HPV4- and 9-valent vaccines continue to be out of stock Urgent. The editor also received a lot of questions from my friends in the background, when can I start the appointment of the quadrivalent nine-valent vaccine?
In fact, what the editor wants to tell you is: You can’t wait for the HPV vaccine. You can make an appointment for which one to get shot. The sooner you get the less effective vaccination the better. “As early as possible” is more important!
Early appointment is more important
1. The incidence of cervical cancer in China tends to be younger
Anita Mui, who was only 40 years old, was diagnosed with cervical cancer Died of illness, and her death was only less than 4 months before she announced that she had cervical cancer, which made fans both sigh and sad.
National first-class actress Li Yuanyuan was pregnant with cervical cancer and died at the age of 41. In 2013, 27-year-old actress Song Wenfei passed away due to cervical cancer. They are as beautiful as flowers, but they all end up with cervical cancer.
In the past 30 years, the proportion of young women ≤35 years old in cervical cancer patients has increased year by year. The youngest cervical cancer patient in China is under the age of 18.
Source:Cai HB;Liu XM;Huang in Cerv al Trends in Cerv al Trends Young Women in Hubei, China. Int J Gynecol Cancer. 2010 Oct;20(7):1240-3.
02, Persistent infection of high-risk HPV is a necessary factor leading to cervical cancer
HPV is mainly transmitted through sexual contact. The risk of developing genital HPV infection increases significantly after initiating sex. 80% of women will be infected with HPV in their lifetime.
And early age at first sexual intercourse, multiple sexual partners, immunocompromised persons, multiple pregnancies and multiple births are all high-risk factors for HPV infection.
03, Chinese female high-risk HPV infection showed a “bimodal” distribution
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The characteristics of high-risk HPV infection in Chinese women showed a “double peak” characteristic, with the highest incidence at 15-24 years old, and the second peak at 40-44 years old.
The proportion of Chinese women who started sexual activity at the age of 15 increased rapidly, and the risk of HPV infection increased sharply. Therefore, it is very necessary to be vaccinated before the age of 15. Source: Zhao FH, Tiggelaar SM, Hu SY, et al. A multi-center survey of age of sexual debut and sexual behavior in Chinese women: suggestions for optimal age of human papillomavirus vaccination in China. Cancer Epidemiol. 2012;36(4):384–390.
04, Swedish Real World Research Younger vaccinated age shows greater benefit
The HPV vaccine is so far effective in preventing invasive cervical cancer, according to a study published in the New England Journal of Medicine The most direct and powerful evidence for cancer: 1.67 million women in Sweden were vaccinated against HPV in 2007. Compared with unvaccinated, HPV vaccination before the age of 17 can reduce invasive uterus by 88%.Neck cancer; 53% reduction in vaccination at 18-30 years old.
Source: Lei, Jiayao, et al. .” New England Journal of Medicine 383.14 (2020): 1340-1348.
05, the difference between bivalent quadrivalent and ninevalent vaccines
To understand the difference between the three vaccines, you need to first understand the HPV types.
The HPV family is very large, and there are more than 200 types of HPV types. . Some low-risk HPV types can cause genital warts, while some high-risk HPV types have been linked to cancer. Recommended reading: ☞ When the HPV vaccine meets the new crown vaccine, how to get it?
Cervical cancer is mainly related to 15 types of HPV. The highest risk types are HPV16 and 18, and HPV31, 33, 45, 52, 58, 35, 39, 51, 56, 59, 68, etc. are also included.
Persistent infection of female reproductive tract type 16 and 18 is the direct culprit of cervical cancer. More than 70% of cervical cancers in the world are related to persistent infection of these two types. About 84.5% of cervical squamous cell carcinomas in China are caused by HPV 16/18. Bivalent and quadrivalent vaccines are mainly used to prevent these two types of HPV. infection to achieve the purpose of preventing cervical cancer and precancerous lesions. The 9-valent vaccine adds five high-risk subtypes 31, 33, 45, 52, and 58 to the 16 and 18 types. Recommended reading: ☞ When the HPV vaccine meets the new crown vaccine, how to get it?
Comparison of the four vaccines span>
Reminder: None of the four vaccines has proven to be effective in preventing disease in people infected with the HPV types contained in the vaccine. The risk of exposure to HPV increases with age, especially as the risk of exposure to HPV becomes more pronounced after sexual activity begins, so early vaccination is recommended.
The reminder above is What does it mean? Simply put, if you are infected or have been infected with HPVtype 16, then vaccination with bivalent or quadrivalent HPV vaccine can only prevent type 18 , the preventive effect of 16 has not been confirmed. This is one of the reasons for emphasizing early vaccination.
06. How to choose a vaccine?
In terms of applicable age, the nine price is only applicable to 16-26 years old, while the second price and the fourth price are suitable for 9-45 years old.
Whether domestic or imported, the effect of bivalent and quadrivalent vaccines in preventing cervical cancer caused by 16 and 18 is almost the same, that is It is said that most cervical cancers can be prevented. The two low-risk types covered by quadrivalent more than bivalent are for the prevention of condyloma acuminatum. In addition, there are also research data showing that imported bivalent vaccines also have a certain degree of cross-protection on 31, 33, 45, etc. Recommended reading: ☞ When the HPV vaccine meets the new crown vaccine, how to get it?
The preventive effect of nine valence on cervical cancer is theoretically increased by 10% to 20%, and the applicable age range is 16- 26 years old, and is currently in a state of hard to find a needle in our country.
According to the 2017 WHO position paper, from a public health perspective, bivalent, tetravalent and 9-valent HPV The vaccine can provide the same immunogenicity and protective efficacy in preventing HPV16/18-related cervical cancer.
It is not advisable to blindly pursue expensive vaccines and blindly reject certain vaccines. Although HPV infection is mainly sexually transmitted, the possibility of indirect infection still exists. And you never know which comes first, tomorrow or the infection. Recommended reading: ☞ When the HPV vaccine meets the new crown vaccine, how to get it?
So the editor recommends: You can’t wait for the HPV vaccine. You can make an appointment for which one to fight, the more The earlier the vaccination, the better.
Is it over here? NO NO
Key points
The risk of exposure to HPV increases with age, so early vaccination is recommended.
No vaccine can prevent all cervical cancers. Cervical cancer screening should be done regularly after vaccination.
Say the important thing three times! ! !
Regular cervical cancer screening is required after vaccination!
Regular cervical cancer screening is required after vaccination!
Regular cervical cancer screening is required after vaccination!
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Editor: Guo Yulin
Reviewer: Wu Xufeng and Wang Ying
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