Vaccination against human papillomavirus (HPV)

Appointment: Preventive appointment (examination, consultation) with a pediatrician before vaccination - from 1,300 rubles; Preventive appointment (examination, consultation) with a general practitioner (before vaccination) - from 1800 rubles; Primary appointment (examination, consultation) with an obstetrician-gynecologist - from 2,450 rubles; DNA of papillomaviruses (Human Papillomavirus) ADVANCED SCREENING with determination of 14 types (Control of material collection, types 6, 11, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59), quantitative, with recalculated in USD Hybrid Capture for each type - from 1000 rubles; Liquid cytology of the cervix - from RUB 9223372036854775807;

Vaccine: Vaccination against human papillomavirus (Cervarix) (in children) - from 7,560 rubles; Vaccination against human papillomavirus (Gardasil) (in children) - from 12,500 rubles; Vaccination against human papillomavirus (Gardasil), 1 dose - from 12,500 rubles; Vaccination against human papillomavirus (Cervarix), 1 dose - from 6,500 rubles; Vaccination against human papillomavirus (Gardasil), 3 doses - from 39,000 rubles;

About the service

Every year in Russia, over 15,000 cases of cervical cancer are detected - this pathology ranks fifth among cancer diseases in women. More than 80% of diagnosed cases occur in the second and more severe stages of the process. About 6,000 women die from this disease every year. Its main cause is certain varieties (serotypes) of the human papillomavirus (abbreviated as HPV). It also causes tumors of adjacent locations, condylomas, and genital warts.

Timely vaccination prevents the adverse consequences of a viral infection and allows you to preserve health and life. At MEDSI clinics in Moscow, you can get vaccinated against HPV using modern vaccines on the day of your visit, with the support of experienced specialists: pediatricians, immunologists and pediatric gynecologists.

Figures and facts

Human papillomavirus Image from pharmaceutical-journal.com
In his interview, Dr. Harper provides the following data: the incidence of cervical cancer without screening and without vaccination is 90 cases per 100,000 women, with vaccination with Gardasil it drops to 14:100,000, with Cervarix - until 9:100,000.

This is a very significant reduction, but both indicators are still lower than the screening efficiency (remember, this is 7:100,000). In this sense, at the population level in a country with a successful screening program, universal immunization will not provide an additional reduction in cervical cancer incidence.

At the individual level, vaccination of girls is justified if the duration of artificial immunity is 10 years, that is, until the moment when the girl enters the screening program. But vaccinating a nine-year-old girl is likely to be of no use if she becomes sexually active after the age of 19.

With all these considerations in mind, Diana Harper insists that in developed countries, immunization against papillomavirus should be an individual choice of the girl's parents or the youngest woman, for whom it would be most effective to be vaccinated in the year of sexual activity.

The prospect of revaccination after 26 years remains vague both from the point of view of the balance of social costs and benefits (in the case of the introduction of vaccination into the national calendar), and from the point of view of individual benefit, since in most studies vaccines have demonstrated low effectiveness in older age groups.

Harper emphasizes that even if a young woman, free of infection, has been vaccinated as an adult, this in no way means that she should not worry about her health and not visit a gynecologist.

“Many vaccinated women have returned to my clinic after testing positive for papillomavirus and with illnesses caused by it. They were very disappointed when they learned that Gardasil did not protect against all types of HPV and they were still at risk for cervical cancer,” says Dr. Harper.

So, whether you're vaccinated or not, don't forget about screening. If you decide that your daughter should be vaccinated against human papillomavirus, be sure to explain to her that the vaccine does not protect against all pathogenic serotypes, and she still needs to monitor her health and visit the gynecologist at certain intervals after the start of sexual activity.

In the United States, screening is carried out from the age of 21; the World Health Organization recommends it for all women starting at 30 years of age. In Russia, there is an increase in the incidence of cervical cancer among young women, although it is possible that this is precisely the result of better diagnostics, revealing more cases of the disease than before. Some experts believe that it makes sense to set the starting age for screening in Russia at 25 years.

Your gynecologist should be willing to discuss your individual lifestyle and health circumstances with you and advise you on when and how often you personally should get examined and tested.

There is one more circumstance in favor of vaccination at the population level. Australian research shows that vaccinating girls against HPV significantly reduces infection in men. There is no data yet on how this affects the incidence of those rare types of cancer that are associated with papillomavirus in men, but it is logical to assume that they should decline.

