Who Should Get Vaccinated?
HPV vaccination is recommended for individuals aged 9 to 45 years. The greatest benefits of vaccination can be achieved by younger individuals, particularly before their first sexual initiation, as studies indicate that by the age of 25, a person is typically already infected with at least one type of HPV. However, vaccination is also recommended for individuals over the age of 26 due to the potential reduction in the risk of HPV-related diseases within the vaccinated population and the potential to decrease the risk of malignant transformation of HPV infections to squamous cell carcinoma. Additionally, patients with high-grade squamous intraepithelial lesions (HSIL) who undergo surgical treatment and vaccination show a lower risk of HSIL recurrence.
Can Prophylactic HPV Vaccination Reduce the Recurrence of Cervical Lesions After Surgery?
In a study conducted by Ling Han and Bingyi Zhang, the impact of prophylactic HPV vaccination on the risk of recurrence of cervical lesions after surgical procedures in patients with HSIL was analyzed. Women with HSIL typically undergo procedures like conization or loop electrosurgical excision procedure (LEEP) to remove cervical lesions; however, the risk of recurrence remains higher than in the general population. While HPV vaccination is crucial in preventing cervical cancer, the impact of prophylactic HPV vaccination on reducing the recurrence risk of cervical lesions after surgery remains unclear.
What Are the Contraindications for Vaccination?
The contraindications for vaccination include an anaphylactic reaction that occurred after a previous dose of the vaccine or after administration of any of its components. The ingredients of the vaccine include:
- L1 protein antigens of HPV produced in Saccharomyces cerevisiae yeast cells,
- Sodium chloride,
- L-histidine,
- Sodium borate,
- Polysorbate 80,
- Water for injection.
HPV and Cervical Cancer
HPV is a small, non-enveloped DNA virus that can infect mucosal and cutaneous epithelial cells. Most genital HPV infections are transmitted through sexual contact, which can lead to minor damage to the cervical epithelium and allow the virus to enter the basal cells of the epithelium. HPV infection can lead to persistent infections, which in some cases progress to precancerous lesions (CIN) and cervical cancer.
Prophylactic Vaccines
Currently, there are three types of prophylactic HPV vaccines available:
- Bivalent vaccine (Cervarix) targeting HPV 16 and 18,
- Quadrivalent vaccine (Gardasil) targeting HPV 6, 11, 16, and 18,
- Nine-valent vaccine (Gardasil 9) targeting HPV 6, 11, 16, 18, 31, 33, 45, 52, and 58.
Therapeutic Vaccines
Therapeutic vaccines differ from prophylactic vaccines in that they rely on cell-mediated immune responses to eliminate HPV-infected cells and lesions. Currently, no therapeutic vaccine has been approved for treating HPV infections and precancerous cervical lesions.
The use of the HPV vaccine in the population of patients who have undergone surgical treatment for HSIL can significantly reduce the risk of recurrence of cervical lesions. Studies indicate the potential benefits of prophylactic HPV vaccination as an adjunct to surgical therapy, though further research is required to fully understand the mechanisms and confirm the effectiveness of this approach.
