HPV vaccination in China based on website platform information / 上海预防医学

ObjectiveTo analyze the online public Q&A texts on HPV vaccine， focus on the important issues related to HPV vaccination and cervical cancer prevention in China， and propose strategies and suggestions. MethodsThe latent Dirichlet allocation （LDA） topic model was employed to extract key topics of 15 565 Q&A texts related to HPV vaccines from the social Q&A platform "Zhihu". The Baidu AI sentiment analysis tool was used to analyze the emotional tendencies of the texts corresponding to each topic， and the topics were classified based on the strategic coordinate method. ResultsOnline users focused on eight topics about HPV vaccine information. Among them， vaccination knowledge， HPV vaccination hesitation， and HPV vaccine development and marketing belonged to the low positivity-high negativity emotional topics， HPV infection and high-risk factors belonged to the low positivity-low negativity emotional topics， and HPV vaccine appointment channels， comparison between domestic and imported vaccines， HPV vaccines and cervical cancer prevention， and HPV vaccine types and selection were grouped under high positivity-low negativity emotional topics. ConclusionPublic concerns regarding HPV vaccines can be classified into three major dimensions： health knowledge， health beliefs， and health behaviors. Overall， the public's views and attitudes towards vaccine-related issues are not optimistic. Strengthening science publicity and education， enhancing vaccine supervision， and encouraging enterprises’ innovative research and development capability are effective strategies to improve public awareness of cervical cancer prevention and accelerate the full HPV vaccination coverage.

Eliminat Cervical Cancer, Focusing on Primary Prevention / 肿瘤防治研究

As one of the most severe malignant tumors, cervical cancer poses a significant threat to women. In 2020, the World Health Organization (WHO) introduced the "Global Strategy to Accelerate the Elimination of Cervical Cancer" in response to well-established tertiary prevention measures. Primary prevention measures prioritize health education and the administration of prophylactic human papillomavirus (HPV) vaccines. China currently offers five HPV vaccines supported by extensive research data specific to the Chinese population. This paper discusses the application of HPV vaccines in China and related issues that need to be paid attention to.

Safety of human papilloma virus vaccine based on Vaccine Adverse Event Reporting System from 2006 to 2021 / 中国生物制品学杂志

@#Objective To investigate the characteristics of distribution of adverse event(AE)associated with human papillomavirus(HPV)vaccine by analysis of data on AE collected from the Vaccine Adverse Event Reporting System(VAERS).Methods The data on AE reported in VAERS from January 1st,2006 to December 31st,2021 were analyzed and compared by using Pearson Chi-square test and Mann-Whitney U test.Results A total of 53 571 cases of AE were included in the study,in which the ratio of male to female was 0. 25∶1,and the median age of vaccinees was 15 years. A portion of 36. 1%of AE occurred after the first dose,while 90. 7% occurred within 3 d after vaccination. Both the gender ratios(χ~2=72. 570,P < 0. 001) and the median ages(Z = 4. 255,P < 0. 001)of vaccinees in non-serious and serious adverse event(SAE)showed significant difference. In terms of classification of SAE,hospitalization,prolonged hospitalization and disability were more common in females than in males,of which the percentages decreased with the increasing age. Among the AE,syncope was the most common clinical symptom. In the SAE,the highest proportion of deaths was caused by HPV2 vaccine,which was 19. 0%. The proportion of prolonged hospitalization caused by HPV4 vaccine was higher than that by HPV9vaccine. In general,HPV4 vaccine was more prone to cause SAE than HPV9 vaccine(χ~2=183. 267,P < 0. 001).Conclusion In all the AE,the largest proportion occurred in the age group of 9 ～ 17 years,followed by those in the groups of 18 ～ 26 and 27 ～ 45 years. Most of the AE occurred after the first dose. The clinical symptoms of AE caused by three vaccines were different. The analysis of distribution characteristics of AE may provide a reference for the study on clinical safety of HPV vaccine and optimization of vaccination.

