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HPV News: April 2020

Coach people about the benefits of the HPV vaccine, don’t just talk about it!

HPV World has released a new article discussing the best approaches for professionals talking about HPV encouraging individuals to go ahead with HPV vaccination. The study has shown that a combination of a thorough understanding of HPV and the benefits of the vaccine and confidence in the professionals recommending and administering the vaccine. Emphasis on the safety and effectiveness of the vaccine has been highlighted, as well as focussing on how the benefits of vaccines far outweigh any rare adverse reactions. As every person considering the HPV vaccine will have a different level of understanding of it, it is necessary to work out what information they need, what needs correcting, and how best to deliver the information. Healthcare providers also need to be prepared to challenge incorrect beliefs about the vaccine potentially picked up from “fake news” sources, engaging honestly, openly, and respectfully. Overall, research shows that effective and active communication will increase HPV vaccine uptake and confidence in medical professionals.

Risk of Oral HPV Among Female Adolescents

There have been manny recent studies highlighting the increasing incidence of oropharyngeal cancers in the US. Between 1988 and 2004, cases increased by over 200%. HPV is responsible for most of these cancers. A study by Nicolas Schlecht, PhD, Angela Diaz, MD, PhD, Robert Burk, MD, has been done to look at the effect of the HPV vaccine on oral HPV, as well as the risks of oral HPV. Over 1200 women between the ages of 13 and 21 who had received or were planning to receive the HPV vaccine were monitored for over 10 years, and routinely given oral rinse specimens. The researchers also collected data on the participants’ sexual behaviour, sexual health, and other factors. DNA from the samples was tested for HPV.

The study revealed that the detection of oral HPV was significantly lower in the women who had been vaccinated. One dose of the HPV vaccine reduced oral HPV by 83%. The findings are similar to similar studies of cervical and anal HPV. Oral HPV is not uncommon, but decreased with time since the onset of sexual activity. More studies are needed for the nonavalent HPV vaccine and in adolescent males.

HPV vaccination coverage drop: common denominators

While successful vaccine programs reduce preventable diseases, they may also impact the perceived need for the vaccine. As disease risk decreases, the public may be more likely to focus on the risk of the vaccine rather than its success.

The impact of HPV vaccination is not as immediately obvious as with some other vaccines, as there is a long time between vaccination and reduction of cancer. It has been seen that, following good vaccine coverage immediately after the introduction of the vaccine, there is a rapid drop in uptake due to confidence crises. Some causes of these crises include organised anti-vaccine groups and the government ministry of health. Anti-vaccine groups promote content of people negatively affected by the HPV vaccine and are well connected online. In general, it was found that the public remained confident about infant vaccination, but there was a drop in HPV coverage. Healthcare professionals can also be affected by anti-vaccination groups, becoming afraid that vaccination could cause harm, as observed in Ireland.

When governments lose faith in vaccines, for example in Japan, vaccine coverage also drops. Looking at countries such as Ireland, Japan, Denmark, and Colombia, where HPV vaccination coverage has dropped due to one or more of these factors, it is clear that there is no room for complacency when maintaining effective vaccination programs.

Post-Op HPV Vaccine Cuts Cervical Precancer Recurrences

A study by Kim Levinson of Johns Hopkins University School of Medicine has shown that women who received a HPV vaccine following surgery for cervical precancers are at a significantly lower risk of recurring precancer. Looking at a sample of almost 3000 women, those who received the vaccine were almost a third less likely to develop precancers or lesions. "Not only can this vaccine prevent HPV-related cancer ... but it also appears to help reduce the risk of recurrent dysplasia in women that already have HPV-related abnormalities," Levinson said in a statement.

Blood Test Spot On for HPV Cancer Recurrence

A prospective study has shown that a blood test for tumour-associated HPV is highly accurate when identifying oropharyngeal cancer patients at a high risk of recurrence post-treatment.

16 patients tested positive over three tests for circulating tumour HPV and, after a biopsy, 15 of these had proven disease recurrence. None of the negative-testing patients developed any recurrence. These results will help with catching oropharyngeal cancer recurrence early and starting treatment when it is most effective. Efficiency will be improved, and medical cost will be reduced.

Bhisham S. Chera, MD, of the UNC Lineberger Comprehensive Cancer Center in Chapel Hill, described the test as the “best surveillance tool we have”. The majority of recurrences occur within the first 2 years after treatment. This blood test can detect recurrent cancer earlier than other tests, and easily show doctors which patients need further imaging and screening.


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