HPV

JCVI interim advice on a one-dose schedule for the routine HPV immunisation programme

The U.K.’s Joint Committee on Vaccination and Immunisation (JCVI) has been considering a potential move to authorize just one dose of the HPV vaccine for several years.

Indeed, the JCVI was aware of the potential for one dose as far back as 2018.

The committee agreed in February 2022 that there is now enough clinical evidence to advise a change in the schedule from two doses of 4-valent HPV vaccine to one dose in the routine adolescent program for those up to 14 years of age.

Two longstanding clinical trials have contributed valuable data with post hoc analyses of non-randomized data on the potential of one dose, the Costa Rica Vaccine Trial (bivalent vaccine) and the IARC Indian trial (quadrivalent vaccine).

These studies have published endpoints followed up to 10 years and have shown persistence of antibody and efficacy over time.

Then, in December 2021, the JCVI reviewed additional data presented from other studies.

Furthermore, the move to the 9-valent vaccine is due to commence in 2022.

The 9-valent HPV vaccine is JCVI’s preferred vaccine for the program because of the additional protection that is provided against the five additional cancer-causing HPV types.

The 9-valent HPV vaccine should offer protection against about 90% of the cervical cancers caused by the HPV high-risk types.

This is an increase of cervical cancers that the bivalent (70%) and quadrivalent (80%) vaccines protect against.

The JCVI says a single-dose schedule should free up resources that can be deployed to further strengthen the adolescent immunization programs in the U.K.

Furthermore, some of the resources made available due to the reduction in vaccination sessions should be re-directed to interventions that strengthen program delivery, increase coverage rates and reduce inequalities.

Current efforts are focused on the ongoing catch-up of those adolescents who have missed their first or second dose due to the interruptions to the schools’ immunization program due to the pandemic.

As with all vaccine programs, a one-dose HPV program will be closely monitored through surveillance and kept under review by the committee with the option of adjusting the program if new data emerges or if new vaccines or technologies become available that could further strengthen protection against HPV infection and the consequent cancers.

This change contrasts with the U.S. CDC’s recently updated HPV vaccination schedule for 2022.

The CDC continues to recommend two HPV vaccine doses for most adolescents, and three doses for other people.

However, the CDC and the JCVI are aligned on preferring the 9-valent HPV vaccine’s extended cancer-prevention capabilities.

In the U.S., the Gardasil 9 vaccine is the CDC’s recommended HPV vaccine.

Additional HPV vaccine news is published here.

PrecisionVaccinations publishes fact-checked, research-based antibody, antiviral, and vaccine news.

Sub Title:

HPV vaccination prevents most cervical cancer cases

References:

Delivery of the HPV vaccine and impact of school closures: statement from the JCVI

CDC: Immunization Schedules

Image:

Age Groups:

Google News Keywords:

health, vaccines, vaccinations, hpv vaccine, hpv cancers, cervical cancers, cancer vaccines, uk and hpv vaccines

Featured:

Fact checked:

Tuesday, March 1, 2022 - 06:00

Bisexual and Gay Men Benefit from HPV Vaccination

Don Hackett — Tue, 25 May 2021 17:53:47 +0000

Reviewer:

Prevalence of human papillomavirus in young men who have sex with men after the implementation of gender-neutral HPV vaccination

A new study led by Monash University and Alfred Health found a 70% reduction in one type of human papillomavirus (HPV) in gay and bisexual men after the implementation of an HPV vaccination program in 2013.

Published in Lancet Infectious Diseases on May 24, 2021, the HYPER2 study found a significant reduction in vaccine-preventable HPV genotypes in men who have sex with men (MSM) aged 16-20 years following the introduction of the vaccine.

And the decrease in anal HPV 16 and 18 may lead to a reduction in the incidence of anal cancer.

This study included 400 MSM with a median age of 19 years from sexual health clinics, and the community in Melbourne, with a median number of lifetime male partners, was ten.

The prevalence of any anal quadrivalent vaccine-preventable HPV genotype was higher in the pre-vaccination cohort (54 [28%] of 193) than in the post-vaccination cohort (14 [7%] of 193; adjusted prevalence ratio [PR] 0·24, 95% CI 0·14–0·42), primarily driven by decreases in HPV6, followed by HPV 11, 16, and 18.

Nevertheless, there was also a significant reduction in anal HPV16 and 18 in the post-vaccination cohort from the pre-vaccination cohort (0·31, 0·14–0·68).

The prevalence of any penile quadrivalent vaccine-preventable HPV genotype was also higher in the pre-vaccination cohort (21 [12%] of 177) than in the post-vaccination cohort (11 [6%] of 179; 0·48, 0·24–0·97), driven by decreases in HPV 6 and 11, but not by 16 and 18.

The prevalence of any oral quadrivalent vaccine-preventable HPV genotype was higher in the pre-vaccination cohort than in the post-vaccination cohort, and there were no cases of oral HPV 6 or 11 detected in the HYPER2 study.

When comparing the pre-vaccinated cohort with the 149 confirmed vaccinated men from HYPER2 showed a reduction in any quadrivalent vaccine-preventable HPV genotype for anal (0·09, 0·03–0·25) and penile (0·18, 0·05–0·59) infection, but not for oral infection (0·17, 0·03–1·08).

Australia is one of the first countries that offered both boys and girls vaccination programs for HPV.

The HPV vaccine used in this program covers four genotypes: 6/11/16/18. Genotypes 6/11 cause about 90% of the genital wart cases, and genotypes 16/18 cause about 70% of cervical and anal cancers.

“Australia has a very successful HPV vaccination program for both boys and girls with high vaccine coverage,” Associate Professor Eric Chow stated in a press release.

“The vaccine is effective in reducing HPV-related diseases and showing some promising evidence that this may lead to a reduction in HPV-related cancer in the future.”

This study was funded by Merck, which produces HPV vaccines, and the Australian Government Department of Health.

In the USA, nearly 35,000 people are estimated to be affected by cancer caused by HPV infection each year. While there is screening for cervical cancer that can detect cancer early, there is no recommended screening for the other cancers caused by HPV infection, like cancers of the back of the throat, anus, penis, vagina, or vulva.