Relationship between awareness of cervical cancer and HPV infection and attitudes towards HPV vaccine among women aged 15-49 years: a cross-sectional study

ABSTRACT BACKGROUND: Cervical cancer is a type of cancer caused by human papillomavirus (HPV). OBJECTIVE: To determine the relationship between awareness of cervical cancer and HPV infection and attitudes towards HPV vaccine among women aged 15-49 years. DESIGN AND SETTING: Cross-sectional study conducted at Karabük Training and Research Hospital, Turkey. METHODS: 500 women who visited the gynecology outpatient clinic of a public hospital between July 15 and December 31, 2019, were selected through random sampling. Data were collected using a sociodemographic questionnaire comprising nine questions (created by the researchers), the HPV and Cervical Cancer Awareness Questionnaire and the Carolina HPV Immunization Attitudes and Beliefs Scale. RESULTS: The relationship between the awareness questionnaire and the beliefs scale was explained through simple effect modeling of a structural equation. The women's knowledge score regarding cervical cancer and HPV infection was 4.69 ± 4.02 out of 15. Women were afraid of being diagnosed with cervical cancer and HPV infection, but they did not have sufficient information. They had poor information about the HPV vaccine, did not know how to obtain the vaccine and did not have enough information about its benefits and harmful effects. Women who were afraid of getting cervical cancer, and who thought that they were at risk, had more information about the HPV vaccine. CONCLUSION: Women need information about cervical cancer, HPV infection and the HPV vaccine. Midwives, nurses and physicians who provide healthcare services in gynecological follow-ups should provide information to women about the HPV vaccine and cervical cancer.

Cognition of prevention and control of cervical cancer and influencing factors of HPV vaccination intention among college students in Xiangyang / 公共卫生与预防医学

Objective The knowledge of cervical cancer prevention and control，the cognition of human papillomavirus (HPV) vaccine and the willingness to vaccinate HPV vaccine among college students in Xiangyang were investigated and analyzed to provide a reliable scientific basis for the primary prevention of cervical cancer prevention and control in Xiangyang. Methods By means of stratified sampling method and self-made questionnaire, this paper conducted a questionnaire survey among college students in 3 universities in Xiangyang. Results A total of 8 523 college students participated in the questionnaire survey, and 4 473 of them had sufficient knowledge of cervical cancer prevention and control and HPV vaccine, with the awareness rate of 52.48%. Male students, rural residents and non-medical majors were the influencing factors of insufficient knowledge of cervical cancer prevention and control and HPV vaccine. Among the 6 459 female college students who participated in the survey, 5,993 (92.79%) were willing to be vaccinated, and 859 (13.30%) were already vaccinated. Major, educational background, living expenses and cognitive scores were the influencing factors of HPV vaccination intention. Conclusion College students in Xiangyang City are relatively deficient in the knowledge of cervical cancer prevention and control and HPV vaccine. Targetable science popularization and education can improve college students' correct understanding of cervical cancer prevention and control knowledge, promote the HPV vaccine vaccination plan, and reduce the occurrence of HPV-related diseases and cervical cancer.

Practices, Recommendations, Knowledge, and Sources of Information for Primary Care Physicians regarding Vaccinations: A Nationwide Survey in Japan, 2019 / 日本プライマリ・ケア連合学会誌

Introduction: Vaccine policies have changed in recent years in Japan. In the present study, we assessed practices, recommendations, knowledge, and sources of information among primary care physicians (PCPs) regarding vaccinations in Japan. Methods: We conducted a nationwide cross-sectional study targeting PCPs in Japan. We used a web-based self-administered questionnaire targeting physicians that were members of the Japan Primary Care Association in 2019. We analyzed respondent administrations, recommendations, knowledge, and sources of information regarding vaccinations. Results: We received responses from 1,084 PCPs (20.1%) and invited 981 participants for the analysis. The rates at which physicians gave routine and voluntary vaccines in their own practices were 23.3-95.5% and 13.2-94.4%, respectively. The active recommendation rates for routine and voluntary vaccines were 41.6-92.0% and 13.6-75.5%, respectively. Furthermore, among routine vaccines, human papillomavirus vaccine was the least administered and recommended. PCPs working at clinics had the most accurate knowledge about vaccinations, and PCPs utilized academic organizations most readily as an information resource. Conclusion: We clarified practices, recommendations, knowledge, and sources of information regarding vaccinations among PCPs in Japan.

