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Experts Expand HPV Vaccine Recommendations Because Study Outcomes Have High Impact



In the development of new human papillomavirus (HPV) vaccines, a federal advisory panel yesterday extended recommendations to men up to the age of 26 and some older adults. An extensive meta-analysis with data from 60 million people from 14 countries revealed that the vaccine was applied has significantly reduced infections and precancerous lesions.

Coverage for more men, adult groups

Yesterday, the Advisory Committee on Immunization Practices (ACIP), an external expert group that unanimously advised the Centers for Disease Control and Disease Control (CDC), advised it, according to a CNN report to recommend an extension of the HPV vaccine for men up to the age of 26 years. The earlier recommendation for adolescent boys and young men went beyond the age of 21

.

In addition, ACIP voted 10 to 4 to recommend adults between the ages of 27 and 45 who had not been vaccinated enough to talk to their doctors about the vaccine. The vaccine is not approved for adults over 45 years.

In a statement yesterday, the American College of Obstetricians and Gynecologists (ACOG) welcomed the expanded recommendations of ACIP. Christopher Zahn, MD, Vice President of Practice Activities at ACOG, said in a statement: "Today's decision by ACIP underlines what the data showed – that the HPV vaccine is safe and effective for use in patients aged 27 to 45 years and that the use of the vaccine in this age group should be the result of shared decisions between patients and their trusted doctors. "

He added that the vaccine, while safe and effective in patients aged 27 to 45 years but the target age is the highest one. Use the vaccine at the age of 11 to 12 years. And Zahn said the ACIP's action should encourage physicians to routinely discuss the vaccine with their adult patients.

The CDC's previous HPV recommendations have not changed. In order to prevent HPV-associated cancers of the cervix, vagina, anus, head or neck, the agency has recommended a routine HPV vaccine for girls and boys 11 and 12 years of age and for other young people not previously were vaccinated. However, the CDC routinely adopts the recommendations of the ACIP.

Study includes precancerous lesions

Meanwhile, the meta-analysis of researchers at the Canadian Laval University is updating their survey of 2015 and appeared yesterday in The Lancet . Apart from 18 studies reviewed in the previous report, the new analysis includes 47 newer ones published between February 2014 and October 2018 and the incidence of another HPV endpoint before and after the introduction of the HPV vaccine in the population examined.

Studies come from 14 high-income countries and include data from 60 million people over 8 years. Of the studies the team examined, 23 examined the influence of the vaccine on HPV infection, 29 examined the impact on anogenital warts and 13 investigated precancerous lesions.

The group's earlier meta-analysis showed significant decreases in both types – HPV 16 – and HPV 18 – which cause the majority of cases of cervical cancer and anogenital warts in vaccinated women, with herd effects for boys and older women. The previous study was unable to assess precancerous lesions as it was too early after vaccination to estimate potential effects.

The team found that HPV 16 and HPV 18 decreased in girls aged 13 to 83% 19 and 66% in women aged 20 to 24 after 5 to 8 years of vaccination. In three other HPV types (31, 33, and 45), they showed a 54% reduction in girls ages 13-19.

The use of the vaccine also reduced the diagnosis of anogenital warts in girls and women aged 15 to 29 and in boys and men aged 15 to 24 years.

Precancerous lesions decreased significantly between 5 and 9 years after vaccination: 51% in screened girls 15 to 19 years of age and 31% in screened women 20 to 24 years of age.

Cohort vaccination and high HPV vaccine coverage showed greater and faster effects, along with herd effects.

Mélanie Drolet, PhD, the first author of the study, said in a Lancet press release, "Our findings provide strong evidence The HPV vaccine prevents cervical cancer in practice because of both HPV infections affecting the Most cervical cancers cause as well as pre-cancerous cervical lesions to decrease. "

The authors said the findings support the recent recommendation of the World Health Organization (WHO) of this country. The introduction of the vaccine should include several age cohorts of girls aged 9 to 14 years and not only include a single cohort.

Another co-author of the study, dr. Marc Brisson, said the HPV landscape is changing rapidly, with several countries changing "It will be crucial to continue monitoring the impact of HPV vaccination at the population level to investigate the full impact of these strategy changes and quantify it Impact of vaccination in low and middle income countries, "he said.

The results could be indicative of politics.

In a similar commentary in the same issue of Lancet Silvia de Sanjose wrote: med. With the nonprofit health group PATH in Seattle and dr. med. Sinead Delany-Moretlwe, of the University of Witwatersrand in Johannesburg, South Africa, said the new study results can help health officials focus on priorities. They are targeting the vaccine and rethinking their current policies, especially in the face of global calls for elimination Cervical cancer.

Defining the optimal number of cohorts for vaccination could bring budget and program benefits, as several cohorts would need fewer vaccine doses. they write.

"The authors emphasize the importance of redoubling our efforts to address the fiscal, supply and programmatic barriers currently limiting HPV vaccination programs," said Sanjose and Delany-Moretlwe. "With these efforts, the HPV vaccine could become an investment in cancer prevention in the 21st century."

See also:

26. June CNN History

26. June ACOG statement

26. June Lancet Summary

26. June Lancet Comment

26. June Lancet Press Release


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