protein from the surface of the HPV virus. Although the protein folds itself to look like a viral particle in a microscope, it does not contain any genetic material, so it cannot replicate and cause an infection. Because the proteins look like a viral particle, scientists refer to them as “virus-like particles.”
No. The vaccine does not protect against any other STD. In fact, since there are more than 100 types of HPV, it does not even protect against all types of HPV.
Free movie! Watch Someone You Love: The HPV Epidemic compliments of the Vaccine Education Center. The 80-minute film tells the powerful story of five incredible women whose lives were forever changed by human papillomavirus (HPV) and cervical cancer. Those stories also provide an opportunity to learn more about HPV disease and common issues faced by families.
In addition, the VEC interviewed the filmmakers, during which they opened up about filming the emotional documentary, getting to know the women featured, and the impact of the women’s stories on their own lives. Watch all or parts of that interview here.
Various professional and advocacy groups provide reliable information about HPV and the HPV vaccine; several are compiled below.
The CDC has several sources of information related to HPV and the HPV vaccine:
The NIH also has several sources of information related to HPV and the HPV vaccine:
Materials in this section are updated as new information and vaccines become available. The Vaccine Education Center staff regularly reviews materials for accuracy.
You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family's personal health. You should not use it to replace any relationship with a physician or other qualified healthcare professional. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult your physician or, in serious cases, seek immediate assistance from emergency personnel.