Protective effect of bivalent HPV vaccination in 9 246 women with high-risk human papillomavirus infection / 公共卫生与预防医学

Objective To analyse the high-risk human papilloma virus (HPV) infection in women, and to analyze the protective effect of bivalent HPV vaccine on HPV infection. Methods A case-control study method was used to retrospectively investigate the HPV infection status of 9246 women who received high-risk HPV infection examination in the outpatient department of Shiyan people's Hospital of Hubei from January 2018 to December 2018. The second-generation hybrid capture method and colposcopy examination were used to diagnose. Using a 1:1 matching method, the uninfected individuals who were examined during the same period were taken as the control group, and the confirmed infected group was taken as the case group, and the differences in the vaccination rates of the bivalent HPV vaccine between the two groups were compared. At the same time, the case group was divided into two groups according to the vaccinated and unvaccinated groups and followed up. The events ranged from 24 to 36 months. The incidence of persistent HPV infection, cervical intraepithelial neoplasia (CIN) and cervical cancer were counted to understand Protective effect of bivalent HPV vaccination against HPV infection in a high-risk female population. Results A total of 1 632 cases (17.65%) of 9 246 women were screened positive for high-risk HPV infection. Chi-square results showed that the HPV positive infection rate of rural women (32.84%) was lower than that of urban women (67.16%). , Marital status also has a certain influence on HPV infection. Among the 1632 cases of HPV positive infection, 629 cases (38.54%) were vaccinated with bivalent HPV vaccine, and 1003 cases (61.46%) were not vaccinated with bivalent HPV vaccine. During the follow-up period of 24-36 months, the vaccination group finally obtained follow-up data of 584 cases due to unwillingness to cooperate (18 cases), unable to conduct research due to organic changes (24 cases), and mental disorders (3 cases), with a loss to follow-up rate of 7.15 cases. %; In the unvaccinated group, 949 cases of follow-up data were finally obtained due to change of residence (32 cases), low degree of cooperation (20 cases) and psychological factors (2 cases), and the loss to follow-up rate was 5.38%. The results after follow-up showed that the persistent HPV infection rate in the bivalent HPV vaccination group, the positive rate of high-risk HPV infection at the last follow-up, the cumulative incidence of CIN1 during the follow-up period, the cumulative incidence of CIN2+ during the follow-up period, the incidence of CIN1 at the last follow-up, and the incidence of CIN2+ at the last follow-up. and cervical cancer incidence rates were 3.07%, 0.82%, 1.84%, 1.02%, 0.82%, 0.20%, and 0.00%, respectively, and the bivalent HPV unvaccinated groups were 12.91%, 15.52%, 7.14%, 4.40%, and 3.02%, respectively. , 1.37% and 0.27%. Persistent HPV infection rate, positive rate of high-risk HPV infection at last follow-up, cumulative incidence of CIN1 during follow-up, cumulative incidence of CIN2+ during follow-up, incidence of CIN1 at last follow-up, and incidence of CIN2+ at last follow-up were significantly lower in bivalent HPV vaccination group in the control group (P<0.05). Conclusion Bivalent HPV vaccination has an important protective effect on HPV persistent infection, cervical lesions and cervical cancer in high-risk women.

School-based HPV Vaccination: The Challenges in a Brazilian Initiative / Vacinação contra o HPV em base escolar: Os desafios de uma iniciativa brasileira

Abstract Objective The present study assesses the implementation and the impact after 2 years of a school-based human papillomavirus (HPV) vaccination program in a Brazilian city. Methods A prospective study assessing the implementation of the program, offering quadrivalent HPV vaccine in two annual doses to girls and boys aged from 9 to 10 years old. The program was started in the city of Indaiatuba, state of São Paulo, Brazil, in 2018, and had authorization from the National Immunization Program. The number of HPV vaccine first doses applied and the coverage in 2018 was calculated and compared to the year 2017. There were described events that have influenced the results. Results The program invited 4,878 children through schools (87.1% of the target population), and 7.5% refused vaccination. Several concurrent events required or competed for health professionals of the vaccination teams. The coverage of the first dose (between 9 and 10 years old) was 16.1% in 2017 and increased to 50.5% in 2018 (p < 0.0001). The first dose in all ages increased 78% in 2018 compared with 2017 (6,636/3,733). Competing demands over the program continued in 2019, and the first dose coverage dropped (26.9%). For 2020, a municipal law instituted school-based vaccination and the creation of dedicated teams for vaccination, and these strategies are waiting to be tested. Conclusion School-based annual HPV vaccination in children between 9 and 10 years old was feasible and increased vaccination coverage, regardless of gender, although the program was vulnerable to competing events.