And finally, about what is called safety concerns in the English-language medical literature, that is, “concern for safety.”

Consequences of HPV

Thus, a person infected with HPV:

Condylomas may occur - growths on the skin, the removal of which is quite labor-intensive and painful.
Precancerous changes, such as cervical dysplasia in women, may develop
There is a high risk of cancer 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 identified cases of cervical neoplasms, and serotypes 6 and 11 cause 92% of all condylomas.

The immunity that occurs when you are naturally infected with HPV is not strong enough to suppress the infection. Vaccination against the human papillomavirus is an opportunity to preserve your health, and sometimes even your life, by preventing possible infection and the development of tumors.

Will vaccination be effective if I am over 27 years old?

Until recently, vaccination was not prescribed after 27 years of age, but not because it could negatively affect the body. The thing is that its effectiveness at this age has not been proven. That is, it was believed that by the age of 28 a person had already become familiar with the virus in one way or another, and there was no point in vaccination.

However, in 2021, the Food and Drug Administration (USA) approved vaccination against the papilloma virus for men and women over 27 years of age. The experience of Australia is also impressive, where they vaccinate all minors under 19 for free and recommend that all adults do it themselves at their own expense. Scientists believe that thanks to such universal vaccination, the number of cervical cancers will drop to 400 cases per year within 10 years, and after 50 years, the problem will be almost completely overcome.

So if you are over 27 years old and sexually active, the HPV vaccine is still an effective cancer prevention method.

Vaccine possibilities

The HPV vaccine is a biological product that helps to form lasting, 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 subsequently 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 prevention for serotypes 16, 18, 6 and 11

Despite the difference in composition, both vaccines provide reliable immunity against all HPV serotypes due to cross-immune reactions.

Expert opinion

We decided to introduce you to the reviews of the center’s doctors about HPV vaccination.

Kruglova Irina Ivanovna: “I recommend that my patients get vaccinated. After all, the risks are minimal, the drugs are absolutely safe. But what is the result - you protect yourself from cancer! Cervical cancer, which accounts for 7.5% of all deaths among women from cancer. And it’s great that the effect exists regardless of age and even the presence of the virus in the blood. But we must remember that vaccination does not cancel regular screening for cervical cancer: once a year it is still necessary to undergo smear cytology or PCR.”

Akhmedova Larisa Maratovna: “When my patients ask me whether to get vaccinated against HPV, I always ask - what do you have to lose? Yes, the vaccine is not free. But its cost is incomparable to what women have to go through when faced with oncology and even genital warts. If you are already 30 years old, technically you could not be vaccinated at 10 years old, as recommended by WHO. But the vaccine is also effective after the onset of sexual activity, when you could theoretically encounter papillomavirus. There are 190 species of them, but only 2 are deadly, and we can completely protect ourselves from them today.”

Safety

The vaccine was created using recombinant technologies. Such drugs have the highest safety profile. Numerous studies confirm that the vaccine can be used with virtually no restrictions. In the United States, more than 10 million women are vaccinated against HPV; In Russia, the drugs Cervarix and Gardasil have been successfully used since 2006.

Everyday practice shows that there are no serious side effects when administering the vaccine. Sometimes there may be slight short-term redness of the skin at the injection site
The HPV vaccine does not contain the DNA of the virus, which means it does not put unnecessary strain on the immune system. The potential risk of complications after its administration 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 medications, without changing their doses or dosage regimen in any way.
Children can be vaccinated simultaneously with other vaccinations according to the National Vaccination Calendar

HPV VACCINATION

Rabbits, papillomas and the Nobel Prize

Every year in America alone, this miracle vaccine prevents up to 40 thousand cases of HPV-associated cancer. After all, HPV is an extremely common infection. Each of us is highly likely to encounter it during our lives. But some will get away with a couple of harmless warts, while others may develop cancer.

The insidious role of HPV in the occurrence of malignant tumors of the cervix, anus, vulva, vagina and even throat has already been proven.

This connection was first suspected back in the 1950s. Then scientists actively searched for the causes of cervical cancer and, among other things, decided to compare the lifestyle of sick women with those who had escaped this fate. It was striking that most often malignant tumors in the cervix were found in representatives of the fair sex who began to be sexually active early and had many partners. This seemed strange, because cancer was not considered contagious. But the data said otherwise.

The famous study of the German virologist Harold zur Hausen helped clarify the situation. He compared medical reports that women with genital warts can develop cervical cancer with the results of the research of his American colleague Richard Shoup, who showed, using the example of rabbits, the possibility of malignancy of viral papillomas. The conclusion suggested itself: what if a similar oncovirus exists in humans?

