现在消除子宫颈癌容易3倍吗?单剂疫苗效力具有深远意义

P. Koczkodaj, J. Dillner, M. Mańczuk
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引用次数: 0

摘要

Jak cytowaki /如何引用:Koczkodaj P, Dillner J, Mańczuk M.消除宫颈癌现在容易3倍吗?单剂疫苗效力具有深远意义。中国科学院学报(自然科学版);72: 65 - 66。越来越多的研究证明,对疫苗的低信任度已成为一种普遍现象,无论世界上哪个地区和疫苗类型如何[1-3]。在COVID-19大流行期间,公众对疫苗效力和安全性的辩论尤其激烈(现在仍然如此)。最近,关于疫苗的大量误解、神话和假新闻浮出水面,导致人们不仅对COVID-19疫苗缺乏信任。寻找应对这一公共卫生挑战的新途径应成为当前国际和国家卫生政策议程的重点之一。在这种情况下,最近的研究结果看起来非常有希望,即单剂HPV疫苗接种与两剂和三剂疫苗的效果相似[4]。这些结果可能具有深远的影响——主要是在公共卫生方面,因为它可能使区域和世界范围内更快地根除HPV,此外,那些不愿接种HPV疫苗的人更有可能只接种一剂,而不是三剂。欧盟委员会于2021年初启动的“欧洲战胜癌症计划”假设,到2030年,目标人群中的女孩疫苗接种率将达到90%的水平,同时加速男孩的疫苗接种率。然而,该文件描述了一个“完全接种”的目标人群,这意味着已经完成了三剂接种计划,考虑到社会对HPV疫苗的高度犹豫,这可能要困难得多。此外,在未来几年(至少4-5年),由于需求迅速增长,预计世界市场上的hpv疫苗将进一步短缺。此外,尽管有新的制造商计划进入市场,但要开始有效生产还需要一段时间(制造最终产品甚至需要4年)。此外,法律上的困难阻碍了HPV疫苗供应从一个国家转移到另一个国家[5]。在讨论所有这些障碍时,显著提高对HPV疫苗接种的社会信任至关重要。实施单剂疫苗接种计划似乎是实现这一目标的最简单和最有益的方法之一。此外,通过有组织的计划将疫苗接种和筛查结合起来,可以更快地根除HPV[6,7],如果筛查和疫苗接种可以在一次就诊中完成,这一策略将大大促进。世卫组织特别呼吁进一步研究创新方法,以更快地实现消除目标。四价疫苗(单剂HPV疫苗接种与三剂全方案一样有效)现在也证明了这一事实,这意味着该结果可能有助于克服广泛疫苗覆盖的最重要障碍之一-社会信任度低。
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Is the elimination of cervical cancer now 3 times easier? One-dose vaccine efficacy has far-reaching implications
Jak cytować / How to cite: Koczkodaj P, Dillner J, Mańczuk M. Is the elimination of cervical cancer now 3 times easier? One-dose vaccine efficacy has far-reaching implications. NOWOTWORY J Oncol 2022; 72: 65–66. More and more studies have proven that low trust in vaccines has become a universal phenomenon, regardless of the region of the world and type of vaccine [1–3]. Particularly intense public debate on vaccines efficacy and safety has been (and still is) visible during the COVID-19 pandemic. A plethora of misconceptions, myths and fake news on vaccines has come to the fore recently, causing a lack of trust, not only in COVID-19 vaccines. Searching for new paths to cope with this public health challenge should be one of the key points of current international and national health policy agendas. In this context, recent research results look very promising, i.e. a single dose of vaccination against HPV has a similar efficacy to two and three doses [4]. These results may have far-reaching implications – primarily in a public health context, as it may enable a much faster eradication of HPV regionally and worldwide, moreover, those reluctant to get the HPV vaccine will be more likely to take just one dose, rather than three. Europe’s Beating Cancer Plan launched by the European Commission at the beginning of 2021 assumes vaccinations of target population of girls will be at the level of 90% by 2030 as well as acceleration of vaccinations among boys. However, the document describes a “fully vaccinated” target population, implying having completed a 3-dose scheme which can be much more difficult taking into consideration high social HPV vaccine hesitancy. Moreover, in the coming years (at least 4-5 years), due to rapidly growing demand, there are predictions of further HPV-vaccine shortages on the world market. Furthermore, despite the plans of new manufacturers to enter the market, it will take some time to begin efficient production (even 4 years are needed for manufacturing the final product). Moreover, legal difficulties impede shifting HPV vaccinations supplies from one country to another [5]. Discussing all of these obstacles, it is crucial to significantly increase social trust in HPV vaccinations. Implementation of the one-dose vaccination scheme seems to be one of the easiest and most beneficial ways to achieve this goal. Additionally, faster HPV eradication can be obtained by combining vaccination and screening in organised programs [6, 7] and this strategy would be greatly facilitated if both screening and vaccination could be completed in a single visit. The WHO has specifically called for further research on innovative ways to achieve the elimination goal faster. The fact that it has also now been shown for the quadrivalent vaccine (that a single-dose HPV vaccination is as effective as a 3-doses full scheme), means the results could help to overcome one of the most important barriers to broad vaccine coverage – low social trust.
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