Human Papillomavirus and Mandatory Immunization Laws: What Can We Learn From Early Mandates?
Human Papillomavirus and Mandatory Immunization Laws: What Can We Learn From Early Mandates?
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DOI：
10.1177/0033354916663184
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发表时间：
2016-09-01
影响因子：
3.3
通讯作者：
Yang, Y. Tony
中科院分区：
文献类型：
--
作者：
Barraza, Leila;Weidenaar, Kim;Yang, Y. Tony
人乳头瘤病毒（HPV）是一种性传播病毒，每年感染约1400万美国人。1目前已鉴定出150多种HPV亚型。有些类型是致癌的，每年在美国男性和女性中引起估计27，000例癌症;非致癌亚型可引起肛门生殖器疣。第一种HPV疫苗是四价（HPV 4）疫苗，于2006年获得许可，可预防引起70%宫颈癌和90%生殖器疣的4种HPV亚型（6，11，16和18）。疫苗在0、2和6个月时以一系列3次注射的形式施用。第二种HPV疫苗于2009年获得许可，可预防16和18亚型，并预防宫颈癌，但不预防生殖器疣。2四价疫苗HPV 4现在被HPV 9取代，HPV 9是一种保护9种HPV亚型（6，11，16，18和5种其他亚型）的疫苗，这些亚型导致85%的宫颈癌。疾病控制和预防中心的免疫实践咨询委员会（ACIP）在2007年建议所有女性在11-12岁时接种HPV疫苗，以便在可能发生暴露于病毒之前获得保护。目前的建议包括所有青少年，也建议26岁以下未接种疫苗的女性，21岁以下异性恋男性和26岁以下与男性发生性关系的男性接种疫苗。2如果在暴露前接种，HPV疫苗在预防感染方面非常有效。2016年的一项研究发现，在疫苗上市后，HPV感染率从2003-2006年的11.5%下降到2009-2012年的4.3%。4证据支持疫苗的安全性;与疫苗相关的唯一严重不良反应是晕厥和皮肤感染。尽管有强有力的证据证明疫苗的有效性和安全性，但公众对疫苗的接受和接受仍然缓慢。虽然接受其他推荐疫苗的青少年比例正在增加，但接受HPV疫苗的青少年比例似乎处于稳定状态。6 2014年，60%的13-17岁青少年接受
Human papillomavirus (HPV) is a sexually transmitted virus that infects an estimated 14 million Americans annually. 1 More than 150 subtypes of HPV have been identified. Some types are carcinogenic and cause an estimated 27,000 cancers among men and women in the United States annually; non-carcinogenic subtypes can cause anogenital warts. 2 The first HPV vaccine, a quadrivalent (HPV4) vaccine, licensed in 2006, offers protection against 4 subtypes of HPV (6, 11, 16, and 18) that cause 70% of cervical cancers and 90% of genital warts. The vaccine is administered as a series of 3 injections at 0, 2, and 6 months. A second HPV vaccine, which offers protection against subtypes 16 and 18 and protects against cervical cancer but not genital warts, was licensed in 2009. 2 The quadrivalent vaccine, HPV4, is now being replaced with HPV9, a vaccine that protects against 9 subtypes of HPV (6, 11, 16, 18, and 5 others) that cause 85% of cervical cancers. 3The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) recommended in 2007 that all females receive an HPV vaccine at 11-12 years of age so that protection is gained before exposure to the virus is likely to occur. The current recommendations include all adolescents and the vaccine is also recommended for unvaccinated women through 26 years of age, heterosexual males through 21 years of age, and men who have sex with men through 26 years of age. 2 HPV vaccines are highly effective in preventing infection if administered before exposure. A 2016 study found that HPV infection rates decreased from 11.5% in 2003-2006 to 4.3% in 2009-2012 among 14-to 19-year-old girls after the vaccine became available. 4 Evidence supports the vaccine’s safety; the only serious adverse reactions associated with the vaccine are syncope and skin infections. 2, 5, 6 Despite strong evidence of the vaccine’s effectiveness and safety, however, public acceptance and uptake of the vaccine are slow. Although the proportion of adolescents receiving other recommended vaccines is increasing, the proportion of adolescents receiving the HPV vaccine appears to be plateauing. 6 In 2014, 60% of adolescents aged 13-17 years received at