Do I need to explain to someone the desire to have children? As one friend told me at the birth of his first child: “This is the best and most important thing that I have done in my life!”. And by that time he had achieved a lot.
Children are a great joy, and serious trials and experiences. But is it worth it to think that the birth of children is the path to one's own immortality? Is it worth hoping that the child will continue your work and realize what you yourself did not have time to do? In no case. Otherwise, you can easily slide into a neurosis if the child will go not in the way you expected. But it gets even worse...
"She died when she was twenty-five." I was looking at a photograph of a young smiling girl hanging in the hallway. “This is my eldest daughter. She died of cervical cancer"
Tatyana, the mother of my newborn patient, is 46 years old. But he looks older. Wrinkles, a dull voice, some kind of general freezing. Also smokes. Tatyana gave birth for the first time when she was about 20. Her husband had a high income, she did not work herself. Dacha and resorts, good car. Sitting at home, raising her daughter. Kindergarten, circles, school, institute. Beauty salons and spas. I didn’t want more children, so as not to disturb the well-established comfort of life.
And here he is, the long-awaited, but small, "foremost" between the grown-up child and the unborn grandchildren ... However, life decreed differently. Terrible diagnosis. The daughter burned out in six months. The grandchildren did not have time to be born. There is no job and no career. Hobbies are not obvious. Was life lived in vain?
And now - as a consolation - Tatyana became a mother for the second time. “It’s good that my son was born,” Tatyana said coolly, continuing to look at the photo of her dead daughter. “At least he doesn’t have a cervix!”
“You will be surprised,” I said, “but he is also in danger of getting sick.”
Every year in the world about half a million women develop cervical cancer, hundreds of thousands die every year from this disease. In Russia, 14 thousand cases of the disease are registered annually, 6 thousand women die annually.
Why am I, a pediatrician, writing about this? Because effective prevention of this terrible disease can and should be done in childhood!
According to modern concepts, 100% of cases of cervical cancer are caused by human papillomaviruses (HPV). HPV is ubiquitous. Allocate non-oncogenic and oncogenic types of HPV.
HPV infection most often occurs through sexual contact. In most cases, the body copes with the virus on its own. But with a number of factors - reduced immunity, smoking, frequent change of sexual partners - the virus can cause disease.
Up to 70% of cervical cancer cases are associated with oncogenic HPV types 16 and 18.
The problem is that HPV effectively evades the immune response of the body, immunity after an infection is not produced. And that's where the vaccine comes in. HPV vaccines contain special substances - adjuvants - that help to multiply the immune response and develop a stable long-term protective immunity.
HPV vaccines do not contain either live or killed viruses, but are made on the basis of recombinant proteins, artificially synthesized and similar to HPV antigens.
In Russia, we are offered two vaccines at once:
- Cervarix- bivalent vaccine against HPV types 16 and 18.
- Gardasil- quadrivalent vaccine against HPV types 6, 11, 16 and 18.
Cervarix protects against cervical cancer and other diseases caused by HPV types 16 and 18. Gardasil additionally protects against genital warts. Gardasil-9, a nine-valent vaccine, is now available in the US. It additionally includes protection against oncogenic HPV types 31, 33, 45, 52 and 58.
The standard regimen includes three doses of the vaccine. Vaccination of girls from 9 to 15 years is recommended. Why so early? Firstly, it is optimal to vaccinate before a possible HPV infection, that is, in fact, before the onset of sexual activity. Secondly, it turns out that at the age of 15 years, the development of immunity to the vaccine is much better than at an older age. According to the data latest research, if vaccinated before the age of 15, only two doses are enough to develop stable immunity. So, it is possible that soon it will be possible to save about 8 thousand rubles - that is how much one dose of the HPV vaccine costs in Russia.
And in a number of regions of Russia, this vaccination is done completely free of charge! Interestingly, many of my patients ask me: is it worth it? “My daughter is offered to get a free Gardasil vaccine at school, we are generally not against it, but maybe it’s better to get a paid vaccine instead of a free one?” This is how distrust of free medicine is developed.
I remember how at the beginning of the 2000s it was considered very cool for a lot of money to bring (smuggling) a hepatitis B vaccine from Europe, which was not available in Russia. But as soon as the hepatitis B vaccine appeared in the public domain in the national vaccination calendar, people began to massively refuse it - they say that it cannot be free, good and useful.
So, if suddenly your child is offered to be vaccinated against HPV for free - you need to take it! HPV vaccines are available only in the West. Vaccines are safe and effective.
Let us clarify that even if a woman is already infected with any type of HPV, the vaccine can be made without prior testing. According to the instructions, the same Gardasil can be done by all women from 9 to 45 years old. HPV vaccines do not have either a curative or a catalytic effect on pre-existing HPV. There will definitely be no harm, but it is not clear whether it is worth spending big enough money.