Zur Hausen first discovered human papillomavirus 6 (HPV-6), but, much to his disappointment, it turned out that it was present only in some biopsies of cervical cancer, and could not explain the diversity of this disease. This is how the scientist came to the idea of the existence of other types of HPV. The most malignant of them turned out to be HPV-16 and HPV-18: the first was found in approximately half of the cases, and the second in every fifth (it is now known for certain that these two types of HPV in total cause 70% of all cervical cancers). Harold zur Hausen was awarded the Nobel Prize for his discovery of the role of papillomaviruses in the development of cervical cancer. Self-cleaning mode enabled

In 1999, a group of American scientists from the Cancer Research Center, having conducted a global investigation, recorded the presence of HPV in 99.7% of cases of cervical cancer. Today, more than 170 different types of HPV are known. Fortunately, only 13 of them are associated with cancer risk. Moreover, most HPV infections are cleared by the immune system within one or two years and do not lead to serious complications.

For example, in 2011, the journal “Cancer Epidemiology, Biomarkers and Prevention” published the results of 10 years of observations of more than 20 thousand patients. It turned out that only 7% of those infected with HPV developed cervical cancer.

Why is this happening? Scientists have not yet determined the mechanism by which the host’s immune system gets rid of the uninvited guest, but factors are known that can interfere with it. This is a genetic predisposition, frequent change of intimate partners, genital tract infections (chlamydia, trichomonas, herpes simplex virus), smoking, poor nutrition.

The emotional state of the patient is also important. Employees of the Los Angeles Medical School found that in women under stress or depression, HPV infection does not self-heal; on the contrary, it worsens or takes on a chronic, recurrent form. During this period, the papillomavirus begins its subversive activities against the body.

Breaking and entering

In the case of the milder so-called episomal form, HPV penetrates the outer layers of the skin and mucous membranes, while the DNA of the intruder does not “mix” with the nuclear material of the host cell. Patients with this form of papillomavirus usually experience an increase in genital tumors or no symptoms at all. Over time, the mild form can transform into an integrated one, when, having firmly established itself in the human body, HPV penetrates all layers of the epidermis, integrating its DNA into the DNA of human cells.

The virus begins to actively produce oncoproteins E6 and E7, which can transform a healthy cell into a malignant one and block the work of the “native” proteins p53 and Rb.

Normally, these proteins prevent a cell from becoming cancerous. If they are “turned off,” the body cannot prevent the growth and reproduction of atypical cells, which leads to pathological changes in cells on the surface of the cervix (dysplasia) or cancer.

This disease is the second most common type of cancer among women and a global health problem. It is not surprising that once scientists discovered a cause-and-effect relationship between papillomavirus and cervical cancer (and a little later with other types of cancer), they had a new goal - to create a vaccine.

Two vaccines containing an empty shell of the virus were released in 2006 and 2009. Both drugs prevented infection by HPV 16 and 18. These two strains are responsible for the majority of cancers of the cervix, anus, vagina, vulva, mouth and pharynx, as well as about half of the cancers of the penis.

One of them was secretly considered more advanced, since it protected not only from high-risk oncogenic strains, but also from two others - HPV-6 and 11, associated with the appearance of genital warts. After a dozen years and the same amount of research, an improved version was created, ready to fight nine strains of the virus.

Hurray, it works!

HPV vaccine has significantly reduced female mortality from cervical cancer. Numerous studies around the world have shown the high effectiveness of immunization in preventing genital warts, precancerous conditions and malignant tumors of the genital organs. It remained to check their long-term effect. But even here everything turned out to be rosy.

In a 2021 study, researchers from the University of Alabama followed the condition of more than 14 thousand women for 6 years after immunization. Gynecological examinations and laboratory blood tests for the level of antibodies against HPV revealed a lasting effect in 97% of cases throughout the entire period. For the first time, doctors have hope to once and for all eliminate cancers caused by HPV, not only in women, but also in men.

"Michael Douglas Disease"

The world community learned that oncogenic papillomaviruses pose a threat to the stronger half of humanity in 2007. In men, HPV causes cancer of the throat, tongue, tonsils, penis and anus. It was later discovered that the strain of HPV-16, which causes oropharyngeal cancer, is 3-5 times more common in men than in women. Doctors mistakenly believed that such an excess was associated with smoking and other unhealthy habits of men.