There are safe and effective HPV vaccines to protect males and females against cancers caused by HPV. These vaccines include 9vHPV, 4vHPV, and/or 2vHPV, says the US Centers for Disease Control and Prevention (CDC).

In the USA, HPV vaccination for adolescents has been recommended for females since 2006 and for males since 2011, says the CDC.

CDC recommends HPV vaccination for children ages 11 or 12 years to protect against cancers caused by HPV infections. Vaccination can be started at age nine and is recommended through age 26 years for those not adequately vaccinated previously.

PrecisionVaccinations publishes research-based HPV vaccine news.

Sub Title:

HPV vaccination reduces cancers caused by human papillomavirus

References:

CDC: Human Papillomavirus

Image:

Google News Keywords:

health, vaccines, vaccinations, hpv, cancers, cancer vaccines, hpv vaccines, preventing cancer

Featured:

HPV Vaccination After 26 Years of Age Found Less Cost-Effective

Don Hackett — Tue, 23 Mar 2021 14:59:30 +0000

Reviewer:

Human papillomavirus vaccination for adults aged 30 to 45 years in the United States: A cost-effectiveness analysis

The journal PLOS published a cost-effectiveness analysis that evaluated extending human papillomavirus (HPV) vaccinations to ages 30, 35, 40, or 45.

This peer-reviewed study found HPV vaccination of women and men aged 30 to 45 years provides limited health benefits at the population level, at a substantial cost.

The HPV vaccine price was the primary cost.

This study found that HPV vaccination to older ages was inefficient or associated with unfavorable Incremental Cost-Effectiveness Ratio (CER) in the USA.

Furthermore, the sensitivity analysis revealed that assumptions about cervical screening compliance, vaccine costs, and the natural history of noncervical HPV-related cancers could significantly impact the vaccination strategies’ estimated cost-effectiveness.

However, even with the most extreme assumptions, both models almost universally found that the cost-effectiveness of HPV vaccination for adults aged 30 to 45 years was more significant than $200,000 per quality-adjusted life-year (QALY).

The only exception was in the scenario assuming imperfect screening compliance. One model found that vaccinating up to ages 40 and possibly 45 years could be cost-effective if assuming an upper-bound willingness-to-pay threshold of $200,000 per QALY.

These international researchers stated, ‘cervical screening is a very effective mechanism for secondary prevention, with the absolute effectiveness increasing, particularly in women over the age of 25 to 30 years.’

‘In general terms, the impact of secondary prevention of cervical cancer is critical to incorporate, and the CISNET models were able to achieve this in great detail.’

Moreover, this analysis has several limitations. Where possible, the researchers erred in the direction of making assumptions that were favorable to increasing the age of vaccination, including assuming no delay between the reduction in HPV infections from vaccination and the reduction in genital warts.

There are approximately 100 types of HPV that have been identified, at least 40 of which can infect the genital area, says the U.S. CDC.

The Gardasil 9 vaccine produced by Merck consists of HPV proteins, Types 6, 11, 16, 18, 31, 33, 45, 52, and 58.

HPV infections can lead to certain cancers. Many females with cervical cancer were probably exposed to cancer-causing HPV types in their teens and early 20s. Unlike some other cancers, cervical cancer is not thought to be passed down through family genes.

Additionally, males can get HPV, causing anal and throat cancers and genital warts say the CDC. Most HPV infections are self-limited and are asymptomatic or unrecognized. Most sexually active persons become infected with HPV at least once in their lifetime.

Although the HPV vaccine holds promise to nearly eliminating cervical cancer with complete population coverage, U.S. vaccination rates remain far below those in other high-income countries.

A Research Brief published by the American Academy of Pediatrics in February 2021 reported the proportion of up-to-date adolescents has improved over time.

However, in 2017–2018, 7.3 million vaccine-eligible US adolescents were unvaccinated.

Notably, despite a provider recommendation, the parents of 60.6% of unvaccinated adolescents had no intention to initiate the HPV vaccine series.

This new study was conducted to directly inform the Advisory Committee on Immunization Practices’ deliberations to guide HPV vaccination policy for women and men in the United States.

These researchers received grant support from the U.S. National Cancer Institute at the National Institutes of Health (grant number U01CA199334). The funders had no role in study design, data collection, analysis, decision to publish, or preparation of the manuscript. All other authors declare no conflicts.

PrecisionVaccinations publishes research-based vaccine news.

Note: updated with additional citation.

Sub Title:

Gardasil 9 vaccine consists of HPV proteins 6, 11, 16, 18, 31, 33, 45, 52, and 58

References:

HPV Vaccine Recommendations and Parental Intent

Gardasil 9 HPV Vaccine

Image:

Age Groups:

22 26 years

27 49 years

Google News Keywords:

health, vaccines, vaccinations, hpv vaccine, gardasil 9 vaccine, how old to get the vaccine, hpv cancers, cervical cancer

GoodRx Vaccine:

Featured:

Fact checked:

Monday, March 29, 2021 - 13:30

Therapeutic HPV16-positive Vaccine Expands Late-stage Study

Don Hackett — Fri, 12 Mar 2021 00:07:46 +0000

Reviewer:

Transgene expands Phase II clinical trial of therapeutic vaccine TG4001 in combination with avelumab versus avelumab monotherapy

The Phase II clinical trial of therapeutic HPV16-positive vaccine has been expanded announced France-based Transgene.

The expansion of a randomized, controlled study with TG4001 combined with avelumab versus avelumab monotherapy in patients with HPV16-positive anogenital tumors will enroll patients in Q2 2021.

TG4001 is designed to have a two-pronged antiviral approach: to alert the immune system specifically to cells presenting the HPV16 E6 and E7 antigens that can be found in HPV16-related tumors and to further stimulate the infection-clearing activity of the immune system through interleukin 2.

The trial will focus on patients with recurrent or metastatic HPV16-positive anogenital cancer without liver metastases, including cervical, vulvar, vaginal, penile, and anal cancer.

