A single dose of HPV vaccine could address low coverage in Brazil – May 13, 2022

HPV (Human Papillomavirus) is one of the most far-reaching viruses that has managed to spread among humans. It is estimated that up to the age of 45, 80% of the sexually active population is infected at some point in their lives.

In most cases, the immune system eliminates the HPV infection without causing any symptoms. In the rare times when this does not happen, HPV can cause genital warts and, in the worst case, various cancers such as cervical, penile, vulvar, anal, oral, and throat cancers.

Because HPV causes asymptomatic infections and is transmitted through the friction between the skin, it is known to be one of the sexually transmitted diseases (sexually transmitted infections) that also spreads to people who use condoms on a regular basis. This is because a condom does not cover the entire body of a person.

Only with the recommendation to use a condom did HPV spread to the Brazilian population, and one of the consequences of this. Global Cancer Observatory According to the World Health Organization (WHO), more than 17,000 cases of cervical cancer are diagnosed in the country each year.

Fortunately, in addition to condoms, we also have vaccines to prevent HPV that help the immune system clear the virus after infection. By removing the virus from the human body, the vaccine is also very effective in reducing the incidence of HPV-related cancers. This can be called a real cancer vaccine.

Maximum vaccine protection is achieved when doses are given before HPV infection occurs in a person’s lifetime. Thus, SUS (Unified Health System) offers vaccination free of charge to both girls and boys under 15 years of age.

Does this mean that Brazil will have eradicated all cases of cancer caused by HPV within a few years? Unfortunately, no. And the main reason for this anticlimax is the difficulty in achieving good vaccination coverage in children and adolescents.

According to a report published in the SBIm (Brazilian Society of Immunizations) report, since 2013, when the HPV vaccine was introduced in the National Immunization Program (PNI), the minimum target of 80 percent has only been reached for the first time. girls (83.4%). At the second dose, however, it drops to 55.6 percent. In boys, the scenario is even more worrying, with coverage of 57.9% for the first dose and 36.4% for the second dose.

It would be utterly unrealistic to imagine that we could achieve a satisfactory reduction in the incidence of cancer caused by HPV if we do not get vaccinated even in four out of ten boys in Brazil. This will become an even more impossible task as the discipline of vaccine prevention in the country increases, spreading false information about the side effects caused by vaccines.

However, one piece of news that came in almost fresh air last week was a change in WHO HPV vaccination recommendations. The Agency’s team of immunization experts looked at several new results from clinical trials published in recent years and found that a single-dose vaccination in children is already able to provide protection against HPV comparable to complete treatment.

With this change, twice as many children can be immunized with the same batch of vaccine, which is of particular interest in the poorest countries, especially those most affected by HPV-related cancers.

So far, in Brazil, the recommendations have not changed. We will continue 2 doses for boys and girls up to 14 years of age and 3 doses for immunosuppressed men 26 years of age and 45 years of age.

The Department of Health is not updating the recommendations for HPV vaccines, but we need to work to improve parental resistance to vaccinating their children and convince them that the benefits will only be seen in the long term. And as they grow up, these kids will surely thank them for being vaccinated at the right time.

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