A message about the "extension of hpvic nine-valent vaccine to 9-45 years old" has attracted attention

On the evening of August 30, a news about the "HPV nine-valent vaccine extended to 9-45 years old" received attention, once again drawing public attention to the HPV virus, among the various cancers it caused, cervical cancer, which has the highest incidence of gynecological malignant tumors, cannot be ignored

In 2003, Mei Yanfang, a superstar of the generation who sang "Women's Flowers, Swaying in Red Dust", died in Hong Kong due to cervical cancer complications at the age of 40, and the reason for her death was cervical cancer complications leading to liver and lung dysfunction

According to WHO, cervical cancer claims about 300,000 lives every year, one case every two minutes

These deaths are still happening

The first cancer

First, the must know the truth about cervical cancer and HPV virus

| HpV viruses cause diseases that are not limited to cervical cancer

| HpV viruses cause diseases that are not limited to cervical cancer

HPV (Human Papillomavirus) is a very common group of viruses with more than 100 types that can carry HPV

Studies estimate that about 70% of cervical cancers are caused by HPV (types 16 and 18), but cervical cancer is not the only malignant tumor

Studies have shown that HPV types 16 and 18 also cause nearly 90% of anal cancers and cause a large proportion of oropharyngeal, vulvar, vaginal and penile cancers

Studies have shown that HPV types 16 and 18 also cause nearly 90% of anal cancers and cause a large proportion of oropharyngeal, vulvar, vaginal and penile cancers

| Why cervical cancer is preventable and controllable

In 1974, german scholar Zur Hausen found that about 99.

With a clear cause, it is no longer impossible

With a clear cause, it is no longer impossible

| Explain the principle of HPV vaccine

At present, the HPV vaccines on the market include the bivalent HPV vaccine produced by the United Kingdom, the quadrivalent and nine-valent HPV vaccines produced in the United States, and the divalent HPV vaccine

The so-called bivalent refers to the prevention of HPV16/18 infection; Tetravalent refers to the fact that in addition to preventing HPV16/18 infection, it can also pre-exist two low-risk HPV infections of HPV6/11; The nine-valent HPV vaccine also has a protective effect

All four HPV vaccines have been shown to be safe and effective in protecting infections against their specific HPV subtypes

Source: Shanghai Municipal Health Commission

Source: Shanghai Municipal Health Commission

| Why does the HPV vaccine need to be given multiple times? Reduce the likelihood of vaccinations

| Why does the HPV vaccine need to be given multiple times? Reduce the likelihood of vaccinations

The HPV vaccine is generally recommended at 0, 2, and 6 months (the first dose is the current month, the second dose is the second month after vaccination, and the third dose is the sixth month after the first dose

In medicine, the first and second doses of vaccines are "sensitized vaccinations", even if the vaccinated person produces antibodies; The third dose is "boosting immunity", which makes the resulting antibody more potent, which makes the preventive effect of the vaccine more durable

In April, the WHO Strategic Expert Group on Immunization (SAGE) meeting reviewed

However, this does not mean that the original three doses are not necessary, the recommended doses in the text vary according to age and individual immune function, and the evidence on the efficacy of a single dose is relatively limited, which cannot replace the current 3-dose plan
for HPV vaccines.

| Why is hpv vaccination age restricted?

| Why is hpv vaccination age restricted?

After this adjustment, the age ranges approved for Chinese mainland three vaccines are: bivalent 9 to 45 years old, quadrivalent 20 to 45 years old, and nine-valent 9 to 45 years old
.

After this adjustment, the age ranges approved for Chinese mainland three vaccines are: bivalent 9 to 45 years old, quadrivalent 20 to 45 years old, and nine-valent 9 to 45 years old
.

How is the vaccination age determined? Why are there sometimes differences between regions?

According to 36Kr, vaccines, as special drugs, have strict systems and processes in management, and it is also crucial
to ensure safety while playing its greatest role.
According to the current Measures for the Administration of Drug Registration, imported vaccines must carry out clinical trials
before they are approved for marketing in China.

Therefore, the vaccine has an age limit, in large part because the safety and efficacy of vaccination at other ages in the local population are not yet well
reported.

The State Food and Drug Administration approved the expansion of the applicable age range, also because it was supported
by more research data.

The State Food and Drug Administration approved the expansion of the applicable age range, also because it was supported
by more research data.

Second, in addition to vaccines, what else can be done to stay away from HPV?

| HPV infection ≠ cervical cancer

| HPV infection ≠ cervical cancer

Long-term, persistent HPV infection is an important cause of cervical lesions and cervical cancer, but it does not mean that hpv infection will inevitably lead to cervical cancer
.

Long-term, persistent HPV infection is an important cause of cervical lesions and cervical cancer, but it does not mean that hpv infection will inevitably lead to cervical cancer
.

In addition, cervical cancer does not mean incurable disease
.
Cervical cancer from precancerous lesions, early cancer to advanced cancer is a slower development process, influencing factors include disease stage, whether there is lymph node metastasis, whether there is vascular infiltration, whether there is parauterine metastasis, etc.
, the earlier treatment, the greater
the chance of cure.

Cervical cancer from precancerous lesions, early cancer to advanced cancer is a slower development process

In fact, Mei Yanfang was diagnosed with cervical cancer more than two years before her death, when it was in the zero stage, and if she underwent local tissue resection, the chance of cure was very high, but she did not seek medical treatment, so that her condition worsened
.

