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Recently, the Harvard University team in the United States and the Cancer Council of NSW Australia jointly published a study on PLOS Medicine, showing that even assuming that the human papillomavirus (HPV) vaccine can prevent 95% of cervical cancers, HPV is vaccinated for adults 26 years and older.
May not be cost-effective.
Human papillomavirus vaccination for adults aged 30 to 45 years in the United States: A cost-effectiveness analysis.
doi.
org/10.
1371/journal.
pmed.
1003534 Researchers used 2 independent HPV microsimulation models to The cost-effectiveness of extending the upper age limit for HPV vaccination to 30, 35, 40 or 45 years old for men (21 years old) and men (21 years old).
These models are empirically calibrated to reflect the burden of HPV and related cancers in the U.
S.
population.
At the same time, the standardization of past and future vaccinations, vaccine efficacy, cervical cancer screening and cost is used for comparison.
Disease results analyzed include cervical cancer, anal cancer, oropharyngeal cancer, vulvar cancer, vaginal cancer, and penile cancer, as well as genital warts.
The results show that both models predict that as the upper age limit for HPV vaccination increases, the cost will be higher, but the difference in health benefits is not significant.
The cost-effectiveness of vaccination strategies for women and men under the age of 30, 35 and 40 is lower than that of vaccination strategies under 45, which has an incremental cost-benefit ratio (ICER) greater than the generally accepted upper limit of US$200,000 The quality adjusted life-year (QALY).
(Note: Quality-Adjusted Life Years or Quality-Adjusted Life Years (QALY) are general measures of disease burden, which include both quality and quantity of living residence.
It is used in economic evaluation to evaluate the value of medical interventions.
) Sensitivity analysis, Harvard model sensitivity analysis, Australia NSW model study found that, considering the current price of HPV vaccine, compared with the HPV vaccine target adolescent age, vaccination over the age of 26 is of little health significance, and the cost is higher .
Jane Kim, professor of health economics at the Harvard TH School of Public Health, pointed out that the HPV vaccine has a preventive effect, so it is most effective when given before HPV infection.
Generally, humans may be exposed to HPV shortly after the start of sexual activity.
Once infected, the vaccine has no effect on the virus.
HPV virus.
medicalpark HPV is a non-enveloped DNA virus that easily infects skin and mucous membrane cells.
Most people infected with HPV have no symptoms, most HPV infectious diseases will clear up, and certain types of low-risk HPV can cause genital warts.
High-risk HPV is the cause of cervical cancer, anal cancer, penile cancer, oral cancer and laryngeal cancer.
According to the WHO 2020 cancer report, there are more than 460,000 cases of cervical cancer in my country, and it has become the second leading cancer killer in the lives of women aged 15 to 44 in my country.
The number of cancer patients in my country in 2020.
As the first human cancer vaccine, the HPV vaccine can be described as a well-deserved vaccine star in recent years.
In life, I often hear that female friends around me get HPV vaccines.
In fact, in addition to cervical cancer, the HPV vaccine is very effective in preventing HPV infections related to anal cancer, oropharyngeal cancer, vulvar cancer, vagina cancer, penile cancer, and genital warts.
However, for the time being, the public has not yet fully understood the carcinogenicity of HPV, so the HPV vaccination rate is low.
Previously, a team from the School of Public Health at the University of Texas Health Science Center in Houston (UTHealth) conducted a study on the popularity of HPV carcinogenicity, and the results were published in JAMA Pediatrics.
Public Knowledge of Human Papillomavirus and Receipt of Vaccination Recommendations.
DOI: 10.
1001/jamapediatrics.
2019.
3105 analysis found that more than 70% of adults do not know that HPV can cause cancer of the anus, penis and oral cavity.
In addition, among those eligible for the vaccine, only 19% of men and 31.
5% of women received recommendations from health care providers for vaccines.
It can be seen that the lack of knowledge may be one of the reasons for the low HPV vaccination rate, and the promotion of HPV vaccines still needs to be accelerated.
For this reason, the American Cancer Society (ACS) updated the HPV vaccination guidelines of the Federal Advisory Committee on Immunization Practice (ACIP) in the Shenkan CA in 2020.
The ideal age guidelines for vaccination suggest that girls and boys should be vaccinated with 2 doses of HPV vaccination when they are 9 to 12 years old; medical institutions are encouraged to start providing HPV vaccination when they are 9 or 10 years old; children who have not received HPV vaccination and youth under 26 years of age It should be possible to replant the vaccine.
However, it should be pointed out that vaccination for people aged 22-26 is not as effective as children and adolescents in preventing cancer.
People over 26 years of age are vaccinated with HPV vaccine effectiveness and cancer prevention potential is low.
For adults over the age of 26, the guidelines do not specifically recommend supplementary vaccination, but it is recommended that for people 27-45 years old, clinicians and patients decide whether to vaccinate HPV vaccine according to their personal circumstances.
The guidelines point out that vaccinating all children between the ages of 9 and 12 will prevent more than 90% of cervical cancer, oropharyngeal cancer, anal cancer, vaginal cancer, vulvar cancer, and penile cancer caused by HPV.