An interesting question is whether men should be vaccinated against HPV. Here you need to know that in addition to cervical cancer, HPV also causes warts, genital warts, penile cancer, cancer oral cavity and throat, anal cancer. So men can get sick too.
In the West, vaccination of boys is recommended for the following purposes. First, it reduces the overall circulation of HPV in the population and protects unvaccinated women from HPV. Secondly, it protects men themselves from a number of HPV-related diseases (see above). Therefore, it makes sense to vaccinate all children.
Mikhail Nikolsky
Photo istockphoto.com
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The site provides background information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!
Papillomas and warts are benign neoplasms on the mucous membranes of the genital organs, the skin of the perineum and around anus as well as in the respiratory tract. The reason for the formation of papillomas are human papillomaviruses (HPV) , of which about a hundred varieties have been identified and studied to date. In most cases, the human papillomavirus is transmitted through sexual contact, but there are other ways of infection. However, the main way is sexual contact.Since the human papillomavirus is widespread in the human population, as puberty and the onset of an active sexual life, a huge number of people become infected. In most cases, infection with this virus occurs in early age. The first episodes of its manifestation are recorded in adolescents who have begun sexual activity, in young boys and girls.
You should know that if a person has been infected with any type of human papillomavirus, then he is no longer afraid of him. The virus lives only in the epithelial layers, without causing a strong reaction of the immune system, so the phenomena of re-infection with the same types of human papillomavirus are very often observed.
Vaccination against papilloma - name, effects
There are two types in the world vaccines, which are used for vaccinations from human papilloma. One vaccine is quadrivalent, that is, it protects against infection with four types of HPV - 6, 11, 16 and 18. And the second vaccine is bivalent, and protects only against two types of HPV - 16 and 18. The quadrivalent vaccine against human papillomavirus is called Gardasil, and is produced by the Dutch pharmaceutical company "MSD - Merck Sharp and Domu B.V.", and the bivalent vaccination is produced in Belgium by the company "GlaxoSmithKline Biologicals" and has the name Cervarix.Vaccines against human papilloma do not contain the genetic material of the virus - DNA, the preparations are based on the shell protein of the microorganism. The protein structures of the human papillomavirus can cause an immune system reaction with the production of antibodies that will protect a person from infection in the future during unprotected sexual intercourse. But due to the absence of virus DNA in the composition of vaccines, they are absolutely safe, and under no circumstances can lead to infection after vaccination.
Human papillomavirus vaccines contain aluminum hydroxide, which is necessary to activate the immune response so that enough antibodies are produced to provide protection against infection in the future. In addition, human papillomavirus vaccines contain traces of yeast, antibiotics and preservatives.
The bivalent and quadrivalent human papilloma vaccines are sterile, the suspension is poured into disposable syringes or vials that contain a single dose of 0.5 ml. Cervarix is available in two-dose vials. Vaccine preparations must be stored in a cold and dry place, at an air temperature of 2 - 8 o C, but it is strictly forbidden to freeze the suspension, since in this case it loses its immunogenic properties.
Both Cervarix and Gardasil have shown very high efficacy in clinical studies, providing 100% protection against infection with oncogenic human papillomaviruses. Both vaccinations protect against oncogenic types of the virus - 16 and 18. But the spectrum of action of Gardasil is expanded due to the fact that the vaccine also protects against infection with viruses of types 6 and 11, which cause the formation of papillomas and genital warts.
Due to the similarity of some types of human papillomaviruses, and cross-reaction, vaccines also provide a fairly high level of protection against infection with HPV 31, 33, 35, 39, 45, 51, 52, 56, 58 and 59. Thanks to the effects of vaccination, it is possible to prevent the development of cancer in 90 - 95% of cases.
To date, human papillomavirus vaccines can be used for both boys and girls. However, it is customary in most countries to vaccinate only girls and young girls, as this interrupts transmission of the virus and indirectly protects boys as well. In the United States of America, the vaccine is administered, on the contrary, to both boys and girls. Unfortunately, not all states have such an opportunity, since the implementation of vaccination requires large financial costs.
What diseases are caused by the human papillomavirus?
Human papillomaviruses are not as harmless as it might seem at first glance. This type viruses can provoke a variety of infections of the genital organs. In the vast majority of cases, infectious pathologies provoked by the human papillomavirus are benign and transient. But some infections that are caused by viruses that have a high oncogenic potential can lead to the development of precancerous (background) conditions of the genital organs of men and women. So, the human papillomavirus can lead to the development of the following pathologies:
- cervical cancer;
- vaginal cancer;
- cancer of the external genital organs;
- penile cancer;
- anal cancer;
- head cancer;
- neck cancer;
- warts of the perineum and the area around the anus;
- recurrent respiratory papillomatosis.
The types of human papillomavirus with a high oncogenic potential (the ability to cause cancer) include HPV 16 and 18. And HPV 6 and 11 cause the formation of benign papillomas and genital warts in men and women in 90% of cases. 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 genital cancers.