Source: Tencent Medical Code

Source: Tencent Medical Code

| To prevent cervical cancer, screening is just as important as vaccines

| To prevent cervical cancer, screening is just as important as vaccines

The HPV vaccine is not a panacea for cervical cancer prevention, and screening is essential
.
If you have been infected with HPV before vaccination, there is still a chance that you will cause cervical lesions
.
Therefore, it is recommended that women with sexual life, whether they have been vaccinated or not, need to undergo regular cervical cancer screening, that is, human papillomavirus examination (HPV) and liquid-based cervical cytology (TCT) in order to detect abnormal examination and deal with
it in time.

The HPV vaccine is not a panacea for cervical cancer prevention, and screening is essential
.
i.
e.
human papillomavirus examination (HPV) and liquid-based cervical cytology (TCT)

WHO recommends that the average woman begin screening at the age of 30 and use reliable testing to screen for HUMAN papillomavirus
regularly every 5 to 10 years.
Women living with HIV should start screening after the age of 25 and should be screened more frequently, every 3 to 5 years
.

Source: World Health Organization

Source: World Health Organization

Can the expansion of HPV vaccination save stigmatized infected people?

| The "hard to find" HPV vaccine

| The "hard to find" HPV vaccine

According to the World Health Organization, women in developing countries account for 80%
of women's deaths from cervical cancer globally.
In China, the incidence and mortality of cervical cancer in rural Chinese women are also higher than in urban areas
.
[note 4]

In the paper "China's Research and Judgment on Achieving the Phased Goal of Eliminating Cervical Cancer Globally" published in December 2021, Zheng Ying, director of the Cancer Prevention Department of the Affiliated Cancer Hospital of Fudan University, believes that China's HPV vaccination rate is low, in addition to the high price, "serious shortage of supply" is also the main reason
.

China's HPV vaccination rate is low, in addition to the high price, "serious shortage of supply" is also the main reason
.

Since the HPV vaccine was first listed in China in 2017, the vaccine has been in short supply
.
According to the hpvide of the Chinese Academy of Inspection, from the approval of China's first HPV vaccine in 2017 to 2021, there are about 20 million HPV vaccinations in China, however, the current number of women aged 9-45 years old who are vaccinated at the right age is about 381 million, and the penetration rate of HPV vaccination is only about 7%.

According to the calculation of 3 injections per woman of appropriate age, the gap in China's HPV vaccine market exceeds 1 billion
.

Therefore, the "one shot is hard to find" HPV vaccine is often associated with words such as "queuing", "lottery", "scalper", "private hospital" and so on
.

Therefore, the "one shot is hard to find" HPV vaccine is often associated with words such as "queuing", "lottery", "scalper", "private hospital" and so on
.

| Stigmatized infected people

| Stigmatized infected people

According to the International Papillomavirus Society and the China Cancer Foundation, the awareness rate of HPV among our people is only 30%.

Moreover, rural areas are relatively closed to news, and the awareness rate of HPV vaccines is relatively low
.

Rural areas are relatively closed to news, and awareness of HPV vaccines is relatively low
.

Zhang Meng, Kang Jiaxun and others published the "Investigation and Research on the Cognitive Status of HPV Vaccines for Rural Women in Henan Province", which shows that the awareness and acceptance of HPV vaccines by rural women in Henan Province are low, and there are many wrong concepts
.
The study surveyed 268 women, and the results showed that women with a zero degree of awareness accounted for more than half (53.
36%)
of the total number.

In addition, like HIV-infected people, HPV infected people are more or less saddled with crosses such as "private life indiscipline", in addition to "sex", HPV virus is ubiquitous in the environment of human survival, and the transmission channels are also diverse, such as close skin contact with infected people, or contact with the infected person's private clothing, daily necessities, special utensils, etc
.
HpV infection is not the same as "misconduct in life.
"

HpV infection is not the same as "misconduct in life.
"

But as Susan Sontag put it in The Metaphor of Disease: "AIDS is a 'natural phenomenon,' not an event
of 'some moral significance.
'" "It is absurd
to give meaning to diseases, including cervical cancer, in the sense of moral judgment.

AIDS is a 'natural phenomenon', not an event
of 'some moral significance'.

epilogue

In the face of the disease, Mei Yanfang once encouraged herself in a firm tone: "I believe that I will get better as soon as I get better, and I will definitely win
this battle.
" "Today, nearly 20 years after her death, with the help of medical development and the dissemination of medical information, cervical cancer is moving towards becoming the first cancer that has truly been eliminated by humans, and the prevention of HPV is gradually penetrating the hearts of the people
.
"

The expansion of hpv vaccine indications and applicable populations means that more women will be free from cervical cancer, and it also makes us believe more in the power of
science.
Perhaps in the near future, humanity will finally truly defeat a cancer
for the first time.

Source:

1.
"Cervical Cancer Diagnosis and Treatment Specification" (2021 edition), National Health Commission;

2.
"Who Director-General's Remarks at the Media Briefing on Cervical Cancer on 17 November 2021", WHO official website;

3.
Launching the Global Strategy to Accelerate the Elimination of Cervical Cancer, WHO official website;

4.
"Cervical Cancer Diagnosis and Treatment Specifications" (2021 edition), National Health Commission;