Seven out of ten cases of cervical cancer are caused by a virus against which there is a vaccine available free of charge in the Unified Health System. This virus is the human papillomavirus (HPV), which also causes nine out of ten cases of anal cancer and is related to malignant neoplasms in the penis, vagina, vulva, mouth and throat. Even with so much evidence of the danger that being unprotected against this sexually transmitted infection (IST) represents, the National Immunization Program (PNI) found a drop in protection of the target public of this vaccine last year. According to data released by the Ministry of Health on February 21, 87.08% of Brazilian girls between 9 and 14 years of age received the first dose of the vaccine in 2019, and in 2022, coverage dropped to 75.81%. Among boys, vaccination coverage dropped from 61.55%, in 2019, to 52.16%, in 2022. Sought this Monday (6) by Agência Brasil to update the data, the ministry informed that, among girls , coverage of the vaccine against HPV, in 2022, reached 77.37% in the first dose, and 58.29% in the second dose. Among boys, 56.76% received the first dose and only 38.39% the second. Infectologist at the Oswaldo Cruz Foundation (Fiocruz) and the I’Dor Institute, José Cerbino Neto explains that few of the more than 100 types of HPV are related to cancer, and types 16 and 18 are the most dangerous. Indicated in the Unified Health System (SUS) for adolescents aged 11 to 14 years and people with specific health situations, the vaccine against HPV protects against these two types and also against two strains responsible for genital warts. In addition to the PNI’s target audience, people up to 45 years old can obtain the vaccine at private immunization clinics, according to authorization from the National Health Surveillance Agency (Anvisa). “It is understood that vaccination in this population aged 11 to 14 years will have a greater impact, because these people will be vaccinated before starting their sexual life. But for anyone not vaccinated up to 45 years, there is a benefit with vaccination”, highlights the researcher. “The vaccine has the ability to protect people from sexually transmitted infection, and ultimately protect them from cancer that they might develop.” People living with HIV/AIDS, solid organ transplants, bone marrow transplants or cancer patients aged between 9 and 45 years can also be vaccinated free of charge at SUS, at a reference center for special immunobiologicals, with a three-dose schedule . Estimates from the Ministry of Health show that about half of all women diagnosed with cervical cancer are between 35 and 55 years of age, and many were probably exposed to HPV in their teens or 20s. age. Incidence Despite being associated with cases of cancer, the vast majority of cases of HPV infection do not evolve in this way. In most cases, the immune system itself takes care of fighting the virus before symptoms appear. According to the Ministry of Health, the first symptoms may appear from two to eight months after infection with HPV, but there are still chances even two decades after contact. Symptomatic manifestations are more common in pregnant women and in people with low immunity. The virus can cause lesions visible and invisible to the naked eye, and the most frequent manifestation is warts in the genital or anal region. These warts are generally associated with non-cancerous types of HPV. Cerbino points out that the majority of the adult population will be infected with HPV at some point in their lives. As the types of virus associated with cancer are the ones that cause the most serious damage, they are the most frequently diagnosed and tested in the laboratory, which does not mean that they are the ones that circulate the most. “They are the most identified because they are the ones that cause the most diseases”, he points out. “As there is more than one subtype, there are benefits in taking the vaccine for those who have had HPV, because you would be increasing your protection against a possible new infection, although this is not common”. The Ministry of Health and the National Cancer Institute (Inca) cite international studies that indicate that up to 80% of sexually active women will have contact with one or more types of HPV at some point in their lives, and this percentage can be even greater in men. Researchers who study the subject estimate that between 25% and 50% of the female population and 50% of the male population worldwide are infected with HPV. For Fiocruz’s infectologist, anti-vaccination campaigns and rumors add to the difficulty of mobilizing the target age group for vaccination as some of the obstacles to greater coverage for immunization against HPV. “Our vaccination schedule has vaccines recommended for all age groups, but our culture is to vaccinate children. So, the fact that the vaccine is applied from 11 to 14 years old may have contributed to the lower coverage”, he assesses. he, who highlights that the vaccine is safe and effective, in addition to being applied in more than 100 countries. New vaccine The vaccine against HPV available in the PNI and in private clinics until this year is the quadrivalent vaccine, which protects against four types of the virus, including 16 and 18, considered the most dangerous. Private clinics should start applying a new version of the vaccine in the coming weeks, against nine strains, also including 16 and 18, and five types of high-risk HPV. Responsible for the Human Immunization sector at Richet Medicina & Diagnostics, Patrícia Rosa Vanderborght explains that this new vaccine will increase protection against cervical cancer and other types. The researcher also points out that communication about HPV prevention has been very restricted to adolescents, because of official vaccination campaigns, and to women, due to the prevention of cervical cancer. “The incidence is very high, and men don’t have the culture of going to the doctor and having tests like women, who go to the gynecologist. We observe a lot of lack of information among men, who think that the vaccine is only important for women “, alert. “Another important population is the LGBT population. We have been talking to infectologists about the need for this population to be aware of the prevention and incidence of cancer”. Patrícia adds that vaccination against HPV in adolescence has the advantage of having only two doses. In private clinics, which vaccinate the adult public, the vaccine now needs three doses.
Agência Brasil
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