Why is the human papillomavirus vaccine necessary?
The human papillomavirus vaccine is used to vaccinate adolescents and young adults under the age of 26. The papilloma vaccine is administered to girls and boys aged 9-14 years, or boys and girls aged 18-26. In Russia, it is recommended to vaccinate against human papilloma for teenage girls at the age of 12. The World Health Organization considers the following age categories optimal for the introduction of the papilloma vaccine:1. 10-13 years old.
2. 16 - 23 years old.
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 10 to 14 years of age. In some cases, the relevant health ministries organize supplementary vaccination programs for young women up to 26 years of age who are not infected with the virus.
Adolescents respond better predictively to the vaccine than adult boys and girls. Adolescents have a stronger immune response, leading to a stronger and more effective defense against human papillomavirus infection in the future. Therefore, it is best to vaccinate a girl or boy between the ages of 10 and 13 to protect their future health and reduce the risk of cervical or penile cancer.
Boys can only be given the quadrivalent vaccine, Gardasil, since Cervarix has not been tested in males.
If the human papillomavirus vaccine is administered to girls or boys who have not had sexual intercourse, then no additional studies and analyzes are required. If a woman or a man is already sexually active at the time of vaccination, then it is necessary to analyze for the detection of HPV 6, 11, 16 and 18. If there are no viruses, then you can get vaccinated - it will provide protection against infection in the future.
If the human papillomavirus is already present in the body, then the vaccine will be useless, that is, it is not necessary to put it. However, studies by Russian specialists have shown that vaccination of infected women before the age of 35 accelerates the cure for the human papillomavirus. Therefore, gynecologists recommend vaccination even if the human papillomavirus is detected. After the introduction of all three doses of the vaccine, 100% protection against the virus is noted within a month. You should be aware that the papilloma vaccine does not protect against other sexually transmitted infections and pregnancy.
The Gardasil and Cervarix vaccines are intended for use in young people under 26 years of age. There is no experience of vaccinating people over 26 years of age, so there is no data on the effectiveness of the immunity of vaccinated people in this age group.
The scheme of administration of the papilloma vaccine
To form full-fledged immunity against the human papillomavirus, three doses of Cervarix or Gardasil vaccines must be administered.
Gardasil is administered according to the following scheme: 0 - 2 - 6, that is, the first dose, two months after it - the second dose, and six months after the first vaccination, the person should receive the third dose. If it is necessary to vaccinate in a short time, then Gardasil is administered taking into account the following requirements: the minimum interval between the first and second dose is 4 weeks, and the minimum interval between the second and third dose is 12 weeks.
Cervarix also administered three times, according to the following scheme: 0 - 1 - 6. This means that a month after the first dose, the woman receives the second, and six months after the first - the third vaccination. If there is a need to vaccinate in a short time, then you can follow the scheme: 0 - 1 - 2.5. That is, the interval between the first and second dose is 1 month, and between the first and third - 2.5 months.
Possibilities and options for administering three doses of human papillomavirus vaccines according to other schedules are currently being explored. If a person received one dose of the vaccine, then, for some reason, the second and third were not administered on time, then there is no need to start the entire vaccination cycle again. In this case, it is necessary to enter only the missing two or one dose, observing the recommended interval between them.
For example, a person received only one vaccination against the human papillomavirus, and the second and third were overdue. In this case, the second dose is administered as soon as possible, and the third - after 4 months if Gardasil was used, and after 5 months if Cervarix was used. If the first and second doses of the vaccine were administered, and the third is overdue, then it should be administered as soon as possible. Thus, a full course of vaccination consists of three doses, which a person should receive in total.
If, after receiving two doses of vaccination, unprotected sexual contact occurs, then there is no need to worry, since in this case the level of antibodies is quite sufficient to protect against infection. The third dose of vaccination is necessary to consolidate the level of antibodies achieved by the introduction of the first two doses of the drug. Therefore, in this situation, you can safely enter the third vaccination against papilloma without undergoing an examination for the detection of HPV in the blood.
Gardasil and Cervarix vaccines are not interchangeable. This means that if you started a vaccination course with the Gardasil vaccine, then all three doses must be made with this particular drug, which cannot be replaced by Cervarix. There is no interchangeability due to the difference in the components of the vaccines, because Gardasil contains antigens of four types of human papillomavirus, and Cervarix contains only two. As a last resort, if it is not possible to complete a course of three vaccinations with the same vaccine, it is allowed to replace it with another, and administer the remaining doses with another drug. However, this substitution is strongly discouraged.
Vaccines against human papilloma may be administered simultaneously with the following immunobiological preparations:
- DTP (Infanrix, Tetrakok, Pentaxim);
- Inactivated polio vaccine (by injection - for example, Pentaxim);
- Hepatitis B vaccine.