Resumo Objetivo O presente estudo avalia a implantação de um programa de vacinação contra o papilomavírus humano (HPV) em escolas de uma cidade brasileira e o impacto após 2 anos. Métodos Estudo prospectivo para avaliar a implementação do programa, oferecendo a vacina quadrivalente contra o HPV em duas doses anuais, para meninas e meninos de 9 a 10 anos. O programa foi autorizado pelo Programa Nacional de Imunizações na cidade de Indaiatuba, estado de São Paulo, Brasil, e teve início em 2018. A cobertura anual da primeira dose foi comparada ao ano de 2017, e os eventos que influenciaram os resultados foram descritos. Resultados O programa convidou 4.878 crianças por meio das escolas (87,1% da população-alvo) e 7,5% recusou a vacinação. Vários eventos concorrentes exigiram ou competiram pelos profissionais de saúde das equipes de vacinação. A cobertura da primeira dose (9 a 10 anos) foi de 16,1% em 2017 e aumentou para 50,5% em 2018 (p < 0,0001). A primeira dose em todas as idades aumentou 78% em 2018 em comparação com 2017 (6.636/3.733). As demandas concorrentes sobre o programa continuaram em 2019, e a cobertura da primeira dose caiu (26,9%). Para 2020, uma lei municipal instituiu a vacinação nas escolas e a criação de equipes dedicadas à vacinação, e estas estratégias aguardam para ser testadas. Conclusão A vacinação anual contra o HPV em base escolar nas idades de 9 a 10 anos foi viável e aumentou a cobertura vacinal, independentemente do gênero, embora o programa fosse vulnerável a eventos concorrentes.

A study on awareness of cervical cancer and human papilloma virus vaccine among the women’s degree college students in Nandyal

Background: In India cervical cancer is the second most common cause of cancer mortality in women after carcinoma breast. Human papilloma virus (HPV) is the principal causative agent for cervical cancer. FDA approved 2 vaccines for primary prevention, and is available in India, but is not part of National Immunization Programme. Due to societal, religious and ethical issues associated with the vaccination of adolescent girls in India together with lack of awareness about HPV and HPV vaccines, no successful HPV immunization program has been employed in India. To study the awareness of Degree college students on cervical cancer and HPV vaccine.Methods: This cross sectional study was conducted at SPY REDDY Women’s Degree College, Nandyal from 16th December 2018 to 15th February 2019. The participants were 327 Degree students of first to final year. Students who were not present during the study were excluded from the study. The data was collected using a semi structured questionnaire. The data was analysed by using spss version 24 and the results expressed as proportions.Results: The mean age of participants was 19.53±1.26 years. 89% of the students were unmarried and 11% were married. 46.4% of the students were aware of cervical cancer. Poor genital hygiene (11.2%), smoking and alcohol (5.8%), multiple sex partners (4.3%), sex at an early age (3.4%), long term OCP usage (2.5%) were considered as risk factors for cervical cancer by the students. 18.4% of the students had knowledge about HPV virus. Among the students who knew about cervical cancer, 22.3% of the students responded as vaginal bleeding after menopause is a symptom of cervical cancer, 8.1% responded as bleeding during or after sex, 3.4% as pain during sex, 1.6% as severe low backache. Only 1% knows about Pap smear. Only 12% know about the vaccine. Only 4% correctly knew the vaccine eligibility. None of the students were HPV vaccinated.Conclusions: The level of awareness of students about cervical cancer and HPV vaccine is far below for effective vaccination and prevention of carcinoma cervix. More effective awareness programmes are needed to screen early for cervical cancer and vaccinate & prevent the high mortality from carcinoma cervix.