This randomized Phase II trial will be supported by continuing collaboration with Merck KGaA, Darmstadt, Germany, and Pfizer, which is supplying avelumab. Transgene retains all rights to TG4001.

The initial Phase Ib/II trial conducted in France and Spain was amended to include a randomized comparison of TG4001 with avelumab versus avelumab monotherapy in anogenital cancers.

The submission of the amended protocol has been initiated in Europe. Also, Transgene received U.S. FDA clearance of the protocol under TG4001 IND.

Current treatments primarily include chemoradiotherapy. However, researchers indicate a therapeutic vaccine combined with other immunotherapeutic agents such as immune checkpoint inhibitors could provide a promising potential treatment option that would address this strong medical need.

Prof. Christophe Le Tourneau, M.D., Head of the Department of Drug Development and Innovation at the Curie Institute and Principal Investigator of the trial, commented in a press release, “The promising data that we generated in the Phase Ib/II part of this study, in patients without liver metastases, gives me confidence that the amended study can generate the additional data needed to confirm the treatment benefits of the combination of TG4001 and avelumab in this patient population with minimal therapeutic options.”

With Transgene’s myvac® platform, therapeutic vaccination enters the field of precision medicine with novel immunotherapy tailored to each individual. The myvac® approach allows the generation of virus-based immunotherapy that encodes patient-specific mutations identified and selected by Artificial Intelligence capabilities.

Transgene (TNG) is a biotechnology company focused on designing and developing targeted immunotherapies to treat cancer. Transgene’s programs utilize viral vector technology with the goal of indirectly or directly killing cancer cells.

Vax-Before-Cancer publishes research-based cancer news.

Sub Title:

Transgene TG4001 is a two-pronged antiviral approach for HPV16 positive cancer treatment

References:

TG4001 HPV Cancer Vaccine

Image:

Google News Keywords:

health, vaccines, vaccinations, cancer, transgene therapy,cancer therapy, HPV16 cancers, hpv cancers

GoodRx Vaccine:

Featured:

Mother’s HPV Status Impacts Oral HPV Persistence for Offspring

Don Hackett — Mon, 01 Feb 2021 23:33:59 +0000

Reviewer:

Oral Human Papillomavirus Infection in Children during the First 6 Years of Life, Finland

The results of a new study focused on 0ral Human Papillomavirus (HPV) infections in children during the first six years of life indicate that HPV infection can be acquired non-sexually and is already common at an early age.

This longitudinal study found children acquire their first oral HPV infection at an early age.

The US Centers for Disease Control and Prevention (CDC) published an Early Release, Volume 27, Number 3, March 2021, based on an extensive study in Finland.

These researchers believe the oral cavity is the familiar site of the first HPV exposure. The mother is the most likely source of initial HPV infection in her child during the intrauterine period, during delivery, or later via saliva.

This conclusion has several significant implications in HPV vaccination programs.

If a subgroup of children can acquire a persistent HPV infection, the timing of prophylactic HPV vaccination is imperative. Maternal HPV antibodies, irrespective of whether they are acquired by natural HPV infection or vaccination, might protect the fetus, newborn, and young child against early HPV infection.

This study evaluated oral samples from 331 children in Finland who participated in the Finnish Family HPV Study from birth during nine follow-up visits, with a mean time of 51.9 months. They tested samples for 24 HPV genotypes.

Oral HPV prevalence for children varied from 8.7% (at a 36-month visit) to 22.8% at birth.

HPV16 was the most prevalent type to persist, followed by HPV18, HPV33, and HPV6.

Persistent, oral, high-risk HPV infection for children was associated with the mother’s oral HPV carriage at birth and seroconversion of the mother to high-risk HPV during follow-up.

And the mode of delivery had no association with oral HPV carriage, and some sex differences were found in oral HPV prevalence during the early months, but not at the end of the follow-up period.

The study’s results indicate that none of the HPV genotypes present at birth would promote acquiring another specific HPV genotype, not even an HPV from the same clade. Although most of the oral HPV infections were cleared during the 6-year follow-up period, persistent oral HPV infection was found in 14.9% of these children.

The six children who had multiple-type HPV infections at birth still harbored those infections at the most recent visit.

Thus, clade α9 resulted most frequently in the full-time persistence of oral HPV infection during early childhood, followed by α7 as the second most frequent clade.

Furthermore, these results are consistent with previous results because they show that oral HPV is detectable in 22.8% of newborns.

This HPV detection rate is almost identical to what Castellsague et al. reported in 2009, showing that the overall oral HPV prevalence at any visit was 18.2% during the mean follow-up of 14 months, by using PCR, followed by subsequent hybridization with specific probes for HPV6, 11, 16, 18, 31, 33, and 39.

That study reported HPV positivity of 12.7% at six weeks of age. In this new study from Finland, HPV positivity at month 2 was 16.2%.

In conclusion, these researchers believe ‘the HPV status of the mother has a major impact on the outcome of oral HPV persistence for her offspring.’

Dr. Stina Syrjänen is a professor and chairman emerita in the Department of Oral Pathology, Faculty of Medicine, University of Turku, Turku, Finland, and chief physician in the Department of Pathology, Turku University Hospital. This study was supported by the Academy of Finland, the Finnish Cancer Foundation, and the Sohlberg Foundation.

In the USA, HPV vaccination is recommended at age 11 or 12 years by the CDC. HPV vaccination is given as a series of either two or three doses, depending on age at initial immunization.

Moreover, HPV vaccinations are also recommended for everyone through age 26 years if not adequately vaccinated previously.

Vaccination is not recommended for everyone older than age 26 years.

However, some adults ages 27 through 45 years may decide to get the HPV vaccine based on discussion with their clinician if they did not get adequately vaccinated when they were younger. HPV vaccination of people in this age range provides less benefit for several reasons, including that more people in this age range have already been exposed to HPV.

The CDC says ‘keep in mind that HPV vaccination prevents new HPV infections but does not treat existing HPV infections or diseases. People who are in a long-term, mutually monogamous relationship are not likely to get a new HPV infection.’

