9-valent HPV vaccine
has been expanded from the original 16-26 years old to 9-45 years old, and the new round of
The topic of HPV vaccine has also become a hot topic.
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At the recent media roundtable on the 9-valent HPV vaccine
age expansion,
Professor Duan Tao of Shanghai First Maternity and Infant Health Hospital,
Professor Lu Yihan of the
Epidemiology Teaching and Research Section of the School of Public Health, Fudan University
A hot topic related to
HPV vaccine that is widely concerned by the public,
will clarify some misunderstandings for everyone.
Recently, many women in their 40s have consulted,
is approaching the maximum age limit for HPV vaccination, and whether
vaccination is effective. Experts pointed out that it is never too late to get vaccinated, and there will be no significant difference in the effect of
after vaccinating older women.
The 40-44-year-old vulnerable population also needs to be protected. In recent years, the morbidity and mortality of cervical cancer in my country are on the rise, and the overall prevention and treatment of cervical cancer is relatively severe.
Lu Yihan pointed out that after the age expansion of the nine-valent vaccine, from 16-26 years old to 9-45 years old, it is not only for the health of women, but also has very important significance for the health of the whole population. Chinese women infected with HPV showed a typical "double peak" feature: the first peak appeared at the age of 17-24, and the other peak was at the age of 40-44. When World Health Organization recommends the age of HPV vaccination, it is mainly aimed at adolescent girls aged 9-15 years, because earlier vaccination can obtain the best preventive effect. However, it should also be noted that the second peak age group of in my country - 40-44 years old, people in this age group actually need to be protected.
"Once you reach the age of 40, will vaccination be the same as vaccination for young people?" In Lu Yihan's view, older women, even if they are 44 or 45 years old, will not have significant effects after vaccination sexual differences. At the second peak of cervical cancer incidence (40-44 years old), women's autoimmunity begins to decline, the probability of infection is greater, and the body's ability to clear it decreases at the same time. Therefore, it is also very important for such an age group to receive the HPV vaccine.
Do HPV-infected women still need the HPV vaccine? There are more than 200 types of
HPV, cervical cancer is mainly caused by persistent infection of high-risk type HPV. The top three high-risk HPV subtypes that Chinese women are most susceptible to are: HPV16, HPV52, and HPV58. Duan Tao introduced that different valences represent the number of HPV types that can be protected or defended against. The "most famous" two types, one is the 16 type and the other is the 18 type. The first three types prevalent in our country are type 52, type 16 and type 58. In China, HPV16/18 types are associated with about 69% of cervical cancers, that is, the types covered by bivalent and quadrivalent vaccines, in addition to HPV31/33/45/52/58 types, which are covered by nine-valent vaccines 92% of cervical cancers and 90% of genital warts can be prevented.
Do women who have been infected with HPV still need to be vaccinated against HPV? Duan Tao pointed out that it is necessary for women of school age who have been infected with HPV to be vaccinated. There are many types of HPV, and infection is common. According to the epidemiological characteristics of China, women are mainly infected with HPV by a single infection, and HPV vaccination can have a good protective effect on other types that have not yet been infected. In addition, a woman who has been infected with HPV indicates that her personal lifestyle or constitution makes her more susceptible, and it is more necessary to vaccinate herself to protect herself.
has been vaccinated with bivalent and quadrivalent vaccines, can they be vaccinated with nine-valent vaccines? The instructions for the 9-valent HPV vaccine state that if the 9-valent HPV vaccine is to be vaccinated after completing 3 doses of the quadrivalent HPV vaccine, the vaccination should be started after at least 12 months, and theThe doses are 3 doses. There is currently no evidence to support the use of the nine-valent HPV vaccine after the full immunization program with the bivalent HPV vaccine. After
was vaccinated, I suddenly found out that I was pregnant, can I continue the pregnancy? Duan Tao believes that expectant mothers do not have to worry about it and can continue their pregnancy, because the HPV vaccine is a class B drug, and class B drugs can be used safely during pregnancy. Neither animal studies nor clinical practice have found any adverse effects of the HPV vaccine on the fetus.
Vaccines alone are not enough
Regular cervical cancer screening is also required
In November 2020, the World Health Organization released the " Global Strategy to Accelerate Cervical Cancer Elimination ", proposing three major action goals for cervical cancer elimination in 2020-2030 : 90% of girls complete the HPV vaccine by age 15; 70% of women receive at least two high-performance cervical cancer screenings at age 35 and 45; 90% of women diagnosed with cervical disease are able to receive treatment. The Global Strategy to Accelerate Cervical Cancer Elimination has received commitments from 194 countries around the world, including China.
To eliminate the public health problem of cervical cancer, in addition to vigorously promoting HPV vaccination, what other effective measures are there to do a good job in comprehensive prevention and treatment? What other efforts do the whole society need to make? Lu Yihan introduced that in 2020, the World Health Organization issued the "Global Strategy to Accelerate the Elimination of Cervical Cancer", and the Chinese government responded positively and made the prevention and control of "two cancers" the top priority in the prevention and control of common diseases in women. This is the first time in human history that it is clear that a tumor will be eliminated, but at the same time, it may be a particularly long-term action, not a one-time job.
"To achieve the goal of eliminating cervical cancer, vaccines alone are not enough. In addition to prevention, regular cervical cancer screening must be carried out." Duan Tao emphasized that cervical cancer has three levels of prevention. Primary prevention refers to avoiding infection with high-risk HPV virus; secondary prevention refers to regular cervical screening to detect cervical precancerous lesions and timely treatment; tertiary prevention refers to early detection of cervical cancer and standardized treatment.
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