The simultaneous administration of the human papillomavirus vaccine with the above vaccinations did not lead to a deterioration in the formation of immunity to any of the components. If several vaccines are administered at the same time, then this should be done with different syringes and in different parts of the body. Do not mix several vaccine preparations in one syringe. The interaction of the human papillomavirus vaccine with other vaccines is currently being studied.
Where is the vaccine given?
The vaccine against papilloma is administered strictly intramuscularly. Subcutaneous and intradermal administration of vaccines leads to the failure of vaccination, which must be redone, that is, this dose simply does not count. Intramuscular administration is necessary in order to create a small depot of the drug, from which it will be absorbed into the blood in parts. Such portioned entry of the drug into the blood provides an effective immune response that will allow the production of a sufficient amount of antibodies. To administer the drug intramuscularly, an injection into the thigh or shoulder is used. It is these places that are used for the introduction of 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 intramuscular injection is relatively easy to make.
Intravenous administration of the vaccine leads to the entire dose of the drug entering the bloodstream at once, which causes excessive activation of the immune system, as a result of which antigens are destroyed and antibodies are not produced. That is, immunity against the papillomavirus will not form.
Subcutaneous or intradermal administration of the drug leads to the fact that it is released and enters the bloodstream 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, getting the drug into the subcutaneous layer can provoke the development of a seal or bump at the injection site, which will resolve within a few months.
It is impossible to administer the vaccine against human papilloma into the buttock, since there is a high risk of damage to the sciatic nerve or getting into the subcutaneous fat layer, which is quite well developed in this part of the body. Penetration into the subcutaneous fat layer will lead to the formation of a seal and poor vaccine effectiveness.
Where to get vaccinated against papilloma?
Today, in Russia, vaccination against human papilloma can be done in polyclinics at the place of residence or work, in special vaccination centers, in the gynecology departments of general hospitals or oncology hospitals. In addition, papilloma vaccination can be given in private clinics or medical centers that are licensed to conduct vaccination activities. Private centers provide an opportunity to call a team of vaccinators at home, who will vaccinate in comfortable conditions.Vaccination at home has a number of advantages, the main of which is the lack of contact with patients present in a clinic or other medical institution. Very often, a person, having come for vaccination, comes into contact with patients from whom they become infected with a cold or flu, resulting in backfire vaccination. Vaccination at home will save a person from such negative consequences.
Reactions and complications to vaccination against papilloma
Vaccination against papilloma has a very low reactogenicity. This means that it is easily tolerated, rarely causing any reactions. Most commonly, the vaccine causes mild reactions at the site of injection of the vaccine, which are manifested by redness, soreness, swelling, and mild antihistamines. It is better to use drugs Erius, Zirtek or Telfast, which belong to the II and III generation of antihistamines. Do not use Suprastin or Diphenhydramine, which greatly dry the mucous membranes, causing discomfort and discomfort. In sensitive people, such drying of the mucous membranes can lead to the appearance of rhinitis and other catarrhal phenomena.There has been an increase in fainting among vaccinated adolescents. This condition is transient, and syncope resolves on its own after puberty. Despite such a mild course of the vaccination reaction, it is necessary to regularly monitor adolescents who have fainted after vaccination against papilloma. There were no reactions in the form of fainting in vaccinated girls aged 16-26 years.
A complication of vaccination against human papilloma is a severe allergic reaction that occurs in the form of anaphylactic shock, Quincke's edema, urticaria, etc.
Vaccination against papilloma and pregnancy
For ethical reasons, human papillomavirus vaccines have not been tested, so data on the effect of vaccination on the fetus are not available. Due to this circumstance, vaccination of pregnant women should be avoided. However, observations of accidentally vaccinated pregnant women did not reveal the negative effects of vaccinations against papilloma. The data relate exclusively to the Gardasil vaccine; there are no similar data on the drug Cervarix. Gardasil can be administered to women during breastfeeding. Data on the safety of administering the Cervarix vaccine during lactation are not available, therefore it is better to refrain from vaccinating with this drug when breastfeeding a child.
Contraindications to vaccination against papilloma
The human papillomavirus vaccine is contraindicated in people who have had a severe allergic reaction to a previous dose of the drug. Also, the vaccine should not be administered to people who are allergic to any component of the vaccine preparation. In these cases, vaccination against human papilloma is absolutely contraindicated.A temporary contraindication is an acute disease, or an exacerbation of an existing chronic pathology. In this case, you should wait for recovery or the onset of remission, and then administer the vaccine preparation.
Vaccine price
The cost of the human papilloma vaccine Gardasil ranges from 5,500 to 8,500 rubles in various medical institutions. The drug Cervarix is somewhat cheaper - from 3500 to 5500 rubles in various institutions. Vaccine preparations are used everywhere the same, they 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 conditions for storing vaccines are observed, since this is the key to their effectiveness and the absence of negative consequences from the introduction of a low-quality immunobiological preparation. Focus on this factor first.
