Since 2020, the work of free HPV vaccination for school-age girls has made new progress in many places in my country, and this year has shown a trend of accelerating progress.
During the local “two sessions” this year, a number of representatives from Anhui, Hunan, Hebei and other places suggested that free HPV vaccination of school-age women should be promoted throughout the province. This year’s National People’s Congress, whether free HPV vaccination for school-age girls will be vigorously promoted on a larger scale and other related topics may become the focus of the National People’s Congress and the National Committee of the Chinese People’s Political Consultative Conference.
In fact, the surging journalists noticed that on the eve of the National People’s Congress and the National People’s Congress this year, some deputies have already called for the promotion of free HPV vaccination for school-age women.
For example, Xu Ping, deputy to the National People’s Congress and director of the Art Committee Office of Chengdu Classics Culture Technology Co., Ltd., said, “The suggestion I will bring to the National People’s Congress this year is to popularize and promote domestically produced two Women of school-aged cervical cancer vaccine are voluntarily vaccinated free of charge.”
According to the client report released by Sichuan, Xu Ping said that this suggestion actually came from the problems that she discovered when she visited the community to participate in research activities and collected opinions and suggestions on a daily basis.
She found that in my country, the incidence and mortality of cervical cancer in urban and rural women are increasing year by year and younger, and the cost is relatively high. has happened. At the same time, in terms of cost, so far, 104 countries in the world have included HPV vaccination into planned immunization, which means that women of a certain age can be vaccinated for free. However, in my country, only a few cities have launched free vaccination programs, and the coverage is narrow, and it needs to be vigorously promoted. .
Therefore, she suggested incorporating the bivalent HPV vaccine into the immunization plan, focusing on girls aged 13 to 15 years to implement voluntary free vaccination, and the health and health commission, women’s federation, education, finance and other related The departments worked together to formulate an implementation plan, popularize vaccination in an orderly manner, and benefit all women as soon as possible.
In addition, Ma Dongping, member of the National Committee of the Chinese People’s Political Consultative Conference and director of the Institute of Sociology of Gansu Academy of Social Sciences, is preparing to submit a proposal this year, calling for free HPV vaccination for women of school age from disadvantaged families in the western region.
Cervical cancer is a high-incidence malignant tumor in women. It is recognized worldwide as the main “killer” that threatens women’s health. It ranks fourth in the incidence and mortality of female cancer in the world. The rate and death rate are gradually increasing and younger. Cervical cancer is caused by persistent infection of high-risk HPV virus, and it is the only cancer with clear etiology, preventable and controllable.
The HPV vaccine is one of the most effective ways to prevent cervical cancer. In its position paper on cervical cancer, the World Health Organization (WHO) proposed the importance of vaccination to prevent the disease; in the “Global Strategy to Accelerate the Elimination of Cervical Cancer”, it also pointed out that there are three key measures to eliminate cervical cancer: vaccination, screening The goal of 90% of girls being vaccinated against HPV by the age of 15 is by 2030.
Currently, the HPV vaccine has not been included in the national immunization plan or covered by medical insurance in my country, and is vaccinated on a voluntary basis. However, since 2020, Ordos City, Inner Mongolia, Xiamen City, Fujian Province, Jinan City, Shandong Province, Guangdong Province, Chengdu City, Sichuan Province, Wuxi City, Jiangsu Province, and Lianyun District, Lianyungang City, etc. have successively launched or announced that school-age girls will be launched soon. HPV vaccine free vaccination works. In the comments of netizens, this initiative to benefit the people was warmly called “a gift from a city”.
It is also worth mentioning that since the beginning of this year, many places have rapidly promoted free HPV vaccination for school-age girls, including Zhengzhou City, Henan Province, Shijiazhuang City, Hebei Province, Hainan Province, Chongqing City, Fujian Province Many places including Sichuan Province, Mianyang City, Sichuan Province, and Linyi County, Dezhou City, Shandong Province have recently announced that they will launch free HPV vaccination for school-age girls.
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1. What is the HPV vaccine?
HPV is the abbreviation of human papilloma virus (human papilloma virus). Studies have confirmed that persistent infection of high-risk types of human papillomavirus, especially HPV16 and 18 infection, is the most important factor in the occurrence and development of cervical cancer. Therefore, the HPV vaccine is also called the cervical cancer vaccine. Currently, the marketed HPV vaccines are divided into bivalent HPV vaccines, quadrivalent HPV vaccines and nine-valent HPV vaccines according to the types of HPV they can prevent.
2. What is the difference between bivalent, quadrivalent and nine-valent HPV vaccines?
The bivalent HPV vaccine contains HPV types 16 and 18; the quadrivalent HPV vaccine contains 6, 11, 16 and 18; the nine-valent HPV vaccine contains 6, 11, 16, 18, 31, Types 33, 45, 52 and 58. However, all three vaccines can target the above-mentioned high-risk HPV types and prevent HPV-related diseases. Compared with the bivalent HPV vaccine, the quadrivalent HPV vaccine can also prevent genital warts caused by HPV6 and 11, and the nine-valent HPV vaccine increases the proportion of cervical cancer prevention from 70% to 90%.
Currently, the WHO position paper on HPV vaccines has no preference for the three vaccine recommendations. Citizens can voluntarily vaccinate at their own expense according to the type of vaccine, price, and their own age conditions.
3. What are the age requirements for bivalent, quadrivalent and nine-valent HPV vaccines?
Currently approved vaccination ages in mainland China are:
Bivalent HPV vaccine: It is suitable for women aged 9-45. The vaccination process is based on the 0, 1, and 6 months of 1 dose each, a total of 3 doses; there are also vaccine varieties for 9- For 14-year-old females, the vaccination process is based on the 0 and 6 months of 1 dose each, for a total of 2 doses.