PrecisionVaccinations publishes research-based vaccine news.

Sub Title:

Mother-to-child transmission of genital HPV genotypes occurs during delivery or via saliva

References:

Oral manifestations of human papillomavirus infections

CDC: HPV Vaccine Recommendations

Image:

Google News Keywords:

health, vaccines, vaccinations, hpv, hpv and births, pregnant and birth hpv, oral hpv, gardasil, hpv vaccines

Featured:

Cervical Cancer Prevention Investments Produce Significant ROI

Don Hackett — Tue, 17 Nov 2020 14:18:16 +0000

Reviewer:

WHO: A cervical cancer-free future: First-ever global commitment to eliminate a cancer

The World Health Organization (WHO) Global Strategy to Accelerate the Elimination of Cervical Cancer announced today marks the first time that 194 countries commit to eliminating cancer - following the adoption of a resolution at the World Health Assembly in 2020.

Cervical cancer is a preventable disease that is also curable if detected early and adequately treated. Yet it is the 4th most common cancer among women globally.

This WHO cervical cancer strategy outlines three key steps: vaccination, screening, and treatment.

Vaccination against human papillomavirus (HPV) is recommended to prevent new HPV infections and HPV-associated diseases, including cervical cancer.

On November 17, 2020, the WHO stated the ‘successful implementation of these actions could reduce more than 40 percent of new cases of cervical cancer and 5 million related fatalities over the next three decades.

The WHO strategy also stresses that investing in the interventions to meet these targets can generate substantial economic and societal returns.

An estimated US $ 3.20 will be returned to the economy for every dollar invested through 2050 and beyond, owing to increases in women’s workforce participation. The figure rises to US $ 26.00 when the benefits of women’s improved health on families, communities, and societies are considered.

The WHO says meeting the following targets by 2030 will place all countries on the path toward elimination:

90% of girls fully vaccinated with the HPV vaccine by 15 years of age
70% of women screened using a high-performance test by age 35 and again by 45
90% of women identified with cervical disease receive treatment (90% of women with pre-cancer treated and 90% of women with invasive cancer managed).

“Eliminating any cancer would have once seemed an impossible dream, but we now have the cost-effective, evidence-based tools to make that dream a reality,” said WHO Director-General Dr. Tedros Adhanom Ghebreyesus, in a press release.

“But we can only eliminate cervical cancer as a public health problem if we match the power of the tools we have with unrelenting determination to scale up their use globally.”

Without taking additional action, the annual number of new cases of cervical cancer is expected to increase from 570,000 to 700,000 between 2018 and 2030, while the annual number of fatalities is projected to rise from 311,000 to 400,000.

In low- and middle-income countries, its incidence is nearly twice as high and its death rates three times as high as those in high-income countries.

“The huge burden of mortality related to cervical cancer is a consequence of decades of neglect by the global health community. However, the script can be rewritten,” added WHO Assistant Director-General Dr. Princess Nothemba (Nono) Simelela.

Many females with cervical cancer were probably exposed to cancer-causing HPV types in their teens and early 20s. Additionally, males can get HPV, causing anal and throat cancers, and genital warts say the WHO.

“Critical developments include the availability of prophylactic vaccines; low-cost approaches to screening and treating cervical cancer precursors; and novel approaches to surgical training. Through a shared global commitment to the Sustainable Development Goals and leaving no-one behind, the countries of the world are forging a new path to ending cervical cancer. “

“The fight against cervical cancer is also a fight for women’s rights: the unnecessary suffering caused by this preventable disease reflects the injustices that uniquely affect women’s health around the world,” says Dr. Princess Simelela.

“Together, we can make history to ensure a cervical cancer-free future.”

There are safe and effective HPV vaccines that can protect males and females against cancers caused by HPV. These vaccines include 9vHPV, 4vHPV, and/or 2vHPV, says the US Centers for Disease Control and Prevention (CDC).

In the USA, the Gardasil 9 vaccine consists of HPV proteins, Types 6, 11, 16, 18, 31, 33, 45, 52, and 58.

PrecisionVaccinations publishes research-based news.

Sub Title:

WHO Global Strategy to Accelerate the Elimination of Cervical Cancer focuses on vaccination, screening, and treatment

References:

Image:

Age Groups:

Google News Keywords:

health, vaccines, vaccinations, cancer vaccines, gardasil, cervical cancer, cancer prevention

GoodRx Vaccine:

Featured:

HPV Vaccinations Vary Across the USA

Don Hackett — Mon, 02 Nov 2020 17:46:44 +0000

Reviewer:

Area-Level Variation and Human Papillomavirus Vaccination among Adolescents and Young Adults in the United States

Understanding how human papillomavirus (HPV) vaccination coverage varies by geography in the USA can help to identify areas of need for prevention and control efforts, stated researchers in a systematic review of published literature.

Across various studies, this new review published on October 27, 2020, found the average initiation rate of HPV vaccination was 40.5 percent (range, 6.3%–78.0%).

And the average rate of completion was 23.4 percent (range, 1.7%–55.2%).

However, the geographic regions and area-level factors associated with HPV vaccination varied by Zipcode, area-level poverty, urbanicity/rurality, racial/ethnic composition, and health service region characteristics.

Previously, the US Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report (MMWR) published on August 21, 2020; National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13–17 Years, United States, 2019, found HPV vaccination initiation by age 13 years increased an average of 5.3 percentage points for each consecutive birth year, from 19.9 percent among adolescents born in 1998, to 62.6 percent among those born in 2006.

And, being fully HPV vaccinated by age 13 years increased an average of 3.4 percentage points for each consecutive birth year, from 8.0% among adolescents born in 1998 to 35.5% among those born in 2006.

This MMWR report concluded by saying ‘the CDC, along with other national health organizations, continues to stress the importance of well-child visits and vaccinations as essential services. The majority of practices appear to be open and resuming vaccination activities for their pediatric patients regardless of the COVID-19 pandemic.

