Human papillomavirus is widespread among humans. According to some reports, they infected more than half of the total population of the globe. The virus has many strains and varieties, some of which cause serious diseases, such as cancer. You can protect yourself with the HPV vaccine. Read more about HPV vaccination in our next article.
What diseases are caused by human papillomavirus
Human papilloma viruses are not as harmless as it may seem at first glance. This type of virus can provoke a variety of genital infections. In most cases, infectious pathologies provoked by the human papillomavirus are benign, and are transient. But some infections that are caused by viruses with a high oncogenic potential can lead to the development of precancerous (background) conditions of the genital organs of men and women.
Thus, human papillomavirus can lead to the development of the following pathologies:
- cervical cancer;
- vaginal cancer;
- cancer of the vulva;
- penile cancer;
- anal cancer;
- head cancer;
- neck cancer;
- condylomas of the perineum and the area around the anus;
- papillomatosis recurrent respiratory.
In developed countries, where high-level skilled medical care is regularly available to the general population, it is possible to identify the early stages of the lesion and prevent the formation of 80% of cancer cases. However, in the absence of such a system, cancer caused by human papillomavirus leads to a large number of deaths of men and women of childbearing age.
The types of human papillomavirus with high oncogenic potential (the ability to cause cancer) include HPV 16 and 18. And HPV 6 and 11 in 90% of cases cause the formation of benign papillomas and condylomas of the genitals of men and women. Since 2006, a vaccine has been used in Russia that can prevent infection with these types of viruses, which allows women to protect themselves from the danger of infection and significantly reduce the risk of developing cancers of the genital organs.
How to protect yourself from diseases associated with HPV
Currently, two inactivated vaccines for the prevention of infections caused by HPV, Gardasil® and Cervarix®, are licensed in the world and on the territory of the Russian Federation.
HPV vaccines contain the main L1 capsid capsid proteins, which themselves are assembled into virus-like particles (VLPs). These particles do not contain viral genetic material, and therefore are not infectious.
Both vaccines are directed against HPV 16 and 18 types, which cause at least 70% of cervical cancer cases in the world. In addition, the Gardasil vaccine is also directed against HPV types 6 and 11, which cause mild cervical pathologies and the vast majority of genital warts.
[*] In 40% of vaccinated products, the drug also provides cross-protection against any manifestations of HPV infection caused by other oncogenic types of HPV.
The results of large-scale studies of the effects of HPV vaccines followed by many years of observation have shown almost 100 percent protection against cervical conditions preceding cancer associated with these genotypes of the virus.
Experience with HPV Vaccines
Currently, HPV vaccines are actively used in many countries around the world. In a number of foreign countries, vaccination against HPV is included in National Immunization Programs. In the USA, vaccination is carried out among all girls aged 11–12 years old, in France at the age of 14, in Germany at 12–17 years old, in Austria at the age of 9–17 years.
The world experience of using these vaccines for several years has shown their safety and high prophylactic efficacy.
Currently, there are two vaccinations that protect against HPV 16 and 18, which are known to cause at least 70% of cervical cancers. These vaccines may also provide some cross-protection against other less common types of HPVs that cause cervical cancer. One of these vaccines also protects against the types of HPV 6 and 11 that cause anogenital warts. Human papillomavirus vaccinations contain the major L1 capsid proteins, which themselves are assembled into virus-like particles (VLPs). These particles do not contain viral genetic material, and therefore are not infectious.
Currently, 2 HPV vaccines have been registered in the Russian Federation: the Gardasil vaccine and the Cervarix vaccine. Vaccines contain the most common oncogenic and non-oncogenic HPV. The development and registration of HPV vaccinations in our country identified the possibility of primary prevention of cervical cancer.
Principles and objectives of vaccination
Cervical cancer, which causes human papillomavirus, is the fourth most common cancer in women in the world, and accounts for 7.5% of all female deaths from cancer. Currently, there are no effective and proven methods for treating HPV infection, therefore the only way to prevent it is vaccination.
Currently, HPV vaccines are actively used in many countries around the world. In a number of foreign countries, vaccination against HPV is included in National Immunization Programs. In the United States, vaccination is carried out among all girls aged 11–12 years old, in France at 11 years old, in Germany at 12–17 years old, in Austria at the age of 9–17 years old. The world experience of using these vaccines for several years has shown their safety and high prophylactic efficacy.
Vaccination done three times. The interval between the first and second is two months, between the second and third is four months. But it can be done according to a more dense scheme: the second – in a month and the third – two months after the second.
When pregnancy occurs, the third dose of the vaccine is postponed for the postpartum period. In the event that all three vaccinations were carried out for 12 months, the vaccination is successful and complete.