Knowledge, awareness and practice of cervical cancer screening among ever married rural women of Ganjam District, Odisha: a community based cross-sectional study

Background: India accounts for 25% of total deaths from cervical cancer. Screening for cervical cancer reduces mortality by early detection and treatment. So, a study was conducted among rural women of Ganjam district with the objective to know knowledge, attitude and practice of cervical screening among them.Methods: A community based cross sectional study was conducted from January to February 2019 among ever married women of more than 30 years of age residing in villages of Chhatrapur block of Ganjam district. Sample size was calculated to be 280 by formula Z2pq/l2. Multistage random sampling and PPS method were used to select participants. A semi-structured questionnaire was used to collect data and all data were analysed in SPSS.Results: Among 280 participants, though 70.7% had heard about cervical cancer, only 32.5% knew that there are tests for screening. Only 13.2% of participants said that Pap smear test was to be taken regularly. However, majority didn’t know who should undergo screening test and what age tests should be started. Main source of information for them was health worker (39%). Only 14.6% had any type of cervical screening in their lifetime. The main reason for not going for screening was ignorance (53.9%) followed by thinking tests are not needed unless any symptoms appearedConclusions: Proportion of participants with proper knowledge and awareness regarding cervical cancer screening was low which led to poor uptake of screening. So, awareness regarding cervical cancer screening should be increased. Health camps and education programs should be conducted regularly.

Understanding of Human Papilloma Virus Vaccine Receipt among Adolescents in Trinidad and Tobago / Comprensión del Recibo de la Vacuna Contra el VPH entre los Adolescentes en Trinidad y Tobago

ABSTRACT Objective: To understand the barriers or factors that may hinder receipt of the human papilloma virus (HPV) among adolescent girls, 14-18 years old, and evaluate the awareness level about HPV and the HPV vaccine acceptance. Methods: A questionnaire consisting of two parts, demographic and family history of cervical cancer, and a cluster of questions about HPV, was distributed to 651 female adolescents in 17 secondary schools in Trinidad and Tobago to determine knowledge, attitude, and awareness levels pertaining to HPV and acceptance of the HPV vaccine. Chi-square tests and logistic regressions were used. Results: Of the 651 students completing questionnaires, the majority (61%) were in the 15-16 age group; and 76% were either of African descent or multi-racial. There were significant associations between a family member having a diagnosis of cervical cancer and knowledge that cervical cancer is caused by the HPV virus, that the virus is spread sexually, and the likelihood of getting cervical cancer in the future (p = < 0.05). However, the majority (63%) did not know that cervical cancer is caused by the HPV virus or that the virus was spread sexually. Conclusion: Lack of knowledge of the HPV vaccine was seen among adolescents from each school. There is need for education on cervical cancer and its causes, and the HPV virus.

RESUMEN Objetivo: Entender las barreras o factores que pueden obstaculizar la recepción del virus del papiloma humano (VPH) entre las adolescentes, de 14-18 años, y evaluar el nivel de concientización sobre el VPH y la aceptación de la vacuna contra el VPH. Métodos: Un cuestionario de dos partes -antecedentes demográficos e historia familiar de cáncer cervicouterino--, y un grupo de preguntas sobre el VPH, fueron distribuidos entre 651 adolescentes femeninas en 17 escuelas secundarias de Trinidad y Tobago para determinar los niveles de conocimiento, actitud y concientización relacionados con el VPH y la aceptación de la vacuna contra el VPH. Se utilizaron pruebas de Chi-cuadrada y regresiones logísticas. Resultados: De las 651 estudiantes que respondieron los cuestionarios, la mayoría (61%) estaban en el grupo de edad de 15-16 años; y el 76% eran de ascendencia africana o multirracial. Hubo asociaciones significativas entre un miembro de la familia con diagnóstico de cáncer cervical y el conocimiento de que el cáncer cervical es causado por el virus del VPH, que el virus se propaga sexualmente, y que existe la probabilidad de contraer cáncer cervical en el futuro (p = < 0.05). Sin embargo, la mayoría (63%) no sabía que ese tipo de cáncer es causado por el virus VPH, ni que el virus se propaga sexualmente. Conclusión: Se observó falta de conocimiento de la vacuna contra el VPH entre las adolescentes de cada escuela. Hay necesidad de educación sobre el cáncer cervical y sus causas, y el virus del VPH.