Before use, you should consult with a specialist.The HPV vaccine is a way to get immunity to certain dangerous strains of the virus. The vaccine is effective against 4 strains of the virus, avoids complications that have spread widely throughout the world. This is especially true for women.
HPV is a virus that causes the appearance of papilloma, some strains infect the zone of cervical dysplasia. Papillomavirus infection is widespread throughout the world, affecting men and women who have an active sex life.
To prevent infection with a virus with oncogenic potential, it was decided to create a vaccine with a preventive purpose.
A feature of the vaccination is that the target group are girls under the age of 25 years. Men have a lower incidence of cancer than women. Vaccination of women is more effective. It is carried out before the onset of sexual activity, when the risk of infection is minimal.
There are countries in which HPV prevention in men is carried out in order to reduce the amount of the virus in the population.
What types of HPV and their effects does the vaccine protect against?
Vaccination contributes to the development of active immunity to human papillomavirus types 6, 11, 16 and 18. The first two - cause the development of genital warts. They are found in 9 out of 10 cases of growths. HPV 6 and 11 are strains with a low oncogenic risk.
HPV 16 and 18 are viruses with a high oncogenic risk that develop in the area of dysplasia of the cervical epithelium.
The use of vaccinations allows you to avoid infection, the development of consequences that cause enormous damage to physical, psychological, and financial well-being.
Which papillomavirus vaccine to choose
There are several options for HPV vaccines (in foreign sources "hpv vaccine"): Gardasil and Cervarix. They have a similar principle of action: they contain recombinant (artificially created) proteins of the capsid (the outer shell of the virus), with which immunocompetent cells interact, active immunity develops.
Gardasil contains four common, dangerous types of proteins (6, 11, 16, 18). There is a vaccine against HPV "Gardasil 9", which provides for the formation of specific antibodies to 5 other types - 31, 33, 45, 52, 58.
"Gardasil" has indications:
- prevention of cancer of the cervix, vulva, vagina in women; penis cancer, anus carcinoma in men;
- prevention of the appearance of pointed papillomas on the genitals.
The vaccine has a low risk of side effects. It is safe for pregnant and lactating women. There is no negative impact on the health of the baby, childbearing.
The Cervarix vaccine is bivalent, immunity is formed to two types - 16 and 18, which are considered provoking factors in 70% of cervical cancer. Contains proteins of the capsid of the virus, but differs in the adjuvant. Adjuvant - a substance capable of depositing an antigen, increasing its effect on immune system. The titer of antibodies when using the vaccine became 16-26 times greater than when they were naturally produced as a result of infection.
The Cervarix vaccine does not protect the body from types 6 and 11. When used, antibodies are cross-produced to 31 and 45 species with a high oncogenic risk, capable of provoking the development of genital warts, carcinomas of the mucous membranes, Bowen's disease, bowenoid papulosis.
Side effects common to most vaccines:
- fever;
- chills;
- hyperemia, edema in the injection area;
- soreness of the injection site;
- hives.
AT this moment A therapeutic vaccine is being developed that can neutralize the oncogenic effect of the virus by destroying oncoproteins and stimulating the immune system to destroy infected atypical cells. It is effective for the treatment of precancerous conditions.
The choice of vaccination depends on the attending physician and the drug.
Both drugs have a low risk of side effects. "Gardasil" has a larger spectrum of action, "Cervarix" - a longer, pronounced antiviral effect, but its range of action is narrower.
According to epidemiological studies, the prevalence of specific types of HPV in different countries different. Rational use of the vaccine will prevent infection with common strains for a particular area.
Vaccination schedule
After contacting a dermatologist, the doctor will conduct an examination, prescribe tests. After the diagnosis, confirmation of the absence of infection in the body, contraindications, the doctor will acquaint you with the vaccination schedule.
Gardasil. Immunization of children is carried out from 9 to 17 years, women from 18 to 26. The method of administration according to the instructions is intramuscularly in the deltoid muscle or in the quadriceps muscle of the thigh. Enter 0.5 ml.
The course consists of three injections: 2 months after the first, the last on the sixth month. There is an accelerated course: the second injection is carried out a month after the first injection, and the last - 3 after the second. If there was a violation of the order of application, vaccination is considered successful with the introduction of all doses during the year.
Cervarix. The optimal dose for vaccination of girls older than 10 years is 0.5 ml. Introduced in the deltoid region of the arm. Introduction scheme:
- first application;
- the second - a month later;
- the third - at 6 months.
Until what age can you get vaccinated?
The human papillomavirus vaccine is given between the ages of 9 and 25-26. In this period, a person either does not have a sexual life, or has just begun, the probability of carrying the virus is small. As a result of vaccination, immunity is formed for a long time (at least 5 years). Revaccination is not carried out.
If a person is not infected with HPV 6, 11, 16, 18 types over the age of 26, he can be vaccinated.
Vaccination against persistent human papillomavirus in the body is ineffective
Does an already infected person need a papillomavirus vaccine?
