Cervical cancer remains the second most common cancer in women worldwide and is a public health priority worldwide. Romania ranks first in the European Union in terms of incidence and mortality rate from cervical cancer. Anti-HPV vaccination provides primary prevention of cervical cancer by preventing HPV (Human Papilloma Virus) infection.
Anti-HPV vaccination provides primary prevention of cervical cancer by preventing HPV (Human Papilloma Virus) infection. Genital tract infections with HPV are the most common sexually transmitted infections. During sexually active life, most women are infected with one or more types of HPV.
In most cases, HPV infection takes on asymptomatic and self-limiting forms. Persistent infections with oncogenic types of HPV present the risk of progression to precancerous lesions, which, untreated, progress to genital and ENT cancers.
The anti-HPV vaccine provides high levels of neutralizing serum antibodies, which exude from the serum to the cervico-vaginal level, where it determines a protective local immune response.
In Romania, screening for cervical cancer is provided since 2012, but has, according to data from the literature, a coverage of only 10% of the female target population, a population represented by all women aged 25-65 years, medically insured and uninsured. Screening should be performed systematically, once every 3-5 years, for all women in the target group, the test used being the Babeș-Papanicolau cytological examination. Women vaccinated against HPV should continue to access the cervical cancer screening program.
The vaccine protects against the types of HPV contained in the vaccine, which causes 90% of cervical cancers. It does not protect against other oncogenic HPV types not contained in the vaccine, nor against the types of HPV with which the woman was infected before being vaccinated. The vaccine has only a prophylactic role, not a therapeutic one. A pre-vaccination cervical lesion will not be affected by the vaccine.
The optimal time for vaccination is before the risk of HPV infection, ie before the onset of sexual life. However, anti-HPV vaccination can be performed at any time during a woman’s sexually active life.
The HPV vaccine is a genetically engineered vaccine, containing exclusively recombinant viral proteins with immunogenic capacity and free of any infectious risk (the vaccine does not cause cancer because the vaccine does not infect children with HPV).
Currently, the 9-valent vaccine (Gardasil 9) is available in Romania, which contains non-infectious L1 proteins of HPV types 6.11 (determines 90% of anogenital warts), 16, 18,31, 33, 45, 52 , 58 (causes 90% of all cases of cervical cancer). This vaccine is licensed for use by females and males from the age of 9 years.
Administration schedule for Gardasil 9 vaccine:
* for the age of 9-14 years the scheme with 2 doses is applied (at 0 and 5-13 months)
* for the age of 15 years and over the 3-dose schedule applies (at 0, 2 and 6 months)
HPV vaccines are given strictly intramuscularly in the deltoid region. Studies since the launch of the HPV vaccine (2006) to date have shown that post-vaccine immunity does not decrease over time, which is why the need for a booster dose after the first vaccination has not been established.
The most common side effects with HPV vaccination are local reactions: pain, erythema, or swelling at the injection site, usually discrete, transient; they show that the immune system responds to vaccination. Other side effects, reported much less frequently, are fever, headache and fatigue.
According to an order of the Minister of Health, approved on September 3, 2021, the age group for free anti-HPV vaccination has been extended to include girls aged 14-18. Until now, anti-HPV vaccination was performed free of charge only for girls aged 11 to 14 years.
Material made by Dr. Cornoiu Cristina, family medicine specialist from the Family Planning Office within the Târgu-Jiu County Emergency Hospital
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