The role of preventive examinations in health care

Vaccination against HPV - recommendations, indications, benefits

The knowledge of parents and guardians concerning the prevention of different diseases including cervical cancer is an essential condition of effective prevention. The recognition of protection principles against serious illnesses beginning from as simple as hygiene rules or vaccination helps developing responsible health behaviours. It is showed that i.a. health service employees and especially GPs and paediatricians have a huge role in informing and educating parents. Schhol, family and the media should also participate in the education of society.

In order to understand the importance of the primary prevention of cervical cancer every parent or guardian should answer a few questions:

  1. do you want the protection of your child in the maximum scope using the available preventive vaccinations?
  2. do you know that the protection against illnesses appears only when it preceeds the contact with contagious factor?
  3. do you know that some types of viral infection involve a certain amount of risk of developing cancer?
  4. do you know that infection results from contacts with peers and we do not have any influence on their behaviour?
  5. do you realise that infections from the young age can withstand through many years and lead to major diseases?
  6. are there any cases of cancers including cervical cancer in your family or amongst your acquaintances?
  7. do you want to lower the risk of cancer diseases?

THE ROLE OF VACCINATIONS AGAINST HPV
The vaccination against HPV is an element of primary prevention of the cervical cancer. However its character is exclusively preventive and not therapeutic therefore is the most effective (up to 100%) for persons who are not infected with HPV.
Vaccination consists in inserting protein antigens into the human body specific for the virus. Antigens do not contain DNA sample of the virus so cannot trigger the infection. Their task is to prompt the immune system to produce the resistance against oncogenic types (types 16 / 18) and low-oncogenic (types 6 / 11) of HPV.

It is proven that vaccinations considerably lower the risk of cervical cancer appearance and other changes triggered by these viruses (i.e. venereal warts) but does not eliminate it entirely. Therefore even if the girl was vaccinated against HPV she should still be regularly examined in subsequent years (screening pap smears).

WHAT TYPE OF VACCINES WE HAVE?
At present 2 types of vaccines are available:

  • 4-valent ("SILGARD" by MSD company) which counteracts the effects of infection with oncogenic types of HPV 16 / 18 and low-oncogenic 6 / 11 responsible for the occurrence of i.a. venereal warts;
  • 2-valent ("CERVARIX" by GSK company) which counteracts the effects of infection with oncogenic types of HPV 16 / 18.

Both vaccines support the immune system in the recognition and destruction of HPV before the development of infection as well as are refraining the development of clinical symptoms after infection.

WHO TO VACCINATE?
Vaccinations against HPV should be provided before the beginning of sexual activity due to the specificity of the virus proliferation.
A medium age of sexual initiation in Poland is between 16-18 years and every fifth girl (19%) had a sexual intercourse at the age of 15 or earlier. According to recommendations of Polish Paediatric Company (PTP) and of Polish Gynaecological Society (PTG) girls aged between 11 and 12 should be subjected to vaccinations and should be given 3 doses of vaccines intramuscularly ("SILGARD" should be introduced in the following scheme: 0, 2, 6 months and the vaccine "CERVARIX" in the scheme of 0,1,6 months). It is also advisable to vaccinate the girls between the ages 13 to 18 years who have not been vaccinated yet in subsequent years.
What is significant - the classification of girls for vaccination doesn't require the gynecological examination.

BEHAVIOURS SUPPORTING THE INFECTION HPV
Additional factor supporting early vaccination against HPV is even earlier interest of young people in different forms of sex such as: cool-sex, oral sex and petting which brings the risk of HPV infections with lower oncogenic type (types 6 / 11).

RESULTING BENEFITS FROM VACCINATION
The benefits from introducing the vaccinations against HPV and the safety of using them are confirmed by numerous scientific evidence. Medical and scientific circles recognised this vaccination as highly effective method in the fight against cervical cancer.
Therefore due to the vaccinations against HPV parents can save their daughters from the infection with human papillomavirus which is the main factor of cervical cancer development.

 

Elaborated by: Agnieszka Wrzesińska, MD