Hello, this is Dr. Li Wen from the Obstetrics and Gynecology Hospital of Zhejiang University School of Medicine. Welcome to the Cervical Health Course of Medical School.
will start the fifth lecture of the course today. In this talk, I mainly answer three questions: 1. How long is the HPV vaccine effective; 2. The safety of the HPV vaccine; 3. How to choose the 3 HPV vaccines and make an appointment.
From the previous lecture, we know that HPV vaccine is the world's first vaccine that can prevent malignant tumors. Its advent makes it possible to eliminate cervical cancer, which is of epoch-making significance. A large number of clinical trials in the early stage of
fully confirmed the effectiveness and safety of the three HPV vaccines. Therefore, since the FDA approved the market, the HPV vaccine has been marketed in many countries and regions around the world. As of March 31, 2017, 71 countries around the world (that is, more than one-third of the countries) have included girls' HPV vaccination into their national immunization programs, and 6 countries have also included boys' HPV vaccination.
1, the effectiveness of HPV
Then, through the data obtained after the market, let’s take a look at the effectiveness and safety of the HPV vaccine. The
study found that the protective rate of the 2-valent and 4-valent vaccines against high-grade cervical precancerous lesions and cancers, vaginal and vulvar high-grade precancerous lesions and cancers caused by HPV16/18 can reach 98.0%-100.0%. The
quadrivalent vaccine can also prevent 90% to 100% of HPV6/11-induced condyloma acuminata on the male penis, perianal, and vulva. The nine-valent vaccine is not inferior to the quadrivalent vaccine against persistent HPV6/11/16/18 infections. In addition to the preventive effect of related lesions, it can also prevent about 97% of high-grade precancerous lesions and cancers of the cervix, vulva and vagina caused by HPV31/33/45/52/58. In another study, a randomized controlled trial of more than 70,000 participants found that the HPV vaccine can reduce the occurrence of cervical precancerous lesions and adenocarcinoma in situ. After women under the age of 20 received HPV vaccine, the infection rate of HPV16 and 18 dropped by 64%, and the infection rate of HPV31, 33, and 45 dropped by 28%.
Canada began to provide 4-valent vaccination for school women aged 17-29 years in 2008. Studies have evaluated the HPV infection rate of vaccinated and unvaccinated women, and found that the overall HPV infection rate among sexually active women is about 40%, and nearly 60% of infected women have multiple infections. Among women aged 17-19, 20-23, and 23-29 who were vaccinated, HPV detection rates were 0.3%, 1.4%, and 10.5%, respectively.
therefore concluded that vaccinated women younger than 23 years old rarely get HPV, and women who have received at least one dose of the vaccine before their first sexual life rarely get HPV. Therefore, judging from the various performances of the HPV vaccine after it was launched, its effect is beyond doubt. The protection period of
for the three vaccines, because the earliest marketed 4-valent vaccine has only been used for 12 years so far, so it is not clear how long the vaccine's immune protection will last, and further follow-up observation is needed. But it is currently believed that at least 10 years is no problem.
2, HPV vaccine safety issues
As for the safety of the HPV vaccine, it has been more than ten years since the first HPV vaccine was applied. Its safety has been confirmed in a wide range of clinical applications and pharmacovigilance data.
WHO Global Vaccine Safety Advisory Committee regularly reviews the safety of HPV vaccines based on post-market surveillance data from the United States, Australia, Japan and other countries and vaccine manufacturers. The latest conclusion in 2016 still believes that the safety of the three vaccines well.
Most vaccinated subjects have only mild adverse reactions. Serious local or systemic adverse reactions rarely occur. Serious adverse events that may be related to the vaccine are very rare. Common adverse reactions are mainly local pain, redness and swelling, and fever is the most common systemic adverse reaction (about 10%). Compared with the 4-valent vaccine, the
9-valent vaccine has a slightly higher incidence of local adverse reactions, and with the increase in the number of dosage forms, the incidence gradually increases, but there is no difference in systemic adverse reactions, such as headache, fever, nausea and fatigue.
At the same time, in clinical trials, data on unintended pregnancies and post-marketing surveillance can not prove that HPV vaccination is related to adverse pregnancy outcomes (such as birth defects, stillbirth, spontaneous abortion, etc.). The Phase III clinical trials carried out in my country also proved that the 2-valent and 4-valent vaccines have better safety, which is consistent with reports in other countries.
However, now there are some false reports about HPV vaccines circulating on the Internet, even conspiracy theories. Some time ago, a friend tweeted me a Weibo with a very eye-catching topic, falsely claiming that "the nightmare of cervical cancer (HPV) vaccine prevention has finally come, and the US courts have begun trialing the terrible corruption of HPV vaccine approval agencies and companies."
