Recently, the age-expansion of the nine-valent HPV vaccine has been approved and the supply has gradually increased. The anxiety of previous age restriction will be greatly reduced, and more adult women will benefit from it.
Professor Lu Yihan from the Department of Epidemiology, School of Public Health, Fudan University, introduced that there are more than 200 types of HPV, and cervical cancer is mainly caused by continuous infection of high-risk HPV. The top three most susceptible high-risk HPV subtypes in Chinese women are: HPV16, HPV52, and HPV58. In addition to sexual behavior, HPV infection can also be transmitted through mother-to-child and skin mucosa contact. In addition to the cervix, HPV can also infect other parts of the body: mouth, throat, skin, anus, etc.
In China, HPV16/18 type causes about 69% cervical cancer , that is, the types covered by bivalent and tetravalent vaccines, can prevent 69% of cervical cancer. In addition, adding HPV31/33/45/52/58 type, that is, the high-risk type covered by nine-valent vaccines, can prevent 92% of cervical cancer and 90% of genital warts.
nine-valent HPV vaccine is currently the only vaccine covering two high-risk types, HPV52 and 58. With the expansion of the nine-valent HPV vaccine, most of the HPV vaccine in China are currently suitable for women aged 9-45.
Shanghai First Maternity and Infant Health Hospital Professor Duan Tao pointed out that the HPV infection rate in Chinese women is distributed "double-peak" according to age: the first peak is "17-24 years old" and the second peak is "40-44 years old". As the main primary preventive measure, the vaccination coverage rate of women of appropriate age in my country is far from enough. After the nine-valent HPV vaccine is expanded, the applicable age covers two age groups: 9-15 years old and 27-45 years old. WHO recommended HPV vaccination optimal age is 9-15 years old, while women aged 27-45 have a greater risk of HPV exposure. The nine-valent HPV vaccine expands its age and can provide women with more comprehensive protection, bringing more options for women of different ages to prevent HPV infection with and reduce the risk of related diseases.
On average, 1 person in every 5 women aged 25-45 years old is infected with high-risk HPV. Therefore, adult women with sex are often at high risk of exposure to HPV infection. Vaccination with HPV vaccine among women who have not had sex will achieve the best preventive effect, and vaccination will also have a good protective effect for women who have sex. The immune function of older women will decrease with age, and the ability to eliminate new and previous infections will also decrease, making it more likely to occur ongoing infections. This makes adult women more harmful after being infected with HPV. Therefore, it is also necessary for adult women to get HPV vaccine. There are many types of
HPV, and infection is very common. Women of appropriate age who have been infected with HPV need to be vaccinated. According to the characteristics of epidemiological in China, the infection of HPV in women in my country is mainly single infection, and HPV vaccine can have a good protective effect on other types that have not yet been infected. In addition, women infected with HPV indicate that their personal lifestyle or physical condition makes them more susceptible, and it is more necessary to be vaccinated and protected. There is currently no clinical data to support the use of nine-valent HPV vaccines interchangeably with other HPV vaccine products. The instructions for the nine-valent HPV vaccine state that if you plan to receive the nine-valent HPV vaccine after completing three doses of tetravalent HPV vaccine, you will not start vaccination after at least 12 months, and the vaccination dose will be 3 doses. There is currently no evidence to support the use of the nine-valent HPV vaccine after the full immunization procedure of the bivalent HPV vaccine. The
vaccine is approved by the National Medical Products Administration , and safety-related data in clinical trials must be provided before it is approved to be approved. More importantly, since vaccines are products used in healthy people, their long-term effectiveness and safety need to be answered through post-market real-world research.
Take the tetravalent HPV vaccine as an example. As the world's first HPV vaccine approved for marketing, it has been vaccinated more than 400 million times worldwide, and the follow-up time among women around the world has reached 14 years; it has been followed up in Chinese women for about 11 years, and the follow-up study shows that the tetravalent vaccine has a protective effect of up to 100% on high-grade cervical lesions, which is also one of the longest follow-up data for HPV vaccine so far; the nine-valent vaccine is slightly late, but there are also 8 years of global follow-up data to date, confirming that its protective effect of up to cervical high-grade lesions is 100%.
(Pan Jiayi)
