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Most Female Vaccine
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The fourth of March is World Day Against Human Papillomavirus, an infection known to be associated with the development of cervical cancer. Experts remind that this is the only cancer that can be prevented by vaccination, and again propose to include the papillomavirus vaccine in the National Calendar.

Most female vaccine
Most female vaccine

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The fourth of March is World Day Against Human Papillomavirus (HPV), an infection that is significantly associated with the risk of cervical cancer. It is held on the initiative of the International Human Papillomavirus Society IPVS under the slogan "Give love, not HPV!" On this day, experts remind that cervical cancer is the only cancer that can be prevented by vaccination, and again propose to include the papillomavirus vaccination in the National Calendar.

Today, cervical cancer is one of the most common cancers in women, it ranks first among the causes of cancer death in women 35-40 years old. In Russia, almost 17 thousand women are diagnosed with cervical cancer every year for the first time, and a third of them die. At the same time, the insidiousness of the papillomavirus of high oncogenic risk is that the disease is absolutely asymptomatic. Even at the precancerous stage, it is usually detected only with targeted screening. Therefore, cervical cancer is often diagnosed at stage 3-4.

At the same time, according to the WHO, cervical cancer can be prevented through mass screening and primary prevention - education of the population and doctors, elimination of risk factors and vaccination.

HPV is currently considered the most common sexually transmitted infection, recalls the expert of the Center for Molecular Diagnostics CMD Central Research Institute of Epidemiology of Rospotrebnadzor, head of the scientific group for the development of new methods for diagnosing papillomavirus infections Olga Shipulina. In countries where attitudes towards sex are more free, the incidence is higher. The second important factor is the general level of education and the level of public awareness. “Unfortunately, many people still believe that HPV is a harmless infection,” says the expert. “However, HPV is a whole group of heterogeneous viruses. Some of them are relatively "harmless" - for example, those that are "responsible" for the appearance of warts and genital warts. But some types of HPV (mainly HPV 16, 18, 31, 33, 35 and 45) are oncogenic and can cause cervical cancer."

Moreover, if a malignant neoplasm is detected in a timely manner - at an early stage of development, it can be removed without serious consequences. Otherwise, the tumor focus begins to grow, penetrate into the tissues of the cervix, eventually affecting the entire organ. The peak of HPV infection in Russia today is under the age of 20, and cervical cancer at a young age is developing rapidly. Therefore, women from 21 to 30 years old are recommended to undergo a cytological examination every three years, after 30 years - every five years a cytological examination plus an HPV test, Shipulina recalls. Do not forget about such "simple" methods of prevention as protected sex and adherence to traditional moral norms.

The main way to protect against HPV infections and diseases associated with this infection is vaccination: vaccination protects against the most common 16 and 18 strains, is approved and used in different countries. Doctors recommend getting the HPV vaccine for all women of reproductive age. In the case of human papillomavirus, only the vaccine creates a strong and sustained immune response, so vaccination is indicated even for people who are already infected.

The advent of the HPV vaccine, which is actually used as a cancer prophylaxis among young women, has been a major advance in immunization. However, there is a lot of scandalous information around this vaccination today. Moreover, it is absolutely implausible, the infectious disease doctor, head. Department of Vaccine Prevention H-Clinic Ekaterina Stepanova.

“The scientist who was the first to understand the connection between the two most common strains with the development of cervical cancer received the Nobel Prize for this discovery. Hoaxes at this level are simply impossible, says the expert. - Another myth is related to the fact that you can become infected with HPV due to the vaccination itself. But a vaccine is a piece of the shell of a virus that has no genetic information in it. And at the same time, this vaccination is made in such a way that the concentration of antibodies formed in response to it is highest in the cervical mucosa."

Initially, many vaccine recommendations said that there was no point in doing it after 25 years. However, according to the new recommendations, women are vaccinated before the age of 45, says Stepanova. “Indeed, this vaccination is most effective before the onset of sexual activity, however, it makes sense even for those who already have HPV, - the expert explains. - The fact is that this virus can live in the body for some time without causing harm, and if a person has good immunity, he copes with it in about six months. And, if a woman was found to have this virus during the first analysis, but not on the next one, this does not mean at all that the treatment helped her (with immunomodulators, suppositories, herbs, lotions). Such self-destruction of the virus is possible when there is no initial damage to the cervix. But as soon as the mucous membrane is damaged, it can penetrate into it, and dysplasia of the cervix begins, and then the oncological process develops. Abroad, men are also vaccinated today, because the same two strains can also cause cancer of the penis and rectal cancer.

In Russia, two vaccines have been registered so far - two and four-valent. They protect against most HPV-related cancers. But a nine-valent vaccine, which creates protection against the maximum number of "harmful" HPV species, has already been developed, and within several years it will be registered in our country as well. However, according to Stepanova, it is better not to delay vaccination and get vaccinated with the vaccines available today.

According to the WHO Regional Office for Europe, 37 out of 53 countries in the European Region are currently vaccinating girls between the ages of 9 and 14, according to the mandatory vaccination schedule. Russia is not included in this number, vaccination is carried out only in some regions of the country at the initiative of local authorities. In total, 86 countries in the world have already included the HPV vaccine in their national immunization program, and 16 of them vaccinate not only girls, but also boys. This is necessary in order to reduce the spread of virus strains, in addition, some types of HPV can provoke some types of cancer in men. According to statistics, about 80% of those who are not vaccinated contract one or more types of HPV during their lifetime.

Portugal was one of the first countries in the world to introduce HPV vaccination, and in November 2018 the National Vaccination Program (Programa Nacional de Vacinação) celebrated 10 years of successful work in maintaining at least 90% vaccination coverage among target groups (since 1995 to 2006. of birth). The Technical Commission for Vaccinations (Comissão Técnica de Vacinação) in Portugal explains that the country owes its success to “increased political commitment, support from the scientific community, the work of medical professionals and the media, and a well-functioning national immunization program”.

If today, following the example of countries such as Portugal, Russia begins mass vaccination of girls 11-12 years old and introduces a national screening program for the most dangerous, oncogenic types of the virus, then the prevalence of precancerous conditions and cervical cancer will be reduced by about 80%, they believe specialists

“We already have targeted regional screening and vaccination programs, there are vaccines registered in Russia that are sold in the public domain, but this is not enough to turn the tide,” says Olga Shipulina. - The most painful question is the question of price: at the first stage, the state's costs will be significant, funds, and considerable, need to be invested now, and the economic effect will manifest itself only in ten years. Extensive HPV testing programs are needed for young women. Sequential, organized screening is one of the most important conditions for successful prevention, as evidenced by the experience of countries such as Australia and the United Kingdom, where vaccinations and a widespread screening program have already led to a sharp decrease in the incidence and death of cervical cancer."

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