According to doctors, HPV lives in the body of almost every person and is dormant
Cervical cancer remains one of the most common types of cancer among women in Russia. At the same time, doctors are observing a “rejuvenation” of the disease – it is increasingly being diagnosed in girls under 29 years of age. Cancer often develops due to HPV – the human papillomavirus, against which all schoolgirls in the Southern Urals have been vaccinated for several years. Around the world, 660 million people are already infected with it.
HPV causes about 5% of all cancers. It is impossible to cure this virus, but there is an effective measure of its prevention in the world – vaccination. In Russia, the HPV vaccine is quite difficult to get: it can be given either for money or for free, but in very complicated ways. There are many concerns around the vaccine: for example, some people believe that the vaccine leads to infertility and even autism.
Our colleagues from MSK1.RU decided to find out whether it is really dangerous to get vaccinated, whether it can save you from HPV infection and why in Russia they are so wary of it. The answers are in our material.
What is HPV?
Human papillomavirus (HPV) is a sexually transmitted infection. It affects the epithelium of the skin and mucous membranes. In most people, HPV is asymptomatic: the immune system clears the body on its own within 2–3 years. However, there is one catch: the virus has 190 types, and only a few of them can lead to cancer.
— According to various sources, from 10 to 25% of women live with HPV. The virus has oncogenic types – 16th, 18th, 31st and so on. The most dangerous are 16th and 18th. They can lead to cervical cancer in women, penile cancer in men, various hyperplastic changes (an increase in the number of cells in any tissue or organ, which leads to a change in the volume of this tissue or organ. – Note ed.), – obstetrician-gynecologist Maria Milyutina explained in a conversation with MSK1.RU.
Typically, the period for cervical cancer to develop after HPV infection is 15–20 years. At the same time, in an infected person, one type of HPV can eventually transform into another, more dangerous one. And if the body has gotten rid of the virus, it can still be infected again. If infection is confirmed, patients must undergo oncocytology annually.
There are three vaccines against this virus registered in the world.
There are no treatments for HPV yet. You can protect yourself from infection through vaccination. In total, three vaccines against the virus are registered in the world: the Belgian “Cervarix” (it protects against the two most dangerous types of HPV), the American “Gardasil” (protects against types 16, 18, 6 and 11) and “ Gardasil-9″, which is not used in Russia.
A domestic vaccine has also been in development for several years; the third stage of its research began in the summer of 2022. At the same time, it was reported that the HPV vaccine would be included in the National Preventive Vaccination Calendar in two years—that is, in the current year 2024.
Previously, it was believed that the HPV vaccine should be given to all girls between the ages of 9 and 14 years, before they became sexually active. Now, according to Milyutina, the vaccination period has been extended to 45 years.
— For a long time, only those women who were not infected with the virus could get vaccinated. Now the vaccine can be administered to those already infected with HPV. It is administered in doses: usually three, but sometimes two are enough,” the gynecologist clarified.
Typically, the second dose of the vaccine is given after two months, and the third after another six months. There is also an emergency option: the second dose is administered after a month, and the third after three.
Does vaccination really cause infertility?
In 2018, the Journal of Toxicology and Environmental Health published an article by economics and finance professor Gail DeLong, “Reduced likelihood of pregnancy among U.S. women aged 25–29 years who received an HPV vaccine injection.” According to it, young girls vaccinated against HPV were less likely to ever be pregnant than women in the same age group who did not receive the vaccine (among those vaccinated, about 35% became mothers, among those who were not vaccinated, 60%).
A year and a half later, due to the high response after publication, the journal’s publishers retracted the article. Readers had questions about the scientific validity of the study and data analysis. In particular, experts identified the following inconsistencies:
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DeLong did not take into account whether the survey participants were using hormonal contraceptives, which could explain whether or not they had children;
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The professor calculated the risk of remaining childless in women who received one, two or three doses of the vaccine, but there were no significant differences in the results. Critics noted that if the vaccine actually destroyed the ovaries, higher doses of the shot would have a greater impact on the chances of getting pregnant;
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US experts also noted that the study results may be due to the fact that young women began to work more;
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researcher Elizabeth Bick found that the groups of vaccinated and unvaccinated women that DeLong compared differed greatly in size: 118 and 582 people, respectively. Also, the author did not take into account in her calculations that these groups differ in level of education;
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some critics recalled that DeLong has already spoken out against vaccination and may be biased in her conclusions.
Despite the fact that the journal article was retracted, many people are convinced that the HPV vaccine actually leads to infertility. Although, according to Milyutina, there is no evidence of this.
– This has not been proven at all. We cannot say that it completely protects against all types of the virus. But, from a safety point of view, this is a fairly harmless vaccination,” the gynecologist noted.
“As for decreased reproductive function, the connection with the vaccine is the same as in the case of ‘it was a sunny day and infertility occurred’”
Maria Milyutina, obstetrician-gynecologist
Milyutina recalled that infertility is influenced by a huge number of factors: late planning of pregnancy, STDs, and female smoking.
— In Russia, we have a very low level of vaccination against cervical cancer. At the same time, ten years ago we said that 15% were infertile. Now it’s already 20%. These are all people who are not vaccinated against HPV.
There is one “but”
In Russia, vaccination against HPV is not included in the National Calendar of Preventive Vaccinations. It can be done in private clinics; one dose costs about ten thousand rubles. In some regions, vaccines can be obtained free of charge through a territorial program, but to do this you must contact the city health department.
According to Milyutina, the HPV vaccine is not included in the vaccination schedule because of its cost. This drug is quite expensive, and cervical cancer is not such a common disease. If every tenth woman in Russia suffers from breast cancer, about one in two thousand suffers from cervical cancer.
At the same time, a general practitioner and senior lecturer at the Department of Pharmacology of the Russian National Research Medical University named after. N.I. Pirogova Andrei Kondrakhin believes that children are not vaccinated against HPV because the virus does not cause serious problems.
— There is such an index in epidemiology: how many people need to be vaccinated in order not to get sick. In fact, there’s not even an epidemiological threshold set here, it’s not that high, so they don’t vaccinate everyone,” Kondrakhin explained. “This is not a socially significant virus; in 100% of cases it does not cause any problems.
At the same time, HPV lives in the body of almost every person and is in dormant mode, said Doctor of Medical Sciences, professor, gynecologist-endocrinologist Irina Filatova. If the infection is confirmed, the infection can be euthanized with antiviral drugs.
— I am not a supporter of vaccinations at all, because all the viruses that we have have been and will be. HPV occurs in both women and men who have only one sexual partner. We don’t treat viruses at all, we can put them to sleep, so we simply prescribe antiviral drugs and produce highly active antibodies. Our body itself is ready to defeat it; we need to let the immune system work calmly,” the doctor is convinced.
According to Filatova, if you are vaccinated against HPV, then both women and men should get the vaccine – they can be carriers of the infection.
We previously reported that the Russian Ministry of Health proposed changing the age for preventive examinations of girls by a gynecologist from 14 to 13 years. The chief freelance gynecologist for children and youth of the Ministry of Health, Elena Uvarova, said that this change is fundamentally important for preserving the reproductive health of girls. MSK1.RU found out does one year really matter?what this initiative may be related to and how changing the age of visiting a gynecologist will affect teenage girls.
2024-02-24 06:00:00
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