Many people have been vaccinated against bivalent or quadrivalent vaccines, so can these people still get the nine-valent vaccine now?

On the evening of August 30, the website of the State Food and Drug Administration showed that the indications for Merck's nine-valent human papillomavirus vaccine (Saccharomyces cerevisiae) (hereinafter referred to as the nine-valent HPV vaccine) were expanded, and the applicable population was extended to 9-45-year-old women of appropriate age

On the same day, Merck also released the news that the new indications for the nine-valent HPV vaccine were approved by

This means that 26 years old is no longer the last time to get the nine-valent HPV vaccine, and more women can choose to get it

At present, the mainstream three HPV vaccines on the market are bivalent, quadrivalent and nine-valent, and vaccines of different price points can prevent different types of HPV viruses, so what is the age of the vaccinated population corresponding to these three prices, and have they also been "extended" before? Nine-valent extended age, so can people who have been vaccinated with bivalent and quadrivalent before get another nine-valent vaccine?

Will the nine-price become better to book after broadening the age?

Nine-valent HPV vaccine

It is currently the most popular vaccine on the market

As the only vaccine that can effectively prevent cancer, in recent years, especially after the epidemic, the public attention to the topic of "HPV vaccine" has increased to an unprecedented height

Cervical cancer is one of the common gynecological malignancies, according to the data released by the National Cancer Center in February this year, the number of new cancers in China in 2020 is 4.

The 2021 ICO/IARC REPORT on HPV and related diseases in China shows that in 2020, among women aged 15-44 in China, the incidence of cervical cancer was 11.

Studies have shown that about 98% of cervical cancer in China is caused by high-risk HPV, although HPVA16/18 is a high-risk type of HPV widely circulated worldwide, but there are differences

As an effective means of preventing cervical cancer, HPV vaccination is particularly important

How do I make a vaccination appointment? Under normal circumstances, after the State Food and Drug Administration approves the new indications for the vaccine, local CDCs, community health service centers, obstetrics and gynecology hospitals and other institutions can be vaccinated, but when to start, still need to wait for the disease control department to issue a notice

In addition to public institutions, there are also some private medical institutions or third-party platforms can also make vaccine appointments, WeChat, Alipay and other platforms can search for appointments, but it is still recommended that you first understand the details before deciding whether to vaccinate

Bivalent and quadrivalent inoculation

Can I still be vaccinated with nine valence?

Due to the age constraint of 26 years old for the previous nine-valent vaccine, many people have been vaccinated with bivalent or quadrivalent vaccines, so can these people still get the nine-valent vaccine now?

First of all, I want to explain to you why the vaccine has not changed the age of the vaccinated population but can be expanded

Vaccine is a special drug, safety, effectiveness is its two major foundations, China's vaccine age approval needs to have strict research data as a support

According to Bi Hui, chief physician of the Department of Obstetrics and Gynecology of Peking University First Hospital, before the expansion of the age, the nine-valent HPV vaccine has not completed clinical research in China, but in 2018, the World Health Organization (hereinafter referred to as "WHO") proposed the goal of eliminating cervical cancer globally, based on the accessibility of vaccines, and recommended the clinical application of 3 HPV vaccines

At that time, the industry's call for the nine-valent HPV vaccine was also very high, so the State Food and Drug Administration conditionally approved the domestic marketing

But now, the HPV nine-valent vaccine has clinical research data in China, and it is found that the immunogenicity of women aged 9-15 and 27-45 years old is consistent with that of 16-26 years old, that is to say, it has the same protective effect

(^Image from drug clinical trial registration and information publicity platform)

Although various vaccines can effectively prevent HPV, it is recommended to abandon this idea

First of all, not all vaccines are 100% resistant to the invasion of the virus, and the "Chinese Expert Consensus on the Clinical Application of Human Papillomavirus Vaccine" clearly states that the HPV vaccine has shown 87.
3% -100.
0% protective efficacy in clinical trials to prevent HPV-related diseases, and the protective effect of different vaccines is also different
.

After receiving bivalent and quadrivalent vaccines, can I still get 9-valent vaccines? The instructions for the nine-valent vaccine are described as follows: "If you need to receive this product after completing 3 doses of quadrivalent HPV vaccination, you can start vaccinating this product after at least 12 months of interval, and the dose dose is 3 doses.
"

Therefore, if the quadrivalent HPV vaccine has been fully administered, it is necessary to receive the nine-valent HPV vaccine
at least one year apart.