Meanwhile, the results of a study by McGill University researchers in 2014 showed that oral papillomavirus was most often found in those whose partners suffered from the same virus. It is now known for certain that HPV infection is possible not only through the “traditional” route (including anal), but also through oral sex. In 2013, the famous actor Michael Douglas, who had previously been diagnosed with throat cancer, publicly stated that the main cause of his illness was not cigarettes and alcohol, but his love for oral sex. Fans took it as a joke. And in vain. The situation with this type of cancer is not at all funny: according to experts, by 2021 the incidence of oral cancer may exceed the number of cases of cervical cancer. No wonder, in 2011, the US Advisory Committee on Immunization Practices published a statement recommending universal vaccination of 11-12 year old boys. “Michael Douglas disease” is almost impossible to recognize at an early stage, unlike cervical cancer, which is easily diagnosed using a PAP test - a cytological examination of cervical smears, so the only way to protect yourself is to get vaccinated.

Get vaccinated? What if I get infected?

But how safe is it? Some are convinced that the vaccine can cause the disease itself. In fact, it is impossible to become infected with HPV as a result of vaccination, simply because the vaccine used for immunization does not contain the genetic material of the virus - only its outer shell. Another popular myth is that the HPV vaccine can negatively affect future fertility. In fact, as scientists from Boston University of Public Health have found, only the virus itself reduces the quality of sperm and reduces the likelihood of conceiving a child in a woman, and the vaccine, on the contrary, increases these chances. Another serious accusation against the human papillomavirus vaccine is that it can cause paralysis. And here not everything is clear. An increased risk of this severe complication was found only in people with multiple sclerosis. In 2009, an article by Australian neurologists was published that reported on five such patients. Within three weeks after they received the vaccine, the process of destruction of the protective layer of nerve fibers, characteristic of the underlying disease, intensified. The authors concluded that the vaccine has powerful immunostimulating properties and in some cases is not recommended for people with chronic autoimmune diseases such as multiple sclerosis. There are quite a few similar descriptions of extreme reactions of the body to the HPV vaccine. They should not be completely written off, because they can serve as an incentive for further clinical studies of discovered side effects. But you shouldn’t treat them without criticism either, given that such phenomena may just be a coincidence. Even in the above study, there is no clear evidence that paralysis occurred as a result of vaccination, and not simply due to the unfavorable course of multiple sclerosis.

One woman told

A completely incidental “anti-vaccination” propaganda happened in 2012 on the eve of the republican elections. Candidate Michele Bachmann loudly stated at the debate that it is necessary to cancel the order on the universal vaccination of girls against HPV due to its incredible danger. As an argument, the lady politician cited a heartbreaking story about how one woman told her that “her daughter was diagnosed with mental retardation after vaccination.” But one case is too small a sample. In order to claim that a complication arose as a result of vaccination against HPV, you must first compare the frequency of this complication in vaccinated and unvaccinated people.

Is there still a risk?

In 2014, the vaccine company conducted its own investigation of the risks and side effects of the vaccine based on 42 published scientific articles and found no significant differences in complications between vaccinated and unvaccinated people. Of course, the authors can be accused of personal interest, but in the same year, an independent group of Norwegian scientists published an article with similar conclusions. The risks of vaccination were carefully analyzed by employees of the largest scientific center in Europe - Karolinska University. Scientists monitored the health of a million girls aged 10-17 for six months. 300 thousand of them were vaccinated, and the rest were a control group. During this time, the participants developed 29 different ailments. Most of them occurred with equal frequency in both groups, and only three autoimmune diseases were found exclusively in the group of vaccinated girls. One of the most likely explanations for the occurrence of post-vaccination autoimmune reactions is associated with adjuvants - substances that enhance the immune system response and increase the effectiveness of vaccination. It is believed that these substances may aggravate or even provoke autoimmune disease. Unfortunately, it is not yet possible to determine in advance who may develop this complication.

Let's protect children

There is another important nuance that must be taken into account when planning HPV vaccination - age. Doctors recommend getting vaccinated at the age of 11-12, before sexual activity begins (before the young person has become infected with the virus from a partner). This fact greatly confuses “anti-vaxxers”. They consider this almost a direct call for early sexual activity. Although scientific research does not confirm these fears. In contrast, there is evidence that adolescents who have been vaccinated are more aware of the risks of unprotected sex, including sexually transmitted diseases.