And ‘healthcare providers can take several steps to ensure that adolescents are up to date with recommended vaccines, including

promoting well-child and vaccination visits;
following guidance on safely providing vaccinations during the COVID-19 pandemic;
leveraging reminder and recall systems to remind parents of their teen’s upcoming appointment, and recalling those who missed appointments and vaccinations; and
educating eligible patients and parents, especially those who might have lost employer-funded insurance benefits, about the availability of publicly funded vaccines.’

Furthermore, the American Cancer Society updated its guideline for HPV vaccination on July 8, 2020, recommending healthcare providers offer routine HPV vaccinations series to boys and girls between ages 9 and 12.

There are safe and effective HPV vaccines that can protect males and females against cancers caused by HPV. These vaccines include 9vHPV, 4vHPV, and/or 2vHPV, says the CDC.

An updated listing of HPV vaccines and vaccine candidates is found here.

Vax-Before-Cancer publishes research-based vaccine news.

Sub Title:

HPV vaccination is recommended for all through age 26 by ACS

References:

CDC: Vaccination Coverage Among Adolescents Aged 13-17 years

Image:

Google News Keywords:

health, vaccines, vaccinations, hpv, cancer vaccines, gardasil, cancer

GoodRx Vaccine:

Featured:

HPV Vaccination Substantially Protects Women From Cancer

Don Hackett — Thu, 01 Oct 2020 18:21:07 +0000

Reviewer:

HPV Vaccination and the Risk of Invasive Cervical Cancer

According to a new study from Sweden, women between the ages of 10 to 30 years old, substantially reduced their risk of invasive cervical cancer following quadrivalent human papillomavirus (HPV) vaccination.

The efficacy and effectiveness of the quadrivalent HPV vaccine in preventing high-grade cervical lesions reached 88 percent for the younger women who participated in this extensive study.

Published in the NEJM on October 1, 2020, this study evaluated 1,672,983 women for cervical cancer until their 31st birthday. Cervical cancer was diagnosed in 19 women who had received the quadrivalent HPV vaccine and in 538 women who had not received the vaccine.

The cumulative incidence of cervical cancer was 47 cases per 100,000 persons among women who had been vaccinated and 94 cases per 100,000 persons among those who had not been vaccinated.

After adjustment for age at follow-up, the incidence rate ratio for the comparison of the vaccinated population with the unvaccinated population was 0.51 (95% confidence interval [CI], 0.32 to 0.82).

And after additional adjustment for other covariates, the incidence rate ratio was 0.37 (95% CI, 0.21 to 0.57).

Furthermore, after adjustment for all covariates, the incidence rate ratio was 0.12 (95% CI, 0.00 to 0.34) among women who had been vaccinated before the age of 17 years and 0.47 (95% CI, 0.27 to 0.75) among women who had been vaccinated at the age of 17 to 30 years.

"Our results also support the recommendation to administer quadrivalent HPV vaccine before exposure to HPV infection to achieve the most substantial benefit, since vaccination has no therapeutic effect against preexisting HPV infection,” stated the study authors.

"Unvaccinated persons would indirectly benefit from HPV vaccination if vaccination coverage of girls and women in a population exceeds 50%," they added. "A herd effect of HPV vaccination against genital warts has been observed previously in the Swedish population."

Recently, the American Cancer Society (ACS) updated its guideline for HPV vaccination on July 8, 2020. The ACS’s new recommendations are for healthcare providers to routinely offer the HPV vaccine series to boys and girls between ages 9 and 12.

Vax-Before-Cancer publishes research-based cancer news.

Sub Title:

Young women benefit from HPV vaccination

References:

Substantially reduced incidence of genital warts in women and men six years after HPV vaccine availability in Sweden

Image:

Age Groups:

Google News Keywords:

health, vaccines, vaccinations, hpv vaccine, cancer vaccines, hpv cancers, swedish girls and cancer

GoodRx Vaccine:

Featured:

HPV Vaccination Significantly Reduced HPV Rates in Women

Don Hackett — Wed, 23 Sep 2020 19:15:53 +0000

Reviewer:

Prevalence of Human Papillomavirus and Estimation of Human Papillomavirus Vaccine Effectiveness in Thimphu, Bhutan, in 2011–2012

The prevalence of vaccine-targeted human papillomavirus (HPV) types has decreased sharply in the Kingdom of Bhutan, offering the first evidence of the effectiveness of a high-coverage national vaccination program in a lower-middle-income country.

Scientists from the International Agency for Research on Cancer (IARC) and partner institutions conducted a study to estimate the effectiveness of a vaccination program against HPV that was implemented in Bhutan in 2010 for women aged 12–18 years.

These researchers announced on September 22, 2020, this vaccination program achieved almost 90 percent coverage of the target population. And, the prevalence of vaccine-targeted HPV types decreased sharply.

The researchers used data from 2 cross-sectional surveys, conducted in 2011–2012 and in 2018, which enabled them to examine responses in more than 3,000 participants.

Between the 2 surveys, the prevalence of HPV vaccine types decreased from 8.3% to 1.4%, whereas the prevalence of non-vaccine types increased from 25.8% to 31.4%.

The overall and indirect adjusted VE against vaccine-targeted HPV types was 88% (95% CI, 80% to 92%) and 78% (CI, 61% to 88%), respectively.

Among women younger than 27 years, who were targeted by the vaccination program, the overall and indirect adjusted VE was 93% (CI, 87% to 97%) and 88% (CI, 69% to 95%), respectively.

No impact on nonvaccine HPV types was detectable in this study.

The presence of HPV DNA was assessed in cervical cell samples from sexually active women aged 17–29 years to estimate age- and sexual behavior-adjusted overall, total, and indirect (herd immunity) HPV vaccine effectiveness.

In a video published on the Annals of Internal Medicine website, Dr. Iacopo Baussano, the study’s lead author, explains the main findings and the impact of the study.

The primary funding source for this study was the Bill & Melinda Gates Foundation.

An updated list of authorized and experimental HPV vaccines is found on this webpage.

Vax-Before-Cancer publishes research-based cancer prevention news.

