对象|《柳叶刀·肿瘤学》：HPV疫苗，一针或许就行！科学研究发现，一针四价HPV疫苗，10年内抗高危HPV感染效力媲美两针和三针( 三 ) 保护|柳叶刀|研究|女性|效力

在中低收入国家，仍有非常多女性打不起HPV疫苗，加上新冠导致的医疗资源倾斜， HPV疫苗覆盖问题更是雪上加霜[12] 。一项预印本模型研究结果表明，即使单剂HPV疫苗效力稍差，只要覆盖率高，也能在人群层面上产生比两剂疫苗更高的健康收益[13] 。通过高覆盖率产生的群体免疫有可能弥补一些个人层面上单剂疫苗保护力随时间减弱的不足[14] 。因此，合理引入单剂HPV疫苗、提高疫苗覆盖率或有望以更经济的形式减少宫颈癌的发生。

文章图片

参考文献
[1] WHO. Immunization coverage. July 15, 2021. https://www.who.int/news-room/fact-sheets/detail/immunization-coverage
[2] WHO. Immunization, vaccines and biologicals. https://www.who.int/teams/immunization-vaccines-and-biologicals/immunization-analysis-and-insights/global-monitoring/data-statistics-and-graphics
[3] Basu P, Malvi SG, Joshi S, et al. Vaccine efficacy against persistent human papillomavirus (HPV) 16/18 infection at 10 years after one, two, and three doses of quadrivalent HPV vaccine in girls in India: a multicentre, prospective, cohort study [published online ahead of print, 2021 Oct 8]. Lancet Oncol. 2021;S1470-2045(21)00453-8. doi:10.1016/S1470-2045(21)00453-8
[4] Sankaranarayanan R, Basu P, Kaur P, et al. Current status of human papillomavirus vaccination in India's cervical cancer prevention efforts. Lancet Oncol. 2019;20(11):e637-e644. doi:10.1016/S1470-2045(19)30531-5
[5] Basu P, Muwonge R, Bhatla N, et al. Two-dose recommendation for Human Papillomavirus vaccine can be extended up to 18 years - updated evidence from Indian follow-up cohort study. Papillomavirus Res. 2019;7:75-81. doi:10.1016/j.pvr.2019.01.004
[6] Kreimer AR, Sampson JN, Porras C, et al. Evaluation of Durability of a Single Dose of the Bivalent HPV Vaccine: The CVT Trial. J Natl Cancer Inst. 2020;112(10):1038-1046. doi:10.1093/jnci/djaa011
[7] Rodriguez AM, Zeybek B, Vaughn M, et al. Comparison of the long-term impact and clinical outcomes of fewer doses and standard doses of human papillomavirus vaccine in the United States: A database study. Cancer. 2020;126(8):1656-1667. doi:10.1002/cncr.32700
[9] Verdoodt F, Dehlendorff C, Kjaer SK. Dose-related Effectiveness of Quadrivalent Human Papillomavirus Vaccine Against Cervical Intraepithelial Neoplasia: A Danish Nationwide Cohort Study. Clin Infect Dis. 2020;70(4):608-614. doi:10.1093/cid/ciz239
[10] Markowitz LE, Naleway AL, Klein NP, et al. Human Papillomavirus Vaccine Effectiveness Against HPV Infection: Evaluation of One, Two, and Three Doses. J Infect Dis. 2020;221(6):910-918. doi:10.1093/infdis/jiz555
[11] Zeybek B, Lin YL, Kuo YF, Rodriguez AM. The Impact of Varying Numbers of Quadrivalent Human Papillomavirus Vaccine Doses on Anogenital Warts in the United States: A Database Study. J Low Genit Tract Dis. 2018;22(3):189-194. doi:10.1097/LGT.0000000000000401
[12] Ginsburg O, Basu P, Kapambwe S, Canfell K. Eliminating cervical cancer in the COVID-19 era. Nat Can 2021; 2: 133–34.
[14] International Agency for Research on Cancer/WHO. Primary end-points for prophylactic HPV vaccine trials. IARC Working Group report, vol 7. Lyon: IARC, 2014.
本文作者丨BioTalker