The quadrivalent HPV vaccine: suitable for women aged 9 to 45. The vaccination process is based on the 0, 2, and 6 months of 1 dose each, 1 dose each, a total of 3 doses.
Nine-valent HPV vaccine: It is suitable for women aged 16 to 26. The vaccination process is based on the 0, 2, and 6 months of 1 dose each, a total of 3 doses.
List of differences between bivalent, quadrivalent, and ninevalent HPV vaccines
4. I have been vaccinated with the bivalent and quadrivalent HPV vaccine, can I still get the nine-valent HPV vaccine?
There are currently no clinical data to support the interchangeability of the nine-valent HPV vaccine with other HPV vaccines. The WHO position paper on HPV vaccines has no preference for the three vaccine recommendations. From a public health perspective, bivalent, quadrivalent, and ninevalent vaccines can provide comparable immunogenicity and protective efficacy in preventing cervical cancer (mainly caused by HPV16 and HPV18). Any of the vaccines are acceptable.
According to the instructions of the nine-valent HPV vaccine, if someone has received 3 doses of the quadrivalent HPV vaccine and wants to receive the nine-valent HPV vaccine, they should be vaccinated after at least 12 months, and the doses should be vaccinated. for 3 doses.
5. I have been vaccinated with one or two doses of bivalent or quadrivalent HPV vaccine, can I switch to nine-valent HPV vaccine?
The 2016 Advisory Committee on Immunization Strategy Implementation (ACIP) recommends that if the vaccination program starts with a quadrivalent or bivalent HPV vaccine, the remaining doses can be switched to a nine-valent HPV vaccine to complete the entire vaccination program procedures, but according to the World Health Organization’s 2017 position paper on HPV vaccines, there is very limited data on the safety, immunogenicity, or efficacy of the three HPV vaccines used interchangeably. These vaccines vary in characteristics, components, and indications; in addition, the instructions for use of the quadrivalent and 9-valent HPV vaccines also specifically state that there is currently no clinical data to support the interchangeable use of the 9-valent HPV vaccine with other HPV vaccines. Therefore, even if there are multiple HPV vaccine options, efforts should be made to achieve a unified vaccination program and use the same vaccine for each dose.
6. Will the HPV vaccine prevent diseases caused by HPV?
It is well known that no vaccine provides 100% protection.
All HPV vaccines provide a high level of protection against HPV types 16 and 18 (about 70%). The HPV vaccine also provides some cross-protection against some non-vaccine-covered types.
The nine-valent HPV vaccine increases the rate of cervical cancer prevention from 70% to 90%, but fails to cover all high-risk HPV types; in addition, there may be immune failures in vaccination. Therefore, the 9-valent HPV vaccine cannot prevent 100% of all infections or diseases caused by HPV, and cervical cancer screening after vaccination should be carried out as usual.
7. How long will the protective effect of the HPV vaccine last? Is it enough to vaccinate three shots of a program? Are you going to hit again later?
12 years after bivalent and quadrivalent HPV vaccination, and 7.6 years after ninevalent HPV vaccination, the antibody-positive rate of vaccine-related types is still >90%, and no related precancerous disease. Model predictions can be maintained for 20-50 years.
The World Health Organization position paper on the HPV vaccine does not recommend revaccination as a booster.
8. Can sexually active women still receive the HPV vaccine?
HPV infection is not a contraindication to the vaccine. The risk of exposure to HPV increases with age, especially after the onset of sexual activity, and therefore, the benefit of HPV vaccination in younger age groups may be higher.
Women who have had sex are not necessarily infected with HPV, as long as they are within the appropriate age range, they can be vaccinated against HPV; HPV vaccination can also prevent persistent HPV infection, thereby preventing related diseases, and HPV vaccine can also be vaccinated.
9. Can pregnant and breastfeeding women be vaccinated? What should I do if I get pregnant after getting vaccinated?
The HPV vaccine should not affect fertility. No direct or indirect adverse effects of HPV vaccination on reproduction, pregnancy, and embryonic development have been found in animal experiments. Because there are no well-controlled studies, HPV vaccination is not recommended for pregnant women as a preventive measure. The HPV vaccine should be avoided during pregnancy.
In clinical trials, the secretion of HPV vaccine-induced antibodies through breast milk has not been observed, but since many drugs are secreted through breast milk, breastfeeding women should use them with caution.
If a woman is or is about to become pregnant, it is recommended to postpone or discontinue vaccination until the end of pregnancy.
10. Are there any side effects after HPV vaccination?
Side effects are rare and symptoms are mild, such as red rash, swelling, and pain at the injection site. The more serious side effects include: fever, nausea, dizziness, muscle weakness and paralysis; but like other vaccines, the benefits outweigh the risks.
11. Should HPV test be done before vaccination with nine-valent HPV vaccine?
Not required. Human infection with HPV virus is a dynamic process, and HPV testing is not necessary before vaccination.
12. Why can’t the nine-valent HPV vaccine be vaccinated over the age of 26?
Because the pre-marketing clinical trials of the nine-valent HPV vaccine were approved in the mainland, the selected population was women aged 16 to 26 years old, and there is currently no effective nine-valent HPV vaccine for people over the age of 26. Sexual clinical data. Therefore, women over the age of 26 cannot yet receive the nine-valent HPV vaccine in the Mainland.
Source: Prevention Community
Sources: The Paper, Guangxi CDC, Zhuhai CDC