Cervical cancer can be effectively prevented by HPV vaccination Did you know? Do non-virgins still need to be vaccinated? Do straight men need it? Where to get it? Take a look at this article.
1.Status of Incidence
Cervical cancer is the second most common cancer of the reproductive system in women (the champion is ovarian cancer), with 600,000 new cases and 300,000 deaths per year worldwide; 135,000 new cases and 80,000 deaths per year in China.
2.Channel of infection
Sexual intercourse is the main way of HPV infection, but not the only way. HPV infection is very common and the probability of being infected with HPV during one’s lifetime is very high as soon as one starts having sex, and the rate of HPV infection in sexually active women is about 50%-80%. HPV infection usually does not have any symptoms, so it cannot be detected by yourself.
3.99.7% of cervical cancer is caused by HPV infection
99.7% of cervical cancer is caused by HPV infection. 2008 German scientist Harald zur Hausen first discovered the relationship between HPV and cervical cancer and finally proved that HPV infection is the main cause of cervical cancer, and finally received the Nobel Prize in medicine. HPV infection not only causes cervical cancer, but 90% of anal cancer, 40% of vulvar/vaginal cancer and 12% of head and neck cancer are related to HPV infection.
There are more than 100 subtypes of HPV, divided into low-risk and high-risk types. 50% to 90% of HPV infections can be cleared by the body’s immune system within a few months to 2 years after infection and do not cause long-term harm; there are no specific drugs for HPV, so HPV infections generally do not require treatment. Only persistent infection (defined as 2 consecutive detections of the same high-risk HPV type more than one year apart) with high-risk HPV types (HPV 16 and 18) will progress to cervical cancer.
The development of cervical cancer is a long process and cervical cancer screening technology (including HPV testing) is now quite mature, so women aged 30+ who have sex or HPV infection should be screened for cervical cancer regularly. Unfortunately, the coverage rate of cervical cancer screening in China is less than 14% of women of appropriate age.
4.Vaccine can prevent 70% of cervical cancer
The HPV vaccine is the first attempt to eradicate a type of cancer through a vaccine, which is of epoch-making significance. 70% of cervical cancer is caused by two high-risk types HPV16 and HPV18, and the current HPV vaccine mainly targets these two types, which means that the current vaccine can only prevent perhaps 70 percent of cervical cancer. Strictly speaking, it is not yet possible to conclude that “HPV vaccines can prevent cervical cancer” because the evolution of persistent HPV infection to cervical cancer can take up to 15-20 years, and the first clinical trial data with cervical cancer incidence as the study endpoint will not be available until 2020.
In the United States and Europe, the current assessment criteria are based on the ability to prevent persistent HPV infection, and theoretically, if you can prevent persistent HPV infection, you should be able to prevent cervical cancer.
5. What vaccines are available?
The 15-year waiting period may mean that women lose the opportunity to prevent cervical cancer within 2-3 years, which is the main reason for the approval of HPV vaccines in Europe and the United States as soon as possible. The “do no harm and benefit” principle is the ethical basis for the approval of HPV vaccines. The two HPV vaccines currently available worldwide are Merck’s Gardasil and GlaxoSmithKline’s Cervarix, which are available in more than 100 countries and used in tens of millions of cases worldwide. Both vaccines have been shown to be highly effective (>95%) in preventing cervical cancer, precancerous lesions, and other genital diseases in women who are not yet infected with HPV, and both vaccines are currently considered to be equally effective, with Gardasil providing additional protection against genital warts such as condyloma acuminata.
6. When should I get vaccinated?
The appropriate age for HPV vaccination varies from country to country and even from agency to agency in the same country, and is 9-45 years old globally. the FDA-approved age is 9-26 years old, and some agencies recommend an optimal age of 11-12 years old because, after high school in the United States, sex seems to be a possibility at any time. The age limit is not absolute, but depends on whether or not one has had sex. The HPV vaccine works best for women with no history of sex, and if one is still not sexually active by age 35, then this is a perfectly cost-effective time to get vaccinated. If someone plans not to have sex for the rest of their life, then the need for the vaccine is very small.
There are also ethical arguments about the HPV vaccine, for example, do some people think that giving the vaccine to teenagers is not a disguised way of encouraging them to start having sex earlier? If pornography cannot be banned, then sex with condoms should be promoted. If parents do not even understand basic logic, they should not act like they have compassion for the next generation.
7. Can I still get the HPV vaccine after having sex?
Yes, basically you can get vaccinated at any time, but once sex starts, the chances of getting HPV infection increase greatly, and the official agencies think it is not cost-effective from the perspective of pharmacoeconomics. Whether or not you have had sex or have been infected with HPV, the vaccine is a possibility to spend money on prevention, and HPV vaccine is not cheap, the official body will consider the overall input and output, and individuals should also choose according to their own situation.