A summary of ACS adaptation recommendations, Human papillomavirus vaccination 2020 guideline update: American Cancer Society guideline adaptation.
https://doi.
org/10.
3322/caac.
21616 At present, more than half of the countries in the world have included HPV vaccine in their national immunization programs.
The US Food and Drug Administration (FDA) approved Merck’s HPV tetravalent vaccine (HPV4) Gardasil in 2006; in 2009, it approved GlaxoSmithKline’s bivalent vaccine (HPV2) Cervarix, which can prevent two high-risk Type of HPV; Gardasil 9 nine-valent vaccine (HPV9) was approved in 2014.
In my country, the HPV vaccine has not been included in the national immunization program and the price is high, resulting in an extremely low HPV vaccination rate in my country.
At present, my country has 4 HPV vaccine products on the market, namely Cervarix, Gardasil, Gardasil 9 and domestic HPV vaccine (329 yuan per shot).
Sina Finance In addition, in addition to the low vaccination rate, the supply gap is also quite large.
In fact, if the HPV vaccine price issue is only solved, it will still be difficult to fully increase the vaccination rate.
At the moment, we are also facing a situation where "a needle is hard to find".
Part of the 9-valent HPV vaccine is seriously out of stock in some vaccination sites, and it may be scheduled until 2022 if it is to be vaccinated.
How should adults over 26 years of age fight cervical cancer? The WHO recommends that HPV vaccination can be promoted among younger women and men, which can provide some herd immunity benefits for the unvaccinated population; secondly, cervical screening should be carried out for unvaccinated women.
Pap smear (cytology) is the only test that is used in a large population and has been shown to reduce the incidence and mortality of cervical cancer.
People who are 21 years of age or older should receive Pap testing every 3 years until they are 30 years old; after that, if the test results are normal, they will receive a Pap test and HPV test every 5 years.
To sum up, despite the rapid development of HPV vaccines in my country, based on the population base, vaccine price and quantity, we still have a long way to go to eliminate cervical cancer.
For the current medical form, the most economical and practical method is to check regularly.
.
Source: Metz Medical Comprehensive Report authorized to reprint, submit articles and break the news, please contact Metz Medical Administrator MedSci (WeChat ID: medsci_m) for recommended reading Surprise! 35 million people worldwide suffer from drug abuse disorder, and opioids are the most harmful.
Is the foreign new crown vaccine okay? Deactivated in multiple countries? Heavy: 13 latest proposals for the pharmaceutical industry at the National Two Sessions in 2021! Lancet: Heavy! Only 2.
7% of the Wuhan population produced effective antibodies to the new coronavirus!
May not be cost-effective.
Human papillomavirus vaccination for adults aged 30 to 45 years in the United States: A cost-effectiveness analysis.
doi.
org/10.
1371/journal.
pmed.
1003534 Researchers used 2 independent HPV microsimulation models to The cost-effectiveness of extending the upper age limit for HPV vaccination to 30, 35, 40 or 45 years old for men (21 years old) and men (21 years old).
These models are empirically calibrated to reflect the burden of HPV and related cancers in the U.
S.
population.
At the same time, the standardization of past and future vaccinations, vaccine efficacy, cervical cancer screening and cost is used for comparison.
Disease results analyzed include cervical cancer, anal cancer, oropharyngeal cancer, vulvar cancer, vaginal cancer, and penile cancer, as well as genital warts.
The results show that both models predict that as the upper age limit for HPV vaccination increases, the cost will be higher, but the difference in health benefits is not significant.
The cost-effectiveness of vaccination strategies for women and men under the age of 30, 35 and 40 is lower than that of vaccination strategies under 45, which has an incremental cost-benefit ratio (ICER) greater than the generally accepted upper limit of US$200,000 The quality adjusted life-year (QALY).
(Note: Quality-Adjusted Life Years or Quality-Adjusted Life Years (QALY) are general measures of disease burden, which include both quality and quantity of living residence.
It is used in economic evaluation to evaluate the value of medical interventions.
) Sensitivity analysis, Harvard model sensitivity analysis, Australia NSW model study found that, considering the current price of HPV vaccine, compared with the HPV vaccine target adolescent age, vaccination over the age of 26 is of little health significance, and the cost is higher .
Jane Kim, professor of health economics at the Harvard TH School of Public Health, pointed out that the HPV vaccine has a preventive effect, so it is most effective when given before HPV infection.
Generally, humans may be exposed to HPV shortly after the start of sexual activity.
Once infected, the vaccine has no effect on the virus.
HPV virus.
medicalpark HPV is a non-enveloped DNA virus that easily infects skin and mucous membrane cells.
Most people infected with HPV have no symptoms, most HPV infectious diseases will clear up, and certain types of low-risk HPV can cause genital warts.
High-risk HPV is the cause of cervical cancer, anal cancer, penile cancer, oral cancer and laryngeal cancer.
According to the WHO 2020 cancer report, there are more than 460,000 cases of cervical cancer in my country, and it has become the second leading cancer killer in the lives of women aged 15 to 44 in my country.