The virus penetrates inside the cells, where it loses its protein shell, its genetic apparatus takes control of the cell, starting the assembly of new viral particles. When active reproduction of the virus occurs, they speak of a productive infection. With the transition of papillomavirus into an integrated form, clinical signs disappear, an unproductive HPV infection develops. It is the integrated form that is most dangerous. In this state, the genes responsible for the synthesis of oncogenic proteins E6 and E7 are activated, which contribute to the immortalization of epidermal cells.
The introduction of the vaccine leads to the appearance of specific antibodies that can recognize the protein coat of the virus. When it enters the body, it undergoes recognition, destruction. If a person is already infected, before going to the hospital, the cells are already subject to changes. Inside them, antibodies cannot recognize the infectious agent. Vaccination in this case is ineffective.
The opinion of doctors about the HPV vaccine: pros and cons
A number of myths have accumulated around the vaccine:
- There is no evidence of protection against cancer.
- The vaccine protects against all types of HPV.
- Leads to infertility.
- They only do it for girls.
- Harm of pregnancy.
- The vaccine is used to treat bovine papillomavirus.
Myth 1: Vaccines were developed at the end of the 20th century and there is little experience with them. It excludes the development of cervical cancer with HPV infection.
Myth 2. Gardasil and Cervarix only protect against a narrow list of HPV types. There are more than 140 types that can cause warts, warts, and other manifestations of infection. The vaccine protects against 4 strains.
Myth 3. Data on impaired fertility in vaccinated people have not been found over the years of monitoring.
Myth 4. Boys are rarely vaccinated. The unpopularity of Gardasil for vaccination of men is due to the fact that forms of cancer induced by HPV do not occur, and cervical cancer is one of the most common oncologies.
Myth 5. Vaccinations in the study did not show negative impact on the fetus, but due to a small sample, one cannot speak of complete certainty in this. Not recommended for use during pregnancy.
Myth 6. Some believe that drugs are used to vaccinate cattle against papillomatosis. Human papillomavirus (not bovine or bovine) does not infect cattle.
HPV vaccination contraindications
Contraindications for vaccination:
- individual intolerance to the components of the drug;
- development of allergic reactions during the previous administration;
- feverish state;
- the presence of inflammation at the injection site.
Relative contraindications for vaccination against HPV "Gardasila":
- thrombocytopenia;
- hemophilia;
- clotting disorders when taking anticoagulants;
- fever.
The human papillomavirus, when it enters the body, can provoke the appearance of growths on the skin and mucous membranes. Some of them are non-hazardous, therefore they create only a cosmetic defect. Others can develop into malignant tumors.
HPV is especially dangerous for women due to the risk of cervical cancer. As a preventive measure, vaccination against the human papillomavirus is carried out among girls and girls.
The danger of HPV
When the human papillomavirus enters the body, various dangerous consequences appear. Infection can provoke the occurrence of not only diseases of the organs of the reproductive system, but also oncological processes. Women are the most susceptible to cancer.
HPV can lead to:
- brain tumors;
- cancer of the reproductive system and cervix;
- malignant tumors in the rectum;
- warts in the perineum;
- respiratory papillomatosis.
To exclude the possibility of dangerous consequences and HPV infection in principle, vaccination against the human papillomavirus is carried out. Vaccination helps reduce the risk of developing cancer. After 2006, when preventive measures began to be applied in Russia, the number of people infected with the virus has significantly decreased.
The virus can cause various life-threatening complications.
Who needs to be vaccinated?
The papillomavirus vaccination is performed for girls and girls. After all, the risk of developing malignant tumors in them is much higher than in men.
Despite this, in Europe, vaccination against HPV of the stronger sex is carried out along with the weak. As a result, the likelihood of spreading the virus through sexual contact is reduced.
It is best to vaccinate girls between the ages of 9 and 13-15. Even if this period is skipped, vaccination is possible before the onset of sexual relations. The deadline for vaccination is 26 years of age. Upon reaching it, it is noted that almost all women are infected with HPV. At the same time, the development of immunity at an older age is more difficult.
What vaccine can be used?
The HPV vaccine contains a man-made virus. After its penetration into the body, the immune system begins to resist the most dangerous strains that provoke damage to the genital organs and cervical cancer.
People who are vaccinated may not be afraid of HPV for a long time. The vaccine creates protection for several decades.
In the presence of HPV in the body, the result of vaccination will not be. Sometimes vaccination can lead to serious complications. Due to the fact that infection often occurs during an intimate relationship, it is better to inject an injection before sexual intercourse.
Cervarix is a vaccine against two strains of the virus
There are two vaccines that are used against HPV.
- The Belgian drug Cervarix allows you to protect the body from 16, 18 types of viruses.
- Gardasil is made in Holland. It covers four types of HPV: 6, 11, 16, 18. Currently, Gardasil is used more widely. It can be used during pregnancy and lactation.
