05/02/2023
*HPV Vaccine*
One upbeat news that was largely missed in the beaten down Adani market (pun intended!!) ..serum institute of India has prepared our own HPV vaccine fully made in India under the brand name *Cervavac*.
It was officially announced on the girl child day 24th January at New Delhi by Adar Poonawala in presence of Home minister Amit Shaha. This brings down the cost of each unit of HPV vaccine from INR 4000 for imported type to mere 400 for desi version.
☘️: Humam Papilloma Virus is a DNA virus infecting only humans. Almost 170 types of HPV have been identified about 40 of them are sexually transmitted. HPV may also show transplacental transfer from mother to foetus.
Other notable fact is this virus is not killed by sanitizers and disinfectants.
As HPV is the most common STD, nearly every sexually active person is infected by HPV at some stage of the life.
But largely most do not show any clinical symptom.
This is mostly HPV 5 type.
HPV 1and 2 may cause common warts. Type 6 and 11 cause veneral warts and(rarely) laryngeal Papillomatosis. Warts are caused by a rapid growth of cells in outer layer of skin. Ancient Greek literature describes these warts, of course its aetiology wasn't known then.
☘️: HPV is one of the most important infectious causes of cancer. Worldwide 5%of total diagnosed cancer cases show association with sexually transmitted HPV infection. Type 16,18, 31 and 45 are labeled as high risk out of which type 16 is most notorious. It is found in nearly 47% of cervical cancers and in many cancer cases of v***a, va**na, a**s and p***s.
☘️: That ge***al HPV infection may lead to cervical cancer was first suspected and studied and proved by a German researcher Herald zur Hausen. Two French virologists too contributed to discovery of HPV. All three were awarded Nobel Prize.
☘️: In the individuals whose immune system fails to curb HPV infection can favour development of cancer. It brings about degradation of p53 protein which is identified as tumor suppressant factor in the cell. Degradation of p53 may promote unregulated cell division, cell growth and cell survival leading to cancer growth.
(Detailed theory is beyond the scope of this article. )
☘️: First HPV vaccine was made in Australia at Queensland University and approved by US FDA in 2006. Merck marketed it under trade name
Gardasil and a yr later GlaxoSmithKline marketed it as cervarix.
WHO recommends HPV vaccine as a part of routine vaccination program for all countries. It is on the list of essential medicines of WHO. Currently 125 countries are adopting it for girls aged 9 to 14( before becoming sexually active). And 47 countries are promoting its use in boys too.
☘️: Latest guidelines issued by WHO in December 2022 recommend..
1)one or two dose schedule for girls aged 9 to 14
2)similar schedule for girls between 15 to 21 yrs
3)two dose six months apart schedule for women older than 21 yrs
☘️: First generation Gardasil offered protection against HPV type 6,11,16 and 18.
In 2014 US FDA brought in Gardasil 9 which offers protection against 5 more types of HPV (total 9 types hence the name Gardasil 9)
☘️: Will the vaccine offer 100% protection against carcinoma of cervix, the answer is No. But it does offer 70% protection. Hence pap smear for cervical cancer detection is to be continued even for vaccinated women.
☘️: Public awareness about HPV vaccine in India is quite low. Lack of knowledge, not being a part of free universal immunization program, imported and hence costly are the main deterents.
The last problem is now solved. The news that was either not watched or not understood its significance.
But it surely is one more item where India has become आत्मनिर्भर!!!
*Dr Pradnya Rotithor*✍️
World Cancer Day
4 Feb 2023
