Free vaccination in many places, can the HPV vaccine "anxiety" be alleviated? Expert: There is no need to cling to the nine-valence

The market demand for HPV vaccine for cervical cancer is strong, but the supply is insufficient. Some people have been queuing for vaccination for more than half a year, and some people have spent a lot of money looking for scalpers to grab vaccines. Recently, some places have tried to get the HPV vaccine free or subsidized. Experts remind that women of appropriate age should be vaccinated and prevented early to avoid over-clinging to the nine-valent vaccine.

Since the beginning of 2021, Ms. Wang of Jinan City, Shandong Province, has been trying to make an appointment for hpvance vaccine for her daughter Sun Yijia, but contacted several vaccination institutions and was told: "There is insufficient supply and there is a need to queue." However, what the mother and daughter did not expect was that a few months later, they had not received the notification of the success of the appointment, but they waited for the good news of free vaccination.

In 2020, China launched the pilot work of the Healthy China Action Innovation Model, and in 2021, many places across the country will promote the universal HPV vaccination policy for women of appropriate age, and cities such as Ordos in Inner Mongolia, Jinan in Shandong, and Xiamen in Fujian have successively launched free or subsidized HPV vaccine vaccination plans. As one of the first batch of 15 pilot cities in the country, Jinan City, Shandong Province, recently took the lead in launching the free vaccination of domestic bivalent HPV vaccine for seventh-grade girls in school, and Sun Yijia and more than 30,000 peers were vaccinated.

In view of why hpv vaccine is so tight, how the free vaccination in pilot cities is progressing, and whether free HPV vaccination can be popularized, the reporter of Workers Daily conducted an interview and investigation.

Appointments for vaccination queues range from as little as 2 to 4 months, and as much as half a year or even longer

Xiao Xiao, a girl in Qingdao, Shandong Province, had a tortuous HPV vaccination process. Xiao Xiao told reporters that she began to pay attention to HPV vaccination information from college, and after graduation, she made an appointment to queue up at the community health service center in front of her home, but waited for half a year without receiving any news.

HPV, known as human papillomavirus, is very susceptible to cervical cancer and other diseases once infected. The data shows that in 2020, there will be 604,000 new cases of cervical cancer and 340,000 deaths worldwide, 110,000 new cases and 60,000 deaths in China. Cervical cancer has become one of the top ten malignant tumors in the world, and the incidence group is getting younger and younger.

In 2006, the world's first batch of HPV vaccines came out, and in 2016, it was approved for listing in China. Imported HPV vaccines are divided into bivalent, quadrivalent, nine-valent, bivalent is suitable for 9 to 45 years old, can prevent HPV16 and 18, which is also the most likely to cause cervical cancer of the two viruses; quadrivalent is applicable to 20 to 45 years old, can prevent HPV16, 18, 11, 6 four viruses; nine valence is applicable to 16 to 26 years old, can prevent HPV16, 18, 11, 6, 31, 33, 45, 52, 58 nine viruses. The prevention rate of all three vaccines is higher than 84.5%.

In order to get the nine-valent vaccine as soon as possible, after queuing in the community health service center without success, Xiao Xiao began to look for other ways to make an appointment. Online merchants, private hospitals in Macau, booking APP... After various comparisons, the appointment was finally successfully made through the Lilac Doctor APP. After the end of the whole process of vaccination, Xiao Xiao released a circle of friends of "nine-valent protective body".

In recent years, the domestic news about the HPV vaccine "one shot is difficult to find" is not uncommon, and even spawned a "scalper" industry. In order to avoid artificial operation, Shenzhen introduced the HPV vaccine lottery policy, last year's 8th nine-valent vaccine lottery, the winning rate of 530,000 effective applicants was only 3.589%.