Both vaccines do not contain papillomavirus DNA. They provoke the appearance of cells that resist viral damage. If contact with an infected person occurs, then the vaccination makes it possible to prevent the development of cancer in the future.
The vaccine is safe. After the introduction of the solution, the infection does not develop. In addition to protein, the preparation contains:
- antibiotics;
- aluminum hydroxide;
- preservative ingredients.
Vaccines are stored under sterile conditions. They are commercially available in 0.5 ml disposable syringes. Storage is carried out in the refrigerator at a temperature not exceeding 8 ° C. If the suspension is frozen, the immunogenic properties are destroyed.
Laboratory studies have shown that vaccines effectively protect against HPV infection. In vaccinated women, the risk of developing cervical cancer is reduced by 95%.
The vaccine is administered to both sexes. But most attention is paid to women, as they can transmit the virus to the child during childbirth.
The most effective vaccine is Gardasil, which protects against four strains of HPV.
Where is the vaccine given?
The HPV vaccine should only be given in the muscle. If the drug is injected into a vein or under the skin, then the effectiveness will be zero. Therefore, this injection will not be counted.
Intramuscular administration allows you to save the drug for some time. Active substances will gradually be absorbed into the blood in small portions. Due to this, an effective immune response is created for the production of antibodies.
Injections are made in the shoulder or thigh. In these areas, the muscular layer is well developed. At the same time, there is practically no fat in these areas, which makes it easy to administer the medicine.
If you inject the drug into a vein, then the entire dose of the drug will immediately enter the bloodstream. In this case, the immune system is activated too quickly. Antigens do not have time to develop in full, which does not allow antibodies to be synthesized. Therefore, there will be no immunity in HPV.
In the case of the introduction of the drug under the skin or inside it, absorption is too slow. Antigens are destroyed, and antibodies do not have time to form. A lump may form at the injection site, which will not go away for a long time.
The buttock is not injected. In this case, there is a high probability of damage to the sciatic nerve or the introduction of a solution into adipose tissue.
Vaccination should be given between the ages of 9 and 14
Vaccination scheme
Three treatments are required for a full HPV vaccination. Gardasil is administered according to the 0:2:6 schedule, during which the injection is performed:
- two months after the first;
- six months after the first injection.
If the vaccine needs to be administered urgently, then the second dose is pricked no earlier than a month, and the third - 12 weeks after the second.
Cervarix is administered one month and six months after the first. In a compressed version, vaccination is possible in a month and two and a half.
If the deadlines are not met, you should not worry. The main thing is to continue vaccination and observe the following time intervals.
Mixing vaccines is prohibited. They are not interchangeable.
Both vaccines are safe and do not cause infection.
To whom are vaccinations contraindicated?
Making the decision to administer a vaccine on your own can be dangerous. Before this, you need to visit a therapist and an immunologist who will examine the patient.
It is important to make sure that there is no HPV in the body. This can be done through laboratory research.
Some women and men are not vaccinated. This is provided for in several cases.
- Vaccination is not given for a long course of the disease provoked by papillomavirus. Vaccination is carried out only after recovery against the background of taking antiviral and immunomodulatory drugs. The disease is not a contraindication at an early stage or in a weak form.
- The drug is not pricked if a person has allergic reactions to one of the components. Among them are antibiotics, yeast. If a person suffers from an allergy, then he should inform the doctor about it. An absolute contraindication is a negative reaction to the first vaccination.
- The introduction is not carried out during the period of infection of the body with infections, as well as exacerbation of chronic pathologies. The exception to this rule is SARS.
- The drug is not administered during pregnancy and lactation. This is due to the fact that there is no confirmation of the safety of the vaccine for the child.
The question of the introduction of the HPV vaccine remains open. After all, studies have shown that it does not negatively affect the fetuses of animals. But it has not been tested on pregnant women. Therefore, it is not recommended to vaccinate during the period of bearing a child.
Pregnant women should not be vaccinated
Complications after vaccination
Vaccinations Gardasil and Cervarix have low reactogenicity. Therefore, after their introduction, there are no negative reactions. In most cases, people tolerate it well. But during the first two days may appear side effects just like after any other vaccination.
- At the injection site, you can feel pain, itching and swelling. Local reactions are not pronounced, do not require treatment.
- After administration, body temperature may rise up to 38°C. Chills and malaise are also found. It is allowed to take antipyretic drugs, as well as painkillers.
- In adolescence, fainting is possible. At this time, it is important to reduce physical activity, take walks.
- Sometimes the work of the organs of the gastrointestinal tract is disrupted. Changes are observed in the form of nausea, diarrhea, vomiting, pain. Symptomatic therapy is allowed.
The injection site may ache a little in the first two days after vaccination.
Where can you get vaccinated?
The HPV vaccine is widely available. Therefore, for the introduction of vaccination, you can contact:
- district clinic;
- institution where vaccination is carried out;
- gynecological department;
- oncological institution;
- private clinics (if licensed).