Sub Title:

HPV vaccines protect women from various human papillomavirus types

References:

Image:

Google News Keywords:

health, vaccines, vaccinations, hpv, hpv cancers, vaccine for hpv, cancer vaccines, hpv cancer effectiveness

GoodRx Vaccine:

Featured:

HPV Vaccination Rates Increased in Most States

Don Hackett — Mon, 14 Sep 2020 18:38:39 +0000

Reviewer:

Trends in Human Papillomavirus Vaccination in Commercially Insured Children in the United States

A new study published by Pediatrics included 19.8 million person-years and found the proportion of 15-year-old girls and boys with at least a 1-dose Human papillomavirus (HPV) vaccination significantly increased over the past decade.

This study was published on September 14, 2020, and reported an increase in vaccination rates from 38% and 5% in 2011, to 57% and 51% in 2017, respectively.

Furthermore, the proportion with at least a 2-dose HPV vaccination went from 30% and 2% in 2011 to 46% and 39% in 2017, respectively.

And by 2017, the 2-dose HPV vaccination coverage significantly varied by state and gender, such as 80% in the District of Columbia, among girls, to 15% in Mississippi among boys. This geo-segmentation was positively correlated with local legislation for HPV vaccine education and pediatrician availability.

The HPV vaccine protects against several types of cancer.

Previously, the U.S. CDC reported on August 21, 2020, HPV vaccination rates among teens made a small improvement in 2019, but still lag behind most other vaccines.

About 54.2% of teens were fully vaccinated against HPV last year, compared to 51.1% in 2018, according to a new analysis of 2019 National Immunization Survey – Teen data published in the Morbidity and Mortality Weekly Report.

Roughly 56.8% of girls were up to date on HPV vaccination, up from 53.7% in 2018. Boys’ rates also improved from 48.7% to 51.8%. Teen coverage with at least one dose was 71.5%, up from 68.1%.

Both the CDC and the AAP recommends starting the HPV vaccine series between 9-12 years. HPV vaccination is also recommended for men and women with compromised immune systems (including people living with HIV/AIDS) through age 26 if they did not get fully vaccinated when they were younger.

There are various HPV vaccines available around the world, with Gardasil 9 the most prescribed vaccine in the USA.

The U.S. FDA approved an expanded indication for GARDASIL9 for the prevention of oropharyngeal cancers caused by HPV types 16, 18, 31, 33, 45, 52, and 58 on June 13, 2020.

The HPV vaccine has been demonstrated to be highly effective in the prevention of HPV infection and HPV associated diseases.

Human papillomavirus is the most common sexually transmitted infection in the USA, with an annual incidence rate of approximately 14 million people, says the CDC.

HPV is a group of more than 150 related viruses. Each HPV virus in this large group is given a number which is called its HPV type.

Some other HPV types can lead to cancer, especially cervical cancer. There are more than 40 HPV types that can infect the genital areas of males and females.

Vax-Before-Cancer publishes research-based oncology news.

Sub Title:

HPV cancers can be prevented with FDA approved vaccines

References:

CDC: Weekly report Vaccination Coverage Among Adolescents Aged 13-17 Years

Image:

Google News Keywords:

health, vaccines, vaccinations, hpv cacners, cancer vaccines, gardasil, hpv vaccines,

GoodRx Vaccine:

Featured:

DNA Medicine Receives FDA Support For Recurrent Respiratory Papillomatosis

Don Hackett — Wed, 05 Aug 2020 12:45:54 +0000

Reviewer:

INOVIO Receives Orphan Drug Designation From U.S. FDA for DNA Medicine INO-3107 To Treat Rare Disease RRP

The US Food and Drug Administration (FDA) announced it has granted Orphan Drug Designation for INO-3107, a DNA medicine being evaluated in a Phase 1/2 trial for the treatment of recurrent respiratory papillomatosis (RRP).

RRP can severely impact the quality of life for those living with the disease, stated the FDA on July 29, 2020.

RRP is a rare disease caused by human papillomavirus (HPV) types 6 and 11 infections. RRP causes noncancerous tumor growths leading to life-threatening airway obstructions and can progress to cancer in rare cases.

Currently, the disease is incurable and is mostly treated by surgery to remove the tumor growths to temporarily restore the airway. The tumor almost always recurs and the surgery must be repeated, often multiple times a year.

Ami Shah Brown, Ph.D., MPH, INOVIO's Senior Vice President, Regulatory Affairs, said in a press statement: "Receiving FDA's orphan drug designation for INO-3107 is an important milestone in the development of INOVIO's DNA medicine for this rare disease and clearly underscores the importance of addressing the unmet medical need for this debilitating condition."

The open-label, multi-center INO-3107 Phase 1/2 clinical trial is currently open to enrollment to recruit 63 subjects in the U.S. and will evaluate the efficacy, safety, tolerability, and immunogenicity of INO-3107 in subjects with HPV 6 and/or 11-associated RRP who have required at least two surgical interventions per year for the past three years for the removal of associated papilloma(s).

For this study, adult subjects will first undergo surgical removal of their papilloma(s) and then receive four doses of INO-3107, one every three weeks. The primary efficacy endpoint will be a doubling or more in the time between surgical interventions following the first dose of INO-3107 relative to the frequency prior to study therapy.

>>Search Antidote for Clinical Trials<<

Last year, INOVIO published data from its pilot clinical study of INO-3106 (DNA medicine candidate targeting HPV 6-caused RRP) in the scientific journal Vaccines. This study’s results demonstrated that INO-3106 generated immunogenicity and engagement and expansion of an HPV 6-specific cellular response, including cytotoxic T cells.

The paper also showed that INOVIO's immunotherapy allowed two out of two patients who previously required approximately two surgeries per year for several years to manage this disease to delay the need for surgery to a robust degree; one patient was able to delay surgery for over a year and a half (584 days surgery-free) and a second remained surgery-free for over two and a half years (over 915 days surgery-free).

Recurrent respiratory papillomatosis is a rare disease, with an estimated 15,000 active cases in the USA, that is characterized by the growth of tumors in the respiratory tract caused by the human papillomavirus, says the FDA.