The number of cancer patients in my country in 2020.
As the first human cancer vaccine, the HPV vaccine can be described as a well-deserved vaccine star in recent years.
In life, I often hear that female friends around me get HPV vaccines.
In fact, in addition to cervical cancer, the HPV vaccine is very effective in preventing HPV infections related to anal cancer, oropharyngeal cancer, vulvar cancer, vagina cancer, penile cancer, and genital warts.
However, for the time being, the public has not yet fully understood the carcinogenicity of HPV, so the HPV vaccination rate is low.
Previously, a team from the School of Public Health at the University of Texas Health Science Center in Houston (UTHealth) conducted a study on the popularity of HPV carcinogenicity, and the results were published in JAMA Pediatrics.
Public Knowledge of Human Papillomavirus and Receipt of Vaccination Recommendations.
DOI: 10.
1001/jamapediatrics.
2019.
3105 analysis found that more than 70% of adults do not know that HPV can cause cancer of the anus, penis and oral cavity.
In addition, among those eligible for the vaccine, only 19% of men and 31.
5% of women received recommendations from health care providers for vaccines.
It can be seen that the lack of knowledge may be one of the reasons for the low HPV vaccination rate, and the promotion of HPV vaccines still needs to be accelerated.
For this reason, the American Cancer Society (ACS) updated the HPV vaccination guidelines of the Federal Advisory Committee on Immunization Practice (ACIP) in the Shenkan CA in 2020.
The ideal age guidelines for vaccination suggest that girls and boys should be vaccinated with 2 doses of HPV vaccination when they are 9 to 12 years old; medical institutions are encouraged to start providing HPV vaccination when they are 9 or 10 years old; children who have not received HPV vaccination and youth under 26 years of age It should be possible to replant the vaccine.
However, it should be pointed out that vaccination for people aged 22-26 is not as effective as children and adolescents in preventing cancer.
People over 26 years of age are vaccinated with HPV vaccine effectiveness and cancer prevention potential is low.
For adults over the age of 26, the guidelines do not specifically recommend supplementary vaccination, but it is recommended that for people 27-45 years old, clinicians and patients decide whether to vaccinate HPV vaccine according to their personal circumstances.
The guidelines point out that vaccinating all children between the ages of 9 and 12 will prevent more than 90% of cervical cancer, oropharyngeal cancer, anal cancer, vaginal cancer, vulvar cancer, and penile cancer caused by HPV.
A summary of ACS adaptation recommendations, Human papillomavirus vaccination 2020 guideline update: American Cancer Society guideline adaptation.
https://doi.
org/10.
3322/caac.
21616 At present, more than half of the countries in the world have included HPV vaccine in their national immunization programs.
The US Food and Drug Administration (FDA) approved Merck’s HPV tetravalent vaccine (HPV4) Gardasil in 2006; in 2009, it approved GlaxoSmithKline’s bivalent vaccine (HPV2) Cervarix, which can prevent two high-risk Type of HPV; Gardasil 9 nine-valent vaccine (HPV9) was approved in 2014.
In my country, the HPV vaccine has not been included in the national immunization program and the price is high, resulting in an extremely low HPV vaccination rate in my country.
At present, my country has 4 HPV vaccine products on the market, namely Cervarix, Gardasil, Gardasil 9 and domestic HPV vaccine (329 yuan per shot).
Sina Finance In addition, in addition to the low vaccination rate, the supply gap is also quite large.
In fact, if the HPV vaccine price issue is only solved, it will still be difficult to fully increase the vaccination rate.
At the moment, we are also facing a situation where "a needle is hard to find".
Part of the 9-valent HPV vaccine is seriously out of stock in some vaccination sites, and it may be scheduled until 2022 if it is to be vaccinated.
How should adults over 26 years of age fight cervical cancer? The WHO recommends that HPV vaccination can be promoted among younger women and men, which can provide some herd immunity benefits for the unvaccinated population; secondly, cervical screening should be carried out for unvaccinated women.
Pap smear (cytology) is the only test that is used in a large population and has been shown to reduce the incidence and mortality of cervical cancer.
People who are 21 years of age or older should receive Pap testing every 3 years until they are 30 years old; after that, if the test results are normal, they will receive a Pap test and HPV test every 5 years.
To sum up, despite the rapid development of HPV vaccines in my country, based on the population base, vaccine price and quantity, we still have a long way to go to eliminate cervical cancer.
For the current medical form, the most economical and practical method is to check regularly.
.
Source: Metz Medical Comprehensive Report authorized to reprint, submit articles and break the news, please contact Metz Medical Administrator MedSci (WeChat ID: medsci_m) for recommended reading Surprise! 35 million people worldwide suffer from drug abuse disorder, and opioids are the most harmful.
Is the foreign new crown vaccine okay? Deactivated in multiple countries? Heavy: 13 latest proposals for the pharmaceutical industry at the National Two Sessions in 2021! Lancet: Heavy! Only 2.
7% of the Wuhan population produced effective antibodies to the new coronavirus!