Acceptance for Human Papilloma virus vaccines, experience at tertiary care centre of northern india: a hospital-based survey

Background: Acceptance of HPV vaccine is varying widely worldwide in   range of 10-70%. For increasing the acceptability for HPV vaccine, finding the obstacles and catering them diligently is required. The aim of the study was to find out acceptability rate for HPV vaccine in northern India and various obstacles and facilitators affecting acceptance of HPV vaccine.Methods: A questionnaire based descriptive study was done in the Department of Obstetrics and Gynecology of King George Medical University, Lucknow, Uttar Pradesh, India from June 2016 to June 2017.  Questionnaire was filled by doctor after taking face to face interview of individuals. Ethical approval was obtained from the Institutional Ethical Committee of the KGMU, Lucknow, Uttar Pradesh, India. (1689/Ethics/R cell/17) acceptability rate and various facilitators and obstacles for HPV vaccine were studied. For continuous variables mean with standard deviation was used. For categorical variables frequencies and percentages were used. IBM SPSS statistics applied.Results: A total of 302 cases were face to face interviewed, amongst which, 70 cases (23%) showed acceptability and 232 did not accept the vaccine. The most common obstacles were lack of knowledge and high monetary cost being the cause of nonacceptance in 48.3% and   33.6% of cases respectively.Conclusions: Higher level of awareness and knowledge about HPV vaccine and inclusion in government immunization programmed may increase acceptability.

HPV infection: in need of timely intervention

Persistent infection with human papilloma virus (HPV) has been proved beyond doubt to be associated with the development of cervical cancer. One woman dies of cervical cancer every 8 minutes in India. As per estimations for the year 2018, about 96922 new cervical cancer cases are diagnosed annually in India and it ranks as the second most common female cancer in all age groups. But being an infectious cause it is possible to contain its development and transmission. Coupled with this, we have a potent vaccine to fight this infection. A well documented account of positive impact of HPV vaccination has been published in numerous studies around the globe. By 2013, its vaccination had been introduced in about fifty countries around the globe. In India also, recently, two HPV vaccination projects for operational feasibility were launched in Andhra Pradesh and Gujarat. In November 2016, Punjab becamethe first state in the country to include the vaccine in its universal immunization program. This era belongs to women empowerment and we cannot deny them the opportunity of good health. Hence it’s high time India introduces an effective HPV vaccination program.

Cervical cancer screening and prevention: how aware is the Indian woman?

Background: Carcinoma of the cervix is the second most common cancer in women worldwide. It is the commonest cancer among Indian women. Awareness regarding cervical cancer and its prevention is quite low amongst Indian women. The Pap test is a simple and cost-effective technique for early diagnosis of cervical cancer.Methods: It was a cross sectional study conducted in the months of September and October 2018. We included 200 women between 30 and 60 years of age.Results: In present study, out of 200 respondents, 160 (80%) respondents got married after 21 years of age while 40 (20%) respondents got married below 21 years of age. 148 (74%) respondents had 2 children, 30 (15%) respondents had one child while 22 (11%) respondents had 3 children. 166 (83%) had heard about cervical cancer, 24 (12%) knew that cervical cancer can be cured if detected in early stage while only 10 (5%) knew that it can be prevented. 54 (27%) respondents knew that pap smear test should be done as screening test to detect cervical cancer in early stage while 22 (11%) respondents knew about HPV vaccine as preventive measure.Conclusions: In present study, though women have heard about cervical cancer, proper knowledge was very less. Also, awareness about HPV vaccine and Pap smear was less. There is need for proper information and facilities for pap smear and HPV vaccination.

Advance in human papillomavirus major capsid protein L1-based vaccines / 中华微生物学和免疫学杂志

L1 is the major capsid protein of human papillomavirus (HPV) encoded by late gene 1. Based on the fact that L1 can self-assemble into virus like particle (VLP) with good immunogenicity, it has aroused wide concern in studying the pathogenesis of and vaccines against HPV. Nevertheless, there are a few limitations of present L1-based HPV vaccines. For instance, low expression of the protein and the complexity of purification result in the relatively low yield of vaccines. Type-specific antibody induced by L1 also results in the unsatisfactory cross-protection rate. Furthermore, there is no reported therapeutic effect against HPV-related diseases because of its undefined role in virus eliminating. This review focused on the structure, immunogenicity and role in immune response of L1 and the development of and latest progress in HPV vaccines.