HPV Vaccination Scheme
A standard vaccination course consists of three vaccinations:
0 – 2 – 6 months
1st – selected day,
2nd – 2 months after the first dose,
3rd – 6 months after the first dose.
0 – 1 – 3 months
1st – selected day,
2nd – 1 month after the first dose,
3rd – 3 months after the first dose.
0-1 – 6 months
1st – selected day,
2nd – 1 month after the first dose,
3rd – 6 months after the first dose.
The vaccine is administered intramuscularly (as an injection) at a dose of 0.5 ml for all age groups.
The need for revaccination has not yet been established.
The results of clinical trials suggest that the current two human papillomavirus vaccines are safe and very effective in preventing infection with HPV 16 and 18. Both vaccines are more effective if vaccination is carried out before exposure to HPV. Therefore, it is preferable to carry out vaccination before the first sexual contact.
Vaccines do not cure HPV infection or an HPV-related disease (such as cancer). In some countries, vaccination of boys has been introduced, given that it helps prevent genital cancer in both men and women, and one of the available vaccines also prevents the development of genital warts in men and women.
Vaccination against HPV does not replace screening for cervical cancer. In countries where the human papillomavirus vaccine is put into effect, the development of screening programs may also be necessary. By the end of 2013, HPV vaccine was introduced in 55 countries. After a full course of vaccination, protective antibodies are detected in more than 99% of those vaccinated.
Modern mathematical models show that if girls of 12-13 years old are covered with a full course of primary immunization (3 doses) with a vaccine against HPV infection, it is possible to predict a decrease in the risk of developing cervical cancer by 63%, third degree cervical intraepithelial neoplasia (precancer) – by 51 %, cytological disorders in age cohorts up to 30 years – by 27%.
HPV vaccination – recommendations for use
Vaccination against human papillomavirus is used to vaccinate adolescents and young people under the age of 26 years. Papilloma vaccine is administered to girls and boys aged 9–14 years, or to boys and girls between 18 and 26 years old. In Russia, it is recommended to vaccinate against human papilloma in adolescent girls at the age of 12 years. The World Health Organization considers the following age categories to be optimal for the introduction of papilloma vaccine:
- 1. 10-13 years.
- 2. 16 – 23 years.
It is optimal to administer vaccines against human papilloma – before the onset of sexual activity, that is, until the child has contact with the virus. Therefore, most countries in Europe and the United States of America have decided to administer the vaccine at the age of 10-14 years. In some cases, relevant ministries of health are organizing additional vaccination programs for young women up to the age of 26 who are not infected with this virus. Adolescents respond to the vaccine in terms of prognosis better than adult boys and girls. In adolescents, a more pronounced immune response is observed, which leads to the formation of a stronger and more effective protection against infection by the human papillomavirus in the future. Therefore, it is better to vaccinate a girl or boy aged 10 to 13 years to protect their future health and reduce the risk of developing cervical or penile cancer.
Boys can only be given the tetravalent vaccine, Gardasil, since the test of Cervarix against the male sex has not been carried out. If human papilloma vaccines are given to girls or boys who have not had sexual intercourse, then no additional studies and tests are required. If a woman or a man is already having sex at the time of vaccination, it is necessary to conduct an analysis to identify HPV 6, 11, 16 and 18.
However, studies by Russian experts have shown that vaccination of infected women up to the age of 35 accelerates the cure of human papillomavirus. Therefore, gynecologists recommend vaccinating even when a human papillomavirus is detected. After the introduction of all three doses of vaccine, 100% protection against the virus occurs within a month. You should know that vaccination against papilloma does not protect against other sexually transmitted infections and pregnancy. Gardasil and Cervarix vaccines are intended for administration to young people under 26 years of age. There is no experience of vaccination of persons over 26 years old, therefore there is no data on the effectiveness of immunity of vaccinated people in this age group.
Where the vaccine is injected
Vaccination against papilloma is administered strictly intramuscularly. Subcutaneous and intracutaneous administration of vaccines leads to inconsistency of vaccination, which must be redone, that is, this dose simply does not count. Intramuscular injection is necessary in order to create a small depot of the drug, from which it will be absorbed into the blood in parts. Such a portion of the drug in the blood provides an effective immune response that will produce a sufficient amount of antibodies.
For the introduction of the drug intramuscularly injected into the thigh or shoulder. It is these places that are used to administer the vaccine, since the muscle layer on the shoulder and thigh is well developed, and comes close to the skin. In addition, the subcutaneous fat layer on the thigh and shoulder is poorly developed, so it is relatively easy to make an intramuscular injection. Intravenous administration of the vaccine leads to the entry of the entire dose of the drug into the blood at one time, which causes excessive activation of the immune system, as a result of which the antigens are destroyed and antibodies are not produced.