At present, no authoritative institution at home and abroad has recommended a higher-priced vaccine after having been vaccinated with a certain HPV vaccine
.
Although it is not said that the nine-valent vaccine cannot be vaccinated after receiving the bivalent and quadrivalent vaccines, considering the types of viruses protected by these vaccines, it is still debatable whether the degree of protection against the nine-valent vaccine can be maximized in a short period of
time.

If you are getting bivalent or quadrivalent vaccines, or if you have only given one or two injections, and then transfer to the nine-valent vaccine after you have finished
, it is even more unnecessary.
After all, the composition of vaccine agents is different between different companies and different price points, and the impact on the body is also different
.

Nine-valent age has expanded

Will it get better?

It should be known that before this expansion, the nine-valent vaccine is the most difficult of these vaccines
in China.
The WHO launched the Global Strategy to Accelerate the Elimination of Cervical Cancer in 2020, which aims to complete HPV vaccination
for 90% of girls worldwide by 2030 by the age of 15.

In this regard, China's Health Commission said that it will fully support the implementation
of the strategy.
According to the latest demographic statistics, China's 9-45-year-old female population base is huge, about 340 million people, but the HPV vaccine is far from meeting the needs
of the population.

According to the data of the Central Inspection Institute, in 2020, China issued a total of 15.
44 million HPV vaccines, and the issuance of nine-valent vaccines is also the fastest, but it still cannot cover the vaccination needs of the age-appropriate population, and after each release of nine-valent vaccination information, HPV is difficult to grab information will reach the top of the hot search, which also reflects the psychology of Women in China eager to receive high-priced vaccines
.

At present, the vaccination rate of young people in China is less than 3%, and the vaccination rate of the whole population is less than 6%, and the vaccination rate is low
.

In this regard, the Chinese government encourages eligible provinces to include HPV vaccines in the scope of public vaccination, and many cities and provinces such as Xiamen, Ordos, Jinan and Guangdong have piloted and begun to give free HPV vaccines
to some girls under the age of 15.

At present, China has not included HPV vaccines into the national immunization program, and the price of HPV vaccination is relatively high, but the most direct reason for the low vaccination rate is still in short supply and dependence on imports
.
According to the statistics of various types of vaccine batches issued and the caliber of the winning price in China, merck's nine-valent, four-valent and GlaxoSmithKline bivalent vaccines account for 80% of China's market in 2021, and the bivalent vaccines of Wantai Biologics in China have only 20% of the market
.

Domestic HPV vaccine research and development started late, but the development speed is fast
.
In March 2022, Yunnan Watson Bio's Wozehui bivalent vaccine was approved for marketing, which alleviated the situation
of vaccine difficulties in China to a certain extent.

Among the HPV vaccine products currently under research in China, quadrivalent and nine-valent products have made rapid
progress.
The nine-valent HPV vaccine under development, such as Wantai Biology, Shanghai Bowei, Kangle Guardian and Ruike Biology, is already in Phase III clinical trials
.
At the same time, in March this year, the 11-valent HPV vaccine jointly developed by Sinopharm Zhongsheng and Chengdu Institute launched Phase III clinical trials, and the quadrivalent HPV vaccine of Chengdu Institute and Shanghai Bowei was in the phase III clinical stage
.

There are so many high-priced vaccines currently under development, and the existing nine-valent vaccines have also expanded, will it be better to book a few more?

This, not necessarily
.

Before the expansion of age, the nine-valent vaccine in the country is a difficult to find state, now after the expansion of age, although many people feel that they can wait, but it is not excluded that many 26-year-old + people have also begun to make an appointment to grab the vaccine, and a large number of data show that the HPV vaccine in the younger the vaccination protection effect will be more, so in the short term, the expansion may aggravate the tight supply of
nine-valent vaccine.

In this regard, Wang Linhong, chairman of the Women's Health Branch of the Chinese Preventive Medicine Association and chief expert of chronic diseases of the Chinese Center for Disease Control and Prevention, suggested that in the current tight supply of vaccines, do not miss the best vaccination time
by waiting for higher-priced vaccines.

Moreover, HPV vaccination can prevent cervical cancer, but after the vaccination is completed, it is still necessary to do regular screening, and the combination of vaccination and cervical cancer screening is the best way
to prevent cervical cancer.