Advance in human papillomavirus major capsid protein L1-based vaccines / 中华微生物学和免疫学杂志

L1 is the major capsid protein of human papillomavirus (HPV) encoded by late gene 1. Based on the fact that L1 can self-assemble into virus like particle (VLP) with good immunogenicity, it has aroused wide concern in studying the pathogenesis of and vaccines against HPV. Nevertheless, there are a few limitations of present L1-based HPV vaccines. For instance, low expression of the protein and the com-plexity of purification result in the relatively low yield of vaccines. Type-specific antibody induced by L1 also results in the unsatisfactory cross-protection rate. Furthermore, there is no reported therapeutic effect against HPV-related diseases because of its undefined role in virus eliminating. This review focused on the struc-ture, immunogenicity and role in immune response of L1 and the development of and latest progress in HPV vaccines.

Reduction in HPV 16/18 prevalence among young women following HPV vaccine introduction in a highly vaccinated district, Japan, 2008–2017 / Journal of Rural Medicine

Objective: Human papillomavirus (HPV) vaccination was introduced in Japan in April 2013, as a national immunization program for girls aged 12–16 years, after an initial introduction in 2010 as a public-aid program for girls aged 13–16 years. The Yuri-Honjo district had the highest vaccine coverage among women aged 17–51 years in 2017, due to the original public-aid program. The aim of this study was to evaluate the differences in the vaccine types of HPV16/18 infections between 2008–2012 (pre-vaccine era) and 2013–2017 (vaccine era).Materials and Methods: We evaluated whether HPV vaccination was associated with a decrease in the prevalence of HPV16/18 and high-risk HPV and the incidence of HPV-associated cervical lesions. A total of 1,342 women aged 18–49 years, covering both the pre-vaccine and vaccine eras, who visited Yuri Kumiai General Hospital and underwent HPV genotype tests from June 2008 to December 2017 were compared.Results: Among women aged 18–24 years with higher vaccine coverage (68.2%), the prevalence of HPV16/18 and high-risk HPV decreased from 36.7% and 69.4%, respectively, in the pre-vaccine era to 5.8% and 50.0%, respectively, in the vaccine era (p=0.00013 and p=0.047, respectively). Among those with cervical intraepithelial neoplasia grade 2− and grade 2+, HPV16/18 prevalence decreased from 30.0% to 2.7% (p=0.0018) and from 81.8% to 36.4% (p=0.030), respectively. In this age group, the rate of HPV16/18 positivity decreased significantly. Among age groups with lower vaccine coverage, HPV prevalence did not significantly differ between the two eras.Conclusion: The prevalence of HPV16/18 and high-risk HPV significantly decreased in women aged 18–24 years, most of whom were vaccinated. HPV vaccination effectively reduced the prevalence of HPV16/18 infections in the Yuri-Honjo district.

Safety of prophylactic HPV vaccine:a systematic review / 中国实用妇科与产科杂志

OBJECTIVE: To systematically review the safety of HPV vaccine among healthy women.METHODS: Primary literature was retrieved from PubMed,CNKI and CBM.Data were searched for randomized controlled trials(RCTs)about safety of HPV vaccine from inception to December 2018.Two investigators screened literature according to the inclusion and exclusion criteria,extracted data,and assessed methodological quality of included studies independently.RESULTS: Totally 16 studies,17 RCTs and 75164 participants were included. A higher incidence of solicited injection-site symptoms(pain,redness)was observed in the vaccine group compared to control group,but these symptoms were tolerable and self-cured.General solicited symptoms(headache,fatigue,etc.)were slight,and there was no significant difference in the incidence between the two groups.Serious adverse events were similar in both groups,and pregnancy outcomes did not differ between the two groups.CONCLUSION: The three types of prophylactic HPV vaccine are safe.The main adverse event is local symptom,which is well tolerated,so the vaccines can be safely used.