That is, immunity against the papilloma virus is not formed. Subcutaneous or intradermal administration of the drug leads to the fact that it is released and enters the blood too slowly, in very small portions. This situation also leads to the destruction of antigens, and antibodies are not formed, that is, the vaccine is not effective. In addition, the drug in the subcutaneous layer may trigger the development of a seal or bumps at the injection site, which will be absorbed within a few months. You can not enter the human papilloma vaccine in the buttock, because there is a high risk of damage to the sciatic nerve or falling into the subcutaneous fat layer, which is developed quite well in this part of the body. Contact with the subcutaneous fat layer will lead to the formation of a seal and a weak vaccine efficacy.
Papilloma vaccination and pregnancy
For ethical reasons, human papilloma vaccines have not been tested, therefore there are no data on the effect of vaccination on the fetus. Because of this circumstance, pregnant women should be vaccinated. However, observations of accidentally vaccinated pregnant women did not reveal the negative effects of papilloma vaccines. The data refer exclusively to the Gardasil vaccine; similar information about the drug Cervarix missing. Gardasil can be administered to women during the breastfeeding period. There are no data on the safety of the vaccine Cervarix during lactation, so it is better to refrain from vaccination with this drug when breastfeeding a child.
Vaccination against papilloma has a very low reactogenicity. This means that it is easily tolerated, rarely causes any reactions. Most often, vaccination causes mild reactions at the injection site, which are manifested by redness, soreness, swelling and slight itching. During clinical trials and the past years of observation, isolated cases of general reactions to vaccinations against papillomas, such as fever, headache, weakness, malaise and
Local reactions in the form of redness, soreness and compaction may have varying degrees of severity. These symptoms do not require any special treatment and go away on their own, without leaving any consequences.
People who are allergic to anything should be given a vaccine against human papilloma against the background of prophylactic antihistamine medication.
It is better to use drugs Erius, Zyrtec or Telfast, which belong to the II and III generation of antihistamines. Do not use Suprastin or diphenhydramine, which is very dry mucous membranes, causing discomfort and discomfort. In sensitive people, such drying of mucous membranes can lead to the appearance of rhinitis and other catarrhal phenomena. Among vaccinated adolescents, an increase in the number of fainting is observed.
This condition is transient, and syncope disappears on its own after puberty. Despite this mild vaccine reaction, it is necessary to regularly monitor adolescents who have fainting after papilloma vaccination. Reactions in the form of fainting in vaccinated girls aged 16 – 26 years was not observed. A complication of vaccination against human papilloma is a severe allergic reaction that takes the form of anaphylactic shock, angioedema, urticaria and
The risk of post-vaccination difficulties
The existing system of monitoring the safety of vaccines used in the USA (VAERS) did not register any complications during the entire period of use of the Gardasil vaccination in the country (more than 12 million doses).
Infection with one of the types of HPV that make up vaccines is not a contraindication to vaccination; but you should consult with your doctor and gynecologist about the need for such vaccinations. HPV vaccines are contraindicated for: allergies to any component of the vaccine, severe allergic reactions to the previous administration of this drug, pregnancy. As with any vaccine, temporary contraindications for vaccination are acute diseases and exacerbations of chronic diseases. In such cases, the HPV vaccine is delayed until recovery.
Where to get vaccinated against papilloma
Today, in Russia, vaccination against human papillomas can be done in polyclinics at the place of residence or work, in special vaccination centers, in the gynecology departments of general hospitals or oncological hospitals.
Vaccination at home has a number of advantages, the main of which is the lack of contact with patients who are present in the clinic or another medical facility. Very often, when a person comes to be vaccinated, he contacts with patients from whom they catch a cold or flu, which results in unpleasant consequences of vaccination. Vaccination at home will save a person from such negative consequences.
The cost of the human papilloma vaccine Gardasil ranges from 5,500 to 8,500 rubles in various medical institutions. The preparation Cervarix costs a little less – from 3,500 to 5,500 rubles in various institutions. Vaccine preparations are used everywhere the same, are purchased from the same pharmaceutical companies, so the difference in cost is due solely to the pricing policy of the medical institution.
For vaccination, choose a medical institution in which the storage conditions of vaccines are met, since this is the key to their effectiveness, and the absence of negative consequences from the introduction of poor-quality immunobiological preparation. Focus, first of all, on this factor. Before use, you should consult with a specialist.