China News Service, August 31 (Zhang Ni, reporter from China News and Finance) On the 30th, the "Merck China" WeChat account announced that the new indication of its nine-valent human papillomavirus vaccine (nine-valent HPV vaccine) has been approved by China. Approved by the State Drug Administration, this approval marks the expansion of the Merck 9-valent HPV vaccine in China to women aged 9-45 years old.

　　As soon as the news came out, it attracted a lot of attention from the outside world.

Merck's vaccine was approved for marketing in China in 2018, but at that time it was suitable for women aged 16-26 years old, and "overage cannot be vaccinated" has always been a pain point for many women.

　　Then the age range of this vaccination has been broadened. Can people who have been vaccinated with bivalent or quadrivalent vaccine before get 9-valent vaccine again?

What are the effects after vaccination?

Screenshot of MSD China official micro

What are the effects of the nine-valent HPV vaccine?

　　What is the role of the nine-valent HPV vaccine?

According to the information released by the Chinese Center for Disease Control and Prevention, the vaccine is suitable for preventing the following infections or diseases caused by the HPV types contained in the vaccine:

　　One is the infection caused by HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58;

　　The second is the precancerous lesions or atypical lesions caused by the above nine HPV types, including cervical intraepithelial neoplasia (CIN) grade 2/3, cervical adenocarcinoma in situ (AIS) and cervical intraepithelial neoplasia (CIN). )Level 1;

　　The third is cervical cancer caused by HPV16, 18, 31, 33, 45, 52 and 58.

What are the main differences between bivalent, quadrivalent and ninevalent vaccines and how to choose?

　　The main difference between bivalent, quadrivalent and ninevalent HPV vaccines is that they contain different HPV types. Bivalent HPV vaccine contains HPV16 and 18 virus L1 protein, and quadrivalent HPV contains 6, 11, 16 and 18 virus L1. Protein, nine-valent HPV contains 6, 11, 16, 18, 31, 33, 45, 52 and 58 virus L1 protein.

　　However, all three vaccines can target the above-mentioned high-risk HPV types and prevent HPV-related diseases.

Compared with the bivalent HPV vaccine, the quadrivalent HPV vaccine can also prevent genital warts caused by HPV6 and 11, and the nine-valent HPV vaccine increases the proportion of cervical cancer prevention from 70% to 90%.

In the data map, photo by Li Chun, a reporter from the News Agency

I have been vaccinated with bivalent and quadrivalent vaccines, can I still get nine-valent vaccines?

　　At present, the question that people are most concerned about is that if the bivalent and quadrivalent vaccines have been vaccinated before, can they continue to be vaccinated with the 9-valent vaccine in the future?

Is it necessary?

　　In this regard, China CDC has stated that there is currently no clinical data to support the interchangeability of the nine-valent HPV vaccine with other HPV vaccines.

The WHO position paper on HPV vaccines has no preference for the three vaccine recommendations.

　　From a public health perspective, bivalent, quadrivalent and ninevalent vaccines can provide comparable immunogenicity and protective efficacy in preventing cervical cancer (mainly caused by HPV16 and HPV18). Any of the vaccines are acceptable.

　　According to the instructions of the 9-valent HPV vaccine, if someone has been vaccinated with 3 doses of the quadrivalent HPV vaccine and wants to be vaccinated with the 9-valent HPV vaccine, they should be vaccinated after at least 12 months, and the doses should be 3 doses.

Can one or two doses of bivalent or quadrivalent vaccine be vaccinated instead of 9-valent vaccine?

　　CDC has previously introduced that in 2016, the Advisory Committee on the Implementation of Immunization Strategy (ACIP) in the United States recommended that if the quadrivalent or bivalent HPV vaccine is used to start the vaccination program, the remaining doses can be replaced with the nine-valent HPV vaccine to complete the entire vaccination program, but According to the World Health Organization's 2017 position paper on HPV vaccines, there is limited data on the safety, immunogenicity, or efficacy of the three HPV vaccines used interchangeably.

These vaccines vary in characteristics, components, and indications; in addition, the instructions for use of the quadrivalent and 9-valent HPV vaccines also specifically state that there is currently no clinical data to support the interchangeable use of the 9-valent HPV vaccine with other HPV vaccines.

　　Therefore, in areas where multiple vaccines can be selected, efforts should be made to achieve a unified vaccination program and use the same vaccine for each dose.

Data map: Photo by Wang Dongming, HPV virus model

Will you get the HPV-caused disease if you get the 9-valent vaccine?

　　No vaccine can provide 100% protection.

　　All HPV vaccines provide high levels of protection against types 16 and 18 (about 70%).

The HPV vaccine also provides some cross-protection against some non-vaccine-covered types.

　　The nine-valent HPV vaccine increases the proportion of cervical cancer prevention from 70% to 90%, but because it fails to cover all high-risk HPV types, the nine-valent HPV vaccine cannot prevent 100% of all HPV-caused infections or diseases. Vaccination Later cervical cancer screening should proceed as usual.

Who is not suitable for the nine-valent HPV vaccine?

　　Severe allergic reactions to any of the active ingredients or excipients in the HPV vaccine are contraindicated.

People with symptoms of hypersensitivity reactions after vaccination should not be vaccinated again.

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