Tan Xin, director of the Disease Planning Department of Jiajiakang Community Service Center on Jinhua Road, Shibei District, Qingdao City, told reporters that the center applied for 200 injections of HPV vaccine from the Municipal Center for Disease Control and Prevention every month, and in fact could only receive about 100 bottles, but "the average number of vaccine consultation appointments received every day is 20 to 30, and many women need to wait for 2 to 4 months, or even longer, we must first ensure the continuity of the follow-up two injections of the population that has been vaccinated." ”

The price of domestic bivalent vaccines is only half that of imports, and many places have launched free or subsidized vaccination programs

"Most women are obsessed with the nine-valent vaccine and want more comprehensive protection, and the only company in the world that can produce the nine-valent vaccine is currently merck in the United States, which is also an important reason for the 'difficult to find a seedling'." Cui Lei, director of the Maternal and Child Health Department of the Jinan Municipal Health Commission in Shandong Province, analyzed and said.

According to data from the China Food and Drug Control Institute, from 2017 to 2020, the number of domestic HPV imported vaccines issued was 1.46 million, 7 million, 10.87 million and 15.43 million, respectively. Although the number of imports is increasing every year, the gap in the domestic market is still close to 1 billion according to the demand of 356 million women of school age for 3 stitches per person.

In 2019, the domestic divalent HPV vaccine developed and produced by Wantai Canghai Biotechnology Co., Ltd. in Xiamen, Fujian Province was officially listed. Unlike the three doses of imported vaccines, women aged 9 to 14 only need two injections of domestic divalent vaccines, and the prevention rate is also higher than 84.5%, and the price is only half of the imported vaccines.

The advent of domestic HPV vaccines has effectively alleviated the shortage of vaccines. In 2021, many places across the country will launch a universal HPV vaccination policy for women of appropriate age, and Jiangsu, Inner Mongolia, Shandong, Fujian, etc. have successively launched free or subsidized HPV vaccine vaccination plans. In Jinan, for example, as of December 29, 2021, 34,056 seventh-grade girls in school have been vaccinated free of charge, achieving the goal of more than 90% vaccination coverage for the target population.

"According to the implementation plan, Jinan will carry out free vaccination of domestic bivalent HPV vaccine for girls in the seventh grade every year in the future, and it is planned that the coverage rate of the population that should be vaccinated will reach 90% by 2025." Cui Lei introduced.

Early vaccination and early prevention, do not blindly believe in "grabbing" and "waiting for appointment" services

In recent years, more and more women have realized the importance of HPV vaccination, but because the nine-valent vaccine can prevent more viruses, many women are obsessed with "must not be nine-valent", resulting in missing the best time for prevention.

Experts from the Qingdao Municipal Center for Disease Control and Prevention said that the current domestically listed HPV bivalent, quadrivalent and nine-valent vaccines have no significant differences in immunogenicity and the efficacy and efficacy of HPV16 and 18 viruses. If the nine-valent vaccine is not booked, the bivalent and quadrivalent vaccines can also play a good preventive effect, and it is not recommended to wait for a higher number of vaccines in order to increase the scope of protection and miss the best time for prevention. Moreover, women who have been vaccinated with bivalent and quadrivalent vaccines can also be vaccinated with nine valents in the future, and should be vaccinated as soon as possible.

In response to the hot discussion on the Internet about "whether men need to be vaccinated with HPV vaccine", experts said that men also have a risk of disease, but the probability of relatively low women is low, and there are also cases of vaccination for foreign men, and clinical trials have not been carried out in China, so they still cannot be vaccinated.

According to reports, at present, more than 10 companies in China have carried out HPV vaccine research and development, and vaccine production will increase significantly in the next few years, and the supply of imported vaccines will also increase. "When vaccine production can meet market demand, the price will naturally decrease, and if it is within the financial capacity of the national or local government, HPV vaccines may also be classified as national vaccines." Qingdao CDC experts said.

Cui Lei called on the female group that cervical cancer is a preventable cancer, that regular "two cancers" screening and vaccination are equally important, and that early detection can help better prevent and control the disease. At the same time, remind everyone that vaccination should go to regular hospitals or community health service centers, can not blindly believe in services such as "rushing" and "waiting for appointments", and receive text messages of "successful appointments", and must call the hospital for verification.