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HPV News: August 2018

31 Aug 2018

The latest monthly roundup of news, announcements and scientific discoveries from the world of Human Papillomavirus (HPV). If you have any comments we’d love to hear from you!

Antigua and Barbuda to introduce HPV vaccine

Antigua and Barbuda have introduced HPV vaccinations for boys and girls, which took effect last month. The country’s Ministry of Health has formed a special taskforce to introduce the vaccine, called The Cervical Cancer Taskforce. Consultant Pediatrician to the taskforce, Dr. Joycelyn Walter-Thomas, said “this lifesaving preventative measure will be effective in reducing the deaths from HPV related cancers especially cervical cancer and other diseases”. The taskforce has developed a plan of action for prevention and control of HPV, focusing on four main areas: increasing information, education and communication, expanding screening programmes, introducing the vaccine, and improving access to cancer treatment and palliative care.

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HPV vaccine proves its effectiveness in Spain

A Spanish study has found that the HPV vaccine has led to a decrease in the prevalence of HPV types 16 and 18 in vaccinated women in Spain. The study found that the vaccine had an extremely high – 94% – direct effectiveness rate, and an indirect effectiveness – ie herd immunity – of 29.7%. This will hopefully lead to recommendations for gender neutral vaccination. The bivalent vaccine, Cervarix, was incorporated into the Spanish childhood vaccination programme in 2008, but it currently only available for free to girls.

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Barriers and Facilitators for the HPV Vaccine

A study has been released examining the factors affecting delivery of the HPV vaccination. Four focus groups, made up of NHS vaccination teams, were formed and questioned on barriers and facilitators affecting the delivery of the vaccine in schools. Barriers to vaccination included limited school and team resources, fear of the vaccination, and poor consent form returns. Factors that made vaccination easier included school support and education around the vaccine. The researchers offer possible solutions that may increase vaccination uptake, such as electronic consent forms and providing culturally sensitive material about the vaccine. The current uptake rate of the vaccine is high in the UK, with at least 87% of girls receiving at least one dose in 2016/7. As the UK begins to roll out the programme to boys, this study will help make their uptake just as high.

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HPV Vaccines are More Practical for LMICs

Dr. Silvia Franceschi, of the International Agency for Research on Cancer in France, has been investigating the use of HPV screenings in low and middle income countries (LMICs). She has found that while screening is effective at preventing cervical cancer, it is more logistically demanding than implementing HPV vaccination. Many policy makers in these countries worry that implementing vaccination will take decades before it produces results, but from what we can see in LMICs that have already begun HPV vaccination programmes, we know that vaccination is much more feasible compared to other prevention strategies. Hopefully these findings will lead to an increase in vaccine implementation.

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Improving Regulators Communication of Vaccine Safety to the Media

When the European Medicines Agency (EMA) began an assessment of the HPV vaccine, it decided to also analyse the accompanying news content. The objective was to evaluate the utility of media monitoring in real life, to see how to then communicate effectively with the press and the general public once the results of the study were available. It was found that media monitoring can allow regulatory bodies to make sure the public’s concerns are addressed in results, as well as providing public statements with a balance of scientific details and empathic tone. It also prepares them for questions posed by the press in public meetings. It is hoped that these findings will help spread the word that the HPV vaccine is safe and effective to use.

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Gender Neutral Vaccination creates Herd Immunity

A study in Finland has found that, even with a very low coverage rate, gender-neutral vaccination is effective at creating a strong herd immunity against HPV. The researchers studied a group with a 20-30% vaccine coverage rate in boys, and 45% rate in girls, and found that this was enough to establish a herd immunity against all HPV-related cancers. This has been followed by a nation-wide study in Finland on the safety of the vaccine, finding no causal links between reported adverse drug reactions and the jab itself. All this will hopefully lead to Finland becoming the next country to provide the vaccine for boys as well as girls.

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New Research Suggests Link between Skin Disease and HPV

A new link has been found between a rare skin disease and a type of HPV, called Beta-HPV. Researchers from the Rockefeller University in New York have uncovered the molecular mechanism that causes people with a skin condition, called Epidermodysplasia Verruciformis (EV), to be vulnerable to HPV. 30-60% of individuals with EV go on to develop non-melanoma skin cancers, such as squamous cell carcinomas. In these people, HPV infects cells called keratinocytes, triggers their proliferation and causes skin growths associated with the condition. This discovery may mean that HPV can cause even more cancers than we previously thought, making gender neutral vaccination all the more important.

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Important Results from HPV Study in Sheffield

The largest ever study of HPV in people in Northern England has been conducted in the University of Sheffield, and results were released this month. The research found more evidence that HPV is linked to oral cancer, and that one in 50 people carry a strain of HPV in their throat. However, overall infection rates for HPV were lower than expected when compared to previous studies, meaning that the introduction of the HPV vaccine for girls in 2008 has been a success. The introduction of the vaccine for boys will continue to reduce the low rates, until HPV will be eliminated forever.

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Wales Reveals more about Gender Neutral Vaccination Plans

Wales has become the first nation in the UK to announce a set date to begin vaccinating boys against HPV as well as girls. Vaccinations will begin in the 2019-2020 school year. The news comes after a written question concerning the vaccine was tabled at the National Assembly for Wales, asking when vaccination will be implemented. The question was answered by Vaughan Gething MP, the Cabinet Secretary for Health and Social Services, and reads “the working assumption is that the HPV vaccine will be provided to boys in the 2019/20 academic year”. The rest of the UK is yet to announce when they will make the vaccine available to boys.

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Vaccination Rates in USA on the Rise

The 2017 National Immunisation Survey – Teen report in the USA has been released, showing that more teens are getting vaccinated against HPV than ever before. The rates of vaccination have increased by 5 percentage points between 2016 and 2017. 66% of teens received at least one dose, and nearly 49% finished the series of vaccines. This is fantastic news, but the numbers show that there is still a long way to go – over half of US children still do not complete the series, meaning they are not fully protected against the virus. There are also disparities in vaccine uptake across regions – teens in rural areas are less likely to get the vaccine. The next goal for America is to continue to increase the rate of vaccination at the same speed, across the entire country, and to not let it fall.

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