Although benign, papillomas can cause severe, even life-threatening airway obstruction and respiratory complications. A distinguishing aspect of this disease is the tendency for the papilloma to recur after surgical procedures to remove them.

Left untreated, if RRP develops in the lungs, affected individuals can potentially experience recurrent pneumonia, chronic lung disease, and ultimately, progressive pulmonary failure. In rare cases, papillomas can become cancerous developing into squamous cell carcinoma.

Additional symptoms of RRP can include a hoarse voice, difficulty in sleeping and swallowing, and chronic coughing. RRP symptoms are usually more severe in children than in adults.

In children, the disorder is most often diagnosed at or around the age of four years. In adults, the disorder occurs most often in the third or fourth decade.

This designation from the FDA qualifies INO-3107 for various development incentives, including a tax credit on expenditures incurred in clinical studies, a waiver of the New Drug Application (NDA) fee, research grant awarded by the FDA, and most importantly, 7 years of U.S. market exclusivity upon approval for the treatment of RRP.

With more than 2,000 patients receiving INOVIO investigational DNA medicines in more than 7,000 applications across a range of clinical trials, INOVIO has a strong track record of rapidly generating DNA medicine candidates with the potential to meet urgent global health needs. For more information, visit INOVIO.

Vax-Before-Cancer publishes cancer vaccine and treatment news.

Sub Title:

FDA orphan drug designation granted for Inovio INO-3107 treatment

References:

Rare Disease Database

INO-3107 Recurrent Respiratory Papillomatosis (RRP)

Image:

Google News Keywords:

health, vaccines, vaccinations, cancer treatments, cancer hpv vaccine, treatment for rrp, Recurrent Respiratory Papillomatosis,

Featured:

New Cancer Screening Guideline Calls For Less and More Simplification

Don Hackett — Fri, 31 Jul 2020 13:52:22 +0000

Reviewer:

American Cancer Society Updates Guideline for Cervical Cancer Screening

An updated cervical cancer screening guideline from the American Cancer Society reflects the rapidly changing landscape of cervical cancer prevention in the USA.

Published on July 30, 2020, the new guideline calls for less and more simplified screening.

And, recommends that women initiate cervical cancer screening at age 25 and that primary human papillomavirus (HPV) testing (HPV testing without the Pap test) every 5 years be the preferred method of testing through age 65.

The guideline says using HPV testing in combination with a Pap test (called co-testing) every 5 years or Pap tests alone every 3 years are acceptable options for now, as not all labs have transitioned to primary HPV testing.

The previous ACS guideline, released in 2012, called for screening starting at age 21. Since then, HPV vaccination rates have improved in the USA.

“These streamlined recommendations can improve compliance and reduce potential harms,” said Debbie Saslow Ph.D., managing director, HPV & GYN Cancers for the American Cancer Society, in a press statement.

“They are made possible by some important developments that have allowed us to transform our approach to cervical cancer screening, primarily a new understanding of the role of HPV and the development of tools to address it.”

HPV is the cause of nearly all cervical cancers.

Evidence shows the HPV test is more accurate than the Pap test and can be done less often; one HPV test every five years is more effective than a Pap test every three years, and even every year as was recommended in the 1980s and 1990s, in reducing the risk of cervical cancer.

A negative HPV test is linked to a very low cervical cancer risk. In addition, a vaccine for HPV has been in use for nearly 15 years, and more women of screening age are now vaccinated and protected from the majority of cervical cancers.

Data suggest HPV vaccination has led to a drop in rates of precancerous cervical changes, the precursors to cancer. In addition, cervical cancer incidence is low in this age group.

Cancer registry data from 2011 to 2015 indicates an estimated 108 cases of invasive cervical cancer in women 20 to 24 years in the U.S. each year. There are also potential harms related to the treatment of precancerous cells identified by screening including preterm birth; and screening has not been shown to lower the rate of cancer in women in this age group.

Also, most HPV infections in women in this age group become undetectable in 1-2 years. Those factors led the ACS to move the recommended age to initiate cervical cancer screening to 25.

“We estimate that compared with the currently recommended strategy of cytology (Pap testing) alone beginning at age 21 and switching to co-testing at age 30 years, starting with primary HPV testing at age 25 prevented 13% more cervical cancers and 7% more cervical cancer deaths,” said Dr. Saslow.

“Our model showed we could do that with a 9% increase in follow-up procedures, but with 45% fewer tests required overall.”

American Cancer Society screening guidelines are created by the Guideline Development Group (GDG), with 11 clinicians and population health care professionals, and a patient advocate appointed by the ACS Board of Directors to create all of its cancer screening guidelines.

To avoid professional conflicts of interest, the GDG considers content specific input and the opinions of expert clinical specialists but is responsible for supervising the review of the evidence and transforming the evidence into writing the guidelines.

Vax-Before-Cancer publishes HPV testing news.

Sub Title:

HPV vaccination has led to a drop in rates of precancerous cervical changes

References:

Cervical cancer screening for individuals at average risk: 2020 guideline update from the American Cancer Society

Image:

Google News Keywords:

health, vaccines, vaccinations, cervical screeening, cancer, cervical cancer, hpv cancers, gardasil 9, cancer vaccines, hpv vaccines

GoodRx Vaccine:

Featured:

‘Parental Hesitancy to Protect Children Against HPV is Troubling’

Don Hackett — Tue, 28 Jul 2020 16:50:12 +0000

Reviewer:

Parental intent to initiate and complete the human papillomavirus vaccine series in the USA: a nationwide cross-sectional survey

Using data from a nationally representative survey of US adolescents, researchers estimated parental intent to initiate and complete the human papillomavirus (HPV) vaccine series and discerned reasons for parental lack of intent for series initiation and completion.

Safety concerns were most commonly cited by these researchers in The Lancet on July 21, 2020, as the main reason for not intending to initiate the HPV vaccination series.

By comparison, a lack of provider recommendation was most commonly cited as the main reason for not intending to complete the HPV vaccine series.