8. Do straight men need to be vaccinated?
Immunization as a public policy, official agencies will definitely consider its input benefit, which is why HPV vaccination for men is not recommended in most countries and official WHO documents. The benefit for men is mainly the prevention of genital warts, which is not fatal. There is no known effect of male vaccination on the prevention of cervical cancer in women.
9. Is the HPV vaccine safe? Can menstruating women, pregnant women, and pregnant women receive the vaccine?
From the tens of millions of uses over the past 8 years, it has stood the test. As for the safety in the long term, it will take time to answer.
The vaccine can be given during menstruation. You can get pregnant immediately after receiving the HPV vaccine without waiting. HPV vaccination is not currently recommended for pregnant women because there is not enough data to support it. No adverse effects of the HPV vaccine on the fetus have been found, and if pregnancy is discovered 6 months after vaccination, there is no need to worry about the health of the fetus, but it is recommended to stop continuing the unvaccinated vaccine until after the birth of the child.
10. Is the HPV vaccine safe after vaccination?
Regular cervical cancer screening is still necessary after HPV vaccination because HPV vaccine does not prevent all high-risk HPV types.
You do not need to be tested for HPV infection before vaccination; measles virus infection once gives lifelong immunity, but HPV does not, so testing before vaccination is not necessary. As for how long the protection period is after vaccination, the CDC’s data is 6 years, and the protection effect does not diminish over time. 6 years is mainly because the vaccine has been on the market for only 8 years, and a longer observation period is needed, so only time can answer whether the HPV vaccine has a longer protection period or even a lifetime effect.
11. When will the vaccine be available in China?
The reason for the delay in the approval of HPV vaccine in China is that China’s drug review center insists on using different criteria for judging efficacy than those of Europe, the United States and WHO. The view is that since it is a cervical cancer vaccine, it must have a definite preventive effect on the occurrence of cervical cancer, or at least on precancerous lesions (cervical intraepithelial neoplasia). The average time between HPV infection and the appearance of precancerous lesions is 5 or even 10 years, so pre-marketing clinical trials of the vaccine will take at least 5 years.
In July 2013, the Chinese Journal of Oncology published an article calling for the Drug Review Center to revise the current criteria for evaluating the effectiveness of HPV vaccines to align with Europe, the United States and WHO, and to accelerate the progress of HPV vaccine marketing in mainland China. In July 2013, the Chinese Journal of Oncology published an article calling for the Drug Review Center to revise the current HPV vaccine efficacy assessment criteria, align with Europe, the United States and WHO, and accelerate the progress of HPV vaccine marketing in mainland China.
Assuming we believe that the HPV vaccine is indeed effective, tens of millions of women of school age in China have been deprived of the opportunity to opt for vaccination during the years of delayed launch. It is hard to say what is wrong with China’s new drug review system; it is not easy to change the rules where they are placed, and it takes extraordinary competence and courage to do so. From the experience in Taiwan and Hong Kong, the HPV vaccine is as effective for the Chinese as it is for Europe and the United States, and there is little difference. The vaccines that are currently available are prophylactic not therapeutic. A therapeutic HPV vaccine is in development and clinical trials have shown preliminary results.
12. How do I get this shot?
The HPV vaccine is usually given in 3 injections, which takes about 6 months to complete, i.e. the first injection at the beginning, the second injection in the second month, and the third injection in the sixth month. Therefore, if you go to Hong Kong for vaccination, you have to make at least 3 round trips and the cost of the vaccine itself is about $2000-3000.
There are some medical checkups that offer HPV vaccination in Hong Kong, but please consider for yourself whether it is worth it. Even though the HPV vaccine has been approved in many developing countries, the vaccination rate is still not high because the vaccine is not cheap. Some articles criticize the companies that produce the vaccine for not having a conscience, but in a non-monopolistic free market, we should respect the free pricing of the companies, and profiteering can give rise to more milestone new drugs.
13.This article is suspected of strongly recommending HPV vaccination
Wrong, it is a call to give everyone a possibility to choose. As for whether to vaccinate or not, each family and individual needs to make their own judgment. The price of going to Hong Kong for vaccination, plus travel expenses (single person) is almost ten thousand dollars, if parents accompany the cost is more, if the vaccine is not lifelong immunity, additional vaccination is needed later, which is a considerable burden.
The technology for early screening for cervical cancer is very mature and much cheaper. Your own health is still your concern.