The most convincing words are from unvaccinated young people in trouble: “My name is Emilia Ubbels. How did it happen that at the age of 28 I had to face cervical cancer, a diagnosis that could have been prevented? The answer is simple: I knew nothing about HPV, much less that you can get vaccinated against this nasty thing. As well as the fact that sex at an early age or with multiple partners can increase the risk of cervical cancer. »

Everyone chooses for themselves

It is believed that immunity after vaccination carried out at an early age will be more durable than if it is postponed until later. But whether a vaccination against HPV is needed after sexual debut is still unclear. Some believe that there is no point in this, since the pathogen has already entered the body. Others, on the contrary, say that the vaccine will contribute to recovery.

It would seem, why fuss if the human immune system in most cases is already capable of coping with this scourge? The problem is that primary infection does not provide lifelong immunity. This means that there is a chance of getting HPV again. It was also recently discovered that the papillomavirus is capable of autoinoculation—re-infection by transferring the virus from one area of the skin or mucous membrane to another, for example, when shaving. So the decision to get vaccinated as an adult doesn't seem so nonsensical. However, it is better to wait for new clinical studies.

In the meantime, it is important to protect children from papillomavirus. How - everyone decides for himself, but today vaccination is the most reliable and safe (with rare exceptions) that humanity has come up with.

Author:
Anna Weissertreiger Published: May 23, 2021

Who is recommended for vaccination?

Vaccination can be given to 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 get vaccinated during this period, before infection with HPV, 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, condylomas, precancerous changes and neoplasms.

At age 26 and older, there is a fairly high probability that a person is already infected with at least one serotype of HPV. This vaccine is preventative, meaning it does not cure an existing viral infection. However, vaccination is still recommended for people over 26 years of age, albeit for slightly different purposes:

Complete protection against infection with dangerous serotypes, if a person is not yet 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 has not yet been infected
Facilitating the treatment of HPV infection that already exists
Preventing the development of malignant tumors in the presence of HPV infection

Will the vaccine help if the virus is already in the body?

According to the latest research from the National Cancer Institute in the United States, if a person is already infected with HPV, the vaccine will protect him from all other types of the virus. And if self-healing occurs, it will prevent re-infection. That is, the vaccine, unfortunately, will not be able to cure you of an existing infection, but will reduce the risk of cancer.

This is why experts do not even recommend getting tested for HPV before vaccination, since the test result does not affect the advisability of vaccination.

How is the procedure performed?

The injection is performed intramuscularly (deltoid muscle - shoulder)
After the procedure, you do not need to observe any restrictions or change your lifestyle.
For a sustainable effect, three doses of the vaccine are required (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
Sustained immunity against the virus is formed within 4 weeks after the first administration of the drug. After three injections it lasts for life

Contraindications and complications

The main contraindications for the use of vaccines are an allergic reaction to the drug after the first intramuscular injection, as well as the patient’s pregnancy. Although there is no information on the effects of anti-HPV drugs on the fetus, doctors recommend against vaccination during pregnancy.

As with all other types of vaccines, the administration of drugs against human papillomavirus infection is contraindicated during periods of exacerbation of chronic diseases or the presence of other infectious diseases. In the presence of chronic diseases, vaccination against papillomavirus is carried out during the period of remission, and in case of infectious diseases - after they are completely cured.

Like any type of vaccine, prophylactic drugs against human papillomavirus can cause the following complications during and after vaccination:

a natural reaction of the body’s immune system to the introduction of HPV protein, which is manifested by skin hyperemia and inflammation at the injection site;
the injection site hurts, itches, and is hard;
general malaise;
temperature increase;
weakness to the point of fainting.

Symptoms of the body's natural immune response usually last no more than 2-3 days and are easily tolerated without the use of medications. If the temperature rises significantly (over 38 degrees), you can take antipyretic medications to relieve the discomfort.

In patients susceptible to allergies, prophylaxis with antihistamines is carried out before vaccination.

Often, when vaccinated with any drug, allergic reactions occur that the patient has never experienced before. Severe complications such as anaphylactic shock or Quincke's edema usually occur during or immediately after administration of the drug. To eliminate them, appropriate means must be available in the manipulation room.

Benefits of vaccination against human papillomavirus at 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 become available
We have the opportunity to preliminarily establish the presence of oncogenic HPV serotypes in the body. This is especially true for people who want to get vaccinated after 25 years of age

Ask about HPV vaccination, find out the cost and sign up for the procedure by calling: +7 (495) 7-800-500.

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