The U.S. Centers for Disease Control and Prevention (CDC) recommends a 2-dose vaccination regimen for children if the first dose is received before age 15, or a 3-dose regimen if the series is started between ages 16 and 26.

However, current vaccination rates reveal that just over half of U.S. teens (51.1%) are fully vaccinated.

Nationally, this study found more than half of the parents of unvaccinated adolescents had no intention to initiate the HPV vaccine series.

And in Idaho, Kansas, Michigan, Montana, Nebraska, North Dakota, Oklahoma, and Utah, more than 65 percent of parents of unvaccinated adolescents had no intention to initiate the HPV vaccine series.

Moreover, 61.9 percent of the parents of unvaccinated adolescents in Wyoming and 57.1 percent in Mississippi (states with some of the lowest HPV vaccine coverage in the nation) did not intend to initiate the series.

Nationally, almost a quarter of the parents of adolescents who received the 1st dose of the HPV vaccine had no intention to complete the series.

In Arkansas, Florida, Georgia, Hawaii, Idaho, Utah, and West Virginia, more than 30% of the parents had no intention to complete the HPV vaccine series.

The lack of parental intent to complete the vaccine series was 11·2 percent in the District of Columbia and 20·4 percent in Rhode Island.

"The hesitancy of parents to protect their child against HPV is troubling because improving HPV vaccination coverage is our only option to curb the rising burden of cancers caused by this virus," said Kalyani Sonawane, Ph.D., an assistant professor at UTHealth School of Public Health, in a press statement.

The research team completed a cross-sectional study using responses from parents and caregivers of 82,297 U.S. children ages 13 to 17.

Data from the CDC has suggested that HPV is responsible for 34,800 new cancer diagnoses yearly. The current vaccine provides protection against nearly 90 percent of cancer-causing HPV infections.

"Our findings suggest that parental reluctance to complete HPV vaccine series for their teen might be a major impediment to achieving the Healthy People 2020 goal of 80 percent coverage," said Ashish A. Deshmukh, Ph.D., MPH, senior author and an assistant professor at UTHealth School of Public Health.

Vax-Before-Cancer publishes HPV vaccine news.

Sub Title:

Many parents of unvaccinated adolescents had no intention to initiate the HPV vaccine series

References:

Parents of 1 in 2 unvaccinated US adolescents have no intention to initiate HPV vaccine

Image:

Age Groups:

Google News Keywords:

health, vaccines, vaccinations, hpv vaccines, hpv cancers, hpv gardasil, cancer vaccines, hpv

GoodRx Vaccine:

Featured:

Facebook’s Vaccine Fake-News Focuses on HPV

Don Hackett — Thu, 16 Jul 2020 00:09:02 +0000

Reviewer:

From bad to worse: The representation of the HPV vaccine Facebook

A new survey focused on Facebook posts about human papillomavirus (HPV) vaccines were mostly negative with a frequent focus on barriers to vaccination.

Published on July 8, 2020, these researchers announced they studied more than 6,500 public HPV vaccine-related posts on Facebook over the first 10 years.

Despite the HPV vaccine's reported benefits of preventing multiple cancers and genital warts, Monique Luisi Ph.D., an assistant professor in the Missouri School of Journalism, said in a related press statement, ‘45 percent of the (Facebook) posts she identified displayed a negative tone toward people getting the vaccine.’

The study found barriers to HPV vaccination appeared more often (47.1%) than benefits (19.8%).

As an example, the post with the most engagement (11,000 reactions, 6,100 comments, and 329,000 shares displayed) was anti-HPV vaccine.

In addition, over the course of a decade, Luisi identified a negative trend occurring on Facebook toward how people perceive the vaccine -- including its safety, and whether its use leads to the encouragement of sexual behavior.

The data published on June 15, 2020, showed evidence for forward momentum (Durbin-Watson values) of HPV infection susceptibility (0.004), HPV infection severity (0.426), HPV vaccine benefits (0.297), and barriers to HPV vaccination (0.226) messages, tone (0.690), and the number of reactions (1.589), comments (1.389), and shares (1.340).

"The representation of the HPV vaccine has not only worsened, but negative posts toward the HPV vaccine have received more public engagement, and evidence shows that these negative posts have generated momentum for other related negative posts," Luisi said.

"It would be one thing if we only saw just the negative information out there.”

“But there's also negative momentum carried by these posts, and if negative posts are encouraging more people to post other negative content, then we can predict how the conversation is going to go and that people are also being influenced by the messages they see."

Luisi said her next step for this research will be to study the implications this content has on parents and guardians as decision-makers. She said it's important for people to recognize the power of sharing content on social media.

"People talk about a lot of things on social media," she said.

"While someone might not be directly involved in a conversation on a particular topic, they still might see that conversation while scrolling through their social media.”

“Therefore, I think it's important to think about intent when sharing content. Even the simple act of sharing -- intentional or unintentional -- can influence others."

The study, "From bad to worse: The representation of the HPV vaccine Facebook," was published in Vaccine, a journal that publishes content related to the field of vaccinology from various disciplines. Dr. Luisi did not disclose any industry conflicts of interest.

In the USA, there are safe and effective HPV vaccines that can protect males and females against diseases, including cancers, caused by HPV, says the Centers for Disease Control and Prevention (CDC).

HPV is transmitted through intimate skin-to-skin contact. People get HPV by having sex with someone who has the virus.

The HPV vaccine often prescribed is Gardasil 9 consists of HPV proteins, Types 6, 11, 16, 18, 31, 33, 45, 52, and 58.

Vax-Before-Cancer publishes HPV vaccination news.

Sub Title:

HPV vaccine posts on Facebook often display a negative tone towards people getting the HPV vaccine

References:

Monique Luisi Ph.D.

Study: 'Anti-vaxxers' gain traction against HPV vaccine on Facebook

Image:

Google News Keywords:

health, vaccines, vaccinations, hpv vaccine, hpv cancer, cancer vaccine, gardasil 9, facebook and hpv vaccine

GoodRx Vaccine: