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History of Vaccines Blog
The prestigious Lasker-DeBakey Clinical Medical Research Award for 2017 goes to two scientists who did groundbreaking work conceptualizing and developing a vaccine for human papillomavirus, the pathogen responsible for almost all cases of cervical cancer and for many other cancers as well. Prize recipients Douglas R. Lowy, MD, and John T. Schiller, PhD, of the National Cancer Institute (U.S. National Institutes of Health) devised a unique solution to a vaccine for an oncogenic (cancer-causing) virus.
Human papillomavirus vaccination series completion will now require only two doses of vaccine for adolescents younger than 15 years. The Advisory Committee on Immunization Practices approved this recommendation at their biannual meeting in Atlanta yesterday. The new schedule for <15 year olds calls for the second dose to be given between 6 and 12 months after the first dose. Adolescents receiving the first dose of HPV vaccine at age 15 or older will continue to be recommended three doses of vaccine, given at 0, 1-2, and 6 months.
In late 2014, the US Food and Drug Administration approved a 9-valent human papillomavirus vaccine. In early 2015, the Advisory Committee on Immunization Practices made the recommendation that it be offered as one of the available HPV vaccines this country. The vaccine, made by Merck, is known commercially as Gardasil 9 and generically as Human Papillomavirus 9-valent Vaccine, Recombinant (9vHPV). This change in the vaccine will make HPV vaccination more broadly effective; 9vHPV protects against HPV strains that cause 90% of cervical cancers – as compared with the quadrivalent vaccine, whose two oncogenic strains account for approximately 68% of cervical cancers in the United States. Moreover, the new vaccine may provide protection to subgroups of women who are more vulnerable to HPV types not in the bivalent and quadrivalent vaccines.
October 20, 2014
A few weeks ago, I attended a talk by the CDC's Anne Schuchat, MD, on US HPV vaccination that she subtitled “How Not to Introduce a Vaccine.” In spite of the promise of HPV vaccines to reduce the burden of cervical and other cancers in this country, uptake of the complete three-dose series has lagged far behind the other vaccines on the adolescent immunization platform. On Friday, I heard a more optimistic talk about HPV vaccination in African countries by Helen Rees, MD, MA, Executive Director, Wits Reproductive Health and HIV Initiative, University of Witswatersrand. Dr. Rees is a member of the WHO immunization policy committee and has a background in pediatrics, HIV care, and obstetrics and gynecology. She spoke as a guest of the Johns Hopkins Vaccine Initiative as part of their annual Vaccine Day events. Globally, 90% of HPV-related cancers are cervical cancers, and sub-Saharan Africa is, as Rees said, the epicenter for cervical cancer. The high prevalence of HIV infection, which is a risk factor for oncogenic HPV infection, and the lack of access to HPV screening contribute to the high HPV disease burden. And apart from HPV-related cancers, Rees also noted that genital warts are not a trivial condition in an HIV-prevalent setting: they can