HPV vaccine acceptance is high among adults in Mexico, particularly in people living with HIV / Aceptación de la vacuna contra VPH es alta entre adultos en México, especialmente en personas con VIH

Abstract: Objective. To measure HPV vaccine acceptance in diverse Mexican adult popula­tions, taking into account HIV status. Materials and methods: A total of 1 329 men and women, with and without HIV, participated in one of three intervention studies, offering HPV vaccination, carried out in the states of Morelos, Tlaxcala and Mexico City; either the bivalent (Morelos n=103, Tlaxcala n=127) or quadrivalent HPV-vaccine (Mexico City n=1 099) was offered. Results: HPV vaccine was accepted by 80.3% of participants; acceptance was higher in people living with HIV than those without (84.4 vs. 78%, p=0.004). Women had greater HPV infection knowledge (p<0.0001) than men and slightly higher (p=0.4) vaccine acceptance. The main reason for vaccine non-acceptance among HIV-positive participants was their doctor recommended they not get vaccinated. Conclusion: Acceptance of HPV-vaccine was high in men and women regardless of HIV status. Even higher rates of acceptability may be achieved by educating healthcare providers to recommend HPV vaccine to their patients.

Resumen: Objetivo. Medir la aceptación de la vacuna de VPH en una muestra diversa de población adulta mexicana, teniendo en cuenta su estado de VIH. Material y métodos: 1 329 hombres y mujeres con y sin VIH participaron en tres estudios de intervención, realizados en los estados de Morelos, Tlaxcala y Ciudad de México. Se ofreció la vacuna bivalente (Morelos n=103, Tlaxcala n=127) o la cuadrivalente (Ciudad de México n=1 099) contra VPH. Resultados: La vacuna fue aceptada por 80.3% de los participantes; la aceptación fue mayor en personas que viven con VIH que en aquéllas que no (84.4 vs. 78%, p=0.004). Las mujeres (p<0.0001) tenían mayor conocimientos sobre VPH que los hombres y una aceptación de la vacuna ligeramente mayor (p=0.4). El motivo principal de la no aceptación de la vacuna entre personas con VIH fue que su médico recomendó que no se vacunaran. Conclusión: La aceptación de la vacuna contra el VPH fue alta en hombres y mujeres, independientemente del estado de VIH. Se pueden lograr mayores tasas de aceptabilidad educando a los proveedores de atención médica para que recomienden la vacuna contra el VPH a sus pacientes.

The effect of a booster dose of HPV tetravalent vaccine after 51 months: implications for extended vaccination schedules / El efecto de un refuerzo de la vacuna tetravalente de VPH después de 51 meses: implicaciones para un esquema de vacunación extendido

Abstract: Objective: To asses the non-inferiority between two different vaccination schedules one month after the administration of the third dose. Materials and methods: We evaluated the anti-HPV 16/18 antibody titers induced by quadrivalent HPV vaccine administered using two different schedules in girls 9 to 10-year-old girls: a traditional (0-2-6) and an alternative (0-6-50). Blood samples were collected at month 7, 21 and 51. Results: The antibody geometric mean titer ratios one month after the application of the third dose -month 51 for the alternative and month 7 for the traditional- were 1.55 for HPV16 (95%CI, 1.15-2.08) and 1.53 for HPV18 (95%CI, 1.12-2.09). The seropositive rate was above 99% in both groups. Conclusions: The application of an alternative 3-dose schedule in 9 to 10-year-old girls induces a non-inferior immune response compared to the standard one month after the last dose. Further research is needed to understand the minimal number of doses and their timing to provide the best coverage for HPV infection.

Resumen: Objetivo: Evaluar la no inferioridad entre dos diferentes esquemas de vacunación un mes después de la administración de la tercera dosis. Material y métodos: Se evaluaron los títulos de anticuerpos anti-VPH 16/18 inducidos por la vacuna contra VPH tetravalente administrada en niñas de 9 a 10 años utilizando dos esquemas diferentes: tradicional (0-2-6) y alternativo (0-6-50). Se recolectaron muestras en los meses 7, 21 y 51. Resultados: La media geométrica de títulos de anticuerpos un mes después de la aplicación de la tercera dosis -mes 51 para la alternativa y mes 7 para el tradicional- fueron 1.55 para HPV16 (95% IC 1.15-2.08) y 1.53 para HPV18 (95% IC 1.12-2.09). La tasa de seropositividad fue superior a 99% en ambos grupos. Conclusiones: la aplicación de un esquema alternativo de tres dosis (0-6-50 meses) en niñas parece inducir una respuesta inmune no inferior al esquema tradicional un mes después de la última dosis. Se necesitan más estudios para determinar las dosis mínimas e intervalos óptimos para obtener la mejor cobertura para la infección por VPH.