Vaccinoprophylaxis
It is possible to ensure a certain immunity from infections sustained by the Papilloma virus by undergoing a prophylactic vaccination: vaccines, presenting the immune system with capsids of the pathogen devoid of viral genetic products (therefore empty), constitute an "excellent defense weapon against the Papilloma virus, especially for young women As easily understood, this vaccine cannot prevent diseases other than the specific papilloma virus against which it acts.
It should not be forgotten, however, that the vaccine is totally ineffective if taken AFTER contracting the virus. On the other hand, according to recent scientific evidence, the quadrivalent vaccine seems effective not only in preventing primary infection, but also in significantly reducing the occurrence of relapses in women with a history of previous cervical lesions.
A step back to understand ...
The Papilloma Virus is involved both in the manifestation of benign hyperproliferative lesions, of negligible entity and of simple resolution (such as warts and acuminate warts), and in the development of malignant tumor cells, whose preferential target is constituted by the cells of the cervix. Vaccination is therefore indicated precisely to hinder the entry of the Papilloma virus into the cells of the organism.
Cancer of the cervix
Much has been said and written about the prevention measures to be followed to protect oneself from papilloma virus infections; let us now try to focus attention on HPV vaccination.
The propaganda concerning vaccination against the Papilloma virus, which the medical profession has excellently developed, aims to sensitize the general population - and young women in particular - about the risks that can derive from a "virus infection. HPV, in particular if sustained by genotypes 6, 11, 16 or 18 (the last two ascribed to a high oncogenic risk).
Before starting to deepen the topic, we report two disconcerting data:
- in Italy over 3,000 new cases of cervical cancer are diagnosed annually, of which 40-50% are fatal.
- Papilloma virus infection, contracted through sexual intercourse with infected partners, is the cause of over 90% of diagnosed cases of cervical cancer; serotypes 16 and 18, in particular, alone are responsible for 70% of diagnosed cases of cervical cancer
- HPV serotypes 6 and 11 alone cause approximately 90% of genital warts.
HPV vaccine
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HPV vaccine
Only a few years ago, in the very recent 2006, EMEA (European Medicines Agency) and AIFA (Italian Medicines Agency) authorized the vaccination against the Papilloma Virus, the first one that promises "excellent (though not absolute) protection from neck cancer. HPV-dependent uterus: the vaccine against papilloma virus infections, not mandatory, is free for girls who have reached the age of 12. Indeed, the vaccine makes people immune to both type 6 papilloma virus infections , 11, 16 and 18, and by the injuries they caused.
The HPV vaccine exerts its maximum effectiveness not only among the very young (as is often believed) but also among women aged between 26 and 45 years; on the other hand, the mechanisms that regulate the immune system are almost identical in all ages (clearly, in the absence of alterations in the immune system).
The best age to undergo vaccination is still the subject of heated debate, as the authors' theories are many and varied: some believe that the vaccine should be administered within 9-11 years, therefore before the start of sexual activity. In fact, as we know, the Papilloma virus can be transmitted almost exclusively through sexual intercourse; therefore, the effectiveness of the vaccine would be canceled if taken after having already contracted the virus. However, other researchers believe that girls can get vaccinated even at age 16, up to 25, the age at which the woman should start having regular routine gynecological check-ups (PAP-tests) every three years.
According to the thinking of others, vaccinating a girl against the Papilloma virus as early as 9 years old could be seen as a kind of stimulus or invitation to start sexual life early.
How the vaccine works
Numerous studies have been conducted on different Papillomavirus vaccines:
- monovalent vaccines (against HPV 16)
- bivalent vaccines (against HPV 16 and 18: eg Cervarix)
- quadrivalent vaccines (against HPV 6, 11, 16 and 18: eg Gardasil and Silgard): Gardasil seems to be particularly suitable for women aged between 16 and 26 years, as well as in girls and adolescents between 9 and 15 years.
- 9-valent vaccines (against HPV 6, 11, 16, 18, 31, 33, 45, 52 and 58: eg Gardasil-9)
Comparing these different types of vaccine, it was observed that the most effective of all is the one that exerts its protective action both towards the 2 serotypes most involved in cancerous lesions of the cervix (HPV 16 and 18), and towards the 2 serum types most involved in the onset of acuminate warts (HPV 6 and 11).
The quadrivalent anti-Papilloma Virus vaccine protects against high-grade dysplastic lesions of the vulva, damage to the external genitalia (eg. Condyloma acuminata), high-grade dysplasia at the level of the uterus and neck cancer. uterus. The preventive efficacy of the quadrivalent vaccine against males has not yet been fully demonstrated.
In the case of the bivalent vaccine, protection is instead limited to precancerous lesions (abnormal cell proliferation) and cervical cancer.
Composition of the vaccine
The HPV vaccine is composed of viral-like particles, known precisely as Virus-like Particles or more simply VLP, associated with adjuvant substances (a compound formulated with aluminum, able to stimulate a better response).
The proteins contained in the capsid are known as L1: the vaccine contains L1 proteins purified (produced with the recombinant DNA technique) for each of the types of human papilloma virus contained in the drug.
After the administration of the vaccine, the woman's immune system begins to produce antibodies against these proteins: in the event of a possible attack by the Papilloma virus, the body immediately recognizes the pathogenic cells, preventing the virus from causing damage.
Hopes and future expectations
The HPV vaccine is used exclusively for prophylactic purposes, in the sense that the drug does NOT act if the woman has already contracted the virus.
However, doctors are mobilizing to achieve another goal: the therapeutic vaccination. The hopes are to produce a vaccine that can stop the progression of the infection even AFTER contracting the Papilloma virus. In other words, the therapeutic vaccination could prevent the possible malignant progression of the cells of the cervix, previously infected by the Papilloma visus.
Currently, the effectiveness of this particular Papillomavirus vaccination is still being tested.
Posology and administration
The vaccine is administered intramuscularly into the shoulder (deltoid) muscle; the therapy involves a cycle of three doses: the second dose should be taken two months after the first, while the third dose should be administered 4 months after the second. Alternatively, it is possible to undergo the boosters, respectively after 30 and 90 days from the first intake.
The vaccine must NOT be administered to pregnant women: just think that the FDA has reported 28 cases of spontaneous abortion after taking the vaccine against Papilloma virus in pregnant women.
The drug is not recommended for women who are allergic to one or more of the ingredients contained in the vaccine.
Adverse Effects
Like any drug, the HPV vaccine can also cause unpleasant side effects, which can be resolved quickly; among the most common are: fever and redness / irritation / pain at the injection point of the drug.
Even after vaccination against HPV, sexually active women are recommended to undergo regular PAP tests, in order to identify, possibly and well in advance, possible attacks by the Papilloma virus. Vaccination, in fact, strongly reduces the risk of developing precancerous lesions of the cervix, but statistically speaking it does not offer absolute protection.
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