She had already planned to get a 9-valent vaccine. She was shocked when she saw this Weibo and asked if I had seen it. I tweeted her a rumor-defending article within 1 minute and told her that it was all rumors, don't believe it. How can the validity of
, which so many researchers have used so many scientific experiments and data to verify, and recognized by so many authoritative magazines, institutions and organizations over the years, be easily overturned by a few microblogs? Moreover, the so-called shady scenes exposed by these microblogs have neither authoritative research and demonstration nor accumulation of professional knowledge, and they cannot stand scrutiny at all. So I asked her to get vaccinated with confidence, and after listening to it, she finally felt relieved.
Therefore, I hope that after listening to our courses, all female friends can let go of their worries and anxiety, believe in the benefits of the HPV vaccine, which benefits mankind, and become supporters of HPV vaccines, and encourage and encourage suitable people around them to get HPV. Vaccine, as a health messenger to prevent cervical cancer.
With the improvement of female friends’ health awareness, many women went to Hong Kong to get HPV vaccines long before the HPV vaccine was launched in my country. As three HPV vaccines are successively launched in the mainland of my country, and due to the ensuing enhancement of related science, there has been a wave of HPV vaccination in China. Many community hospitals are even in short supply of vaccines, and it takes a long time to wait for an appointment.
3, the choice of three types of vaccines
But regarding the HPV vaccination, there is a question that may bother you: how to choose the three vaccines? Since the 9-valent vaccine has the strongest preventive effect, should the 9-valent vaccine be chosen if the age of vaccination is all met?
is not the case. The coverage of the 9-valent vaccine is indeed wider, and it can also prevent more types of diseases. However, the 2-valent and 4-valent vaccines can prevent HPV16 and 18 subtypes of viruses, which can cause about 70% of cervical cancers. Therefore, from the perspective of preventing cervical cancer, the 2-valent and 4-valent cervical cancer vaccines can prevent most cervical cancers, and the overall protection rate is very high.
In addition, the 2-valent and 4-valent vaccines can also have a certain degree of cross-protection against other high-risk HPV other than HPV16/18. In other words, in addition to HPV 16 and 18, it can also prevent other high-risk HPV infections, especially HPV 31/33/45. The Phase III clinical registration trial of 3 doses of 2-valent and 4-valent vaccines carried out in my country also showed a cross-protective effect consistent with global data. Since the
2-valent vaccine contains advanced adjuvants for enhancing immunogenicity, this cross-protection effect is stronger, and the overall protection against cervical cancer is about 90%. Current data show that the total protection of the 9-valent vaccine is 93%. Therefore, it can be said that the 2-valent and 4-valent vaccines are not inferior to the 9-valent vaccine in terms of preventing cervical cancer. Which category to choose depends on personal conditions and needs, and it does not advocate the nine-price theory.
Currently, in the World Health Organization's position paper on HPV vaccines, there is no preference for the recommendation of 3 vaccines including 9 valences. People in various regions can voluntarily vaccinate according to the types and prices of vaccines currently available. For individuals who have been vaccinated with 3 doses of 2-valent or 4-valent HPV vaccine in the past, it is not recommended to re-vaccinate 9-valent vaccine. In other words, one of the HPV vaccines is enough, and there is no need for stacking.
It is necessary to remind you that vaccination is not the only way to prevent cervical cancer. The completion of vaccination does not mean peace of mind. It also requires regular cervical cancer screening.
Because the current vaccine is a preventive vaccine for a specific virus type, although it has a cross-protective effect, there are still a small number of carcinogenicThe virus type is not covered. Therefore, in order to fully prevent the occurrence of cervical cancer, women still need to insist on regular screening after vaccination.
Another question about HPV vaccination is where to go for vaccination? How to make an appointment? I am here to provide you with a way. Open the Alipay app, search for cervical cancer vaccine on the homepage, click on the vaccine service, click on HPV vaccine appointment, select the province, city and region, you can make an appointment registration, which is very convenient.
This lesson is over here. In this lecture, I mainly explained three aspects to you.
First of all, we learned about the effectiveness of the HPV vaccine. Whether it is a large number of clinical trials before the vaccine is marketed, or a large number of follow-up reports after the market, it has confirmed the effectiveness of the HPV vaccine in preventing cervical cancer and other diseases caused by HPV.
Then, we learned about the safety of the HPV vaccine. Also judging from the data before and after the HPV vaccine is on the market, the safety of the vaccine is very good, most of which have only minor adverse reactions. I hope to eliminate the worries of female friends about the side effects of HPV vaccine. It is recommended that suitable female friends try to get HPV vaccine.
Finally, we learned about the choice of 3 HPV vaccines. We do not advocate the 9-valent theory, because in preventing cervical cancer, the 2-valent and 4-valent HPV vaccines can achieve immune protection equivalent to the 9-valent vaccine. The specific choice depends on personal conditions and needs. In addition, even if the HPV vaccine is vaccinated, a standardized cervical cancer screening is required.
Learn more about cervical health , the BTV Health Hall column, and I only did the course "HPV Vaccine and Cervical Cancer Screening" has been launched. The instruction course is dedicated to preventing cervical cancer, wanting to receive HPV vaccine, If you want to customize cervical cancer screening, click the column below to join my course.