The price of vaccines can vary depending on the type and region where the person is applying. The cost of Gardasil is determined in the range of 5-8 thousand rubles per injection. Cervarix is cheaper - from 3 to 6 thousand rubles.
Vaccination is an important preventive measure to prevent the development of cervical cancer and HPV symptoms. Therefore, it is necessary to give Special attention this stage during adolescence.
About 80% of the population becomes infected with the human papillomavirus during their lifetime. There are many HPV serotypes. Most are relatively harmless - they may be asymptomatic or cause minor problems, such as single warts and papillomas on the skin. But there are also dangerous serotypes:
- HPV 16 and 18 are oncogenic, that is, they can cause neoplasms (malignant tumors)
- HPV 6 and 11 - the cause of genital warts
Thus, in a person infected with HPV:
- Condylomas may occur - outgrowths on the skin, the removal of which is quite laborious and painful
- Precancerous changes may develop, such as cervical dysplasia in women
- There is a high risk of oncological diseases of the genital organs (in women - the cervix, less often the vulva and vagina, in men - the penis, anus, rectum)
- Other infectious diseases of the genital organs develop more often and are more difficult to treat.
Oncogenic HPV serotypes cause a total of about 70% of all detected cases of cervical neoplasms, and serotypes 6 and 11 provoke 92% of all warts.
The immunity that comes with natural HPV infection is not strong enough to suppress the infection. Vaccination against the human papillomavirus is an opportunity to preserve your health, and sometimes life, by preventing possible infection and the development of tumors.
Vaccine Opportunities
HPV vaccine - biological preparation, which helps to form a stable lifelong immunity against the human papillomavirus.
This is not a live vaccine, but only fragments of the virus shell, that is, infection from the drug is completely excluded. At the same time, it causes the body to produce full-fledged antiviral antibodies, which further protect against the disease.
You can get vaccinated against HPV and cervical cancer with two drugs:
- Cervarix (Belgium) includes serotypes 16 and 18
- Gardasil (Holland) provides prophylaxis for 16, 18, 6 and 11 serotypes
Despite the difference in composition, both vaccines provide reliable immunity against all HPV serotypes due to cross-immune reactions.
Safety
The vaccine was created using recombinant technologies. These drugs have the highest safety profile. Numerous studies confirm that the vaccine can be used almost without restrictions. In the US, more than 10 million women have been vaccinated against HPV; In Russia, Cervarix and Gardasil have been successfully used since 2006.
- Daily practice shows that there are no serious side effects with the introduction of the vaccine. Sometimes there may be a slight transient reddening of the skin at the injection site.
- The HPV vaccine does not contain the DNA of the virus, which means that it does not overburden the immune system. The potential risk of complications after its introduction is extremely small.
- The safety of the drug is confirmed by the fact that it is approved for use even by pregnant and lactating women.
- It is allowed to be vaccinated while taking other medicines, without changing their doses and regimen in any way.
- Children can be vaccinated simultaneously with other vaccinations according to the National vaccination calendar.
Vaccination can be carried out in patients of both sexes, but it is especially recommended for women (as a group at high risk of cervical formations).
The main indication for HPV vaccination is age from 9 to 25 years (immunization up to 45 years is acceptable). It is optimal to vaccinate during this period, before HPV infection, best of all - before the onset of sexual activity. This will provide 100% protection against the virus and the consequences of its activity in the body: warts, genital warts, precancerous changes and neoplasms.
At the age of 26 and over there are quite high probability that the person is already infected with at least one HPV serotype. This vaccine is prophylactic, meaning it does not cure an existing viral infection. However, vaccination for people over 26 is still recommended, albeit with slightly different goals:
- Full protection against infection with dangerous serotypes if the person is not already infected with any of them
- In the case of HPV vaccination in the presence of the virus, protection against infection with those serotypes with which the person is not yet infected
- Facilitate the treatment of HPV infection that you already have
- Prevention of the development of malignant forms of tumors in the presence of HPV infection
How is the procedure carried out
- The injection is performed intramuscularly (deltoid muscle - shoulder)
- After the procedure, you do not need to comply with any restrictions and change your lifestyle
- Three injections of the vaccine are required for a sustainable effect (for the Cervarix vaccine at the age of vaccination up to 15 years - 2 doses). The interval between the first and second injections is 1-2 months (depending on the drug), between the second and third - 6 months
- Stable immunity against the virus is formed within 4 weeks after the first injection of the drug. After three injections, it remains for life
Advantages of vaccination against human papillomavirus in MEDSI
- We use modern vaccines, the effectiveness and safety of which have been confirmed by international clinical trials involving hundreds of thousands of people
- Medicines are always in stock - no need to wait for them to be available
- We have the ability to preliminarily establish the presence of oncogenic HPV serotypes in the body. This is especially true for people who want to get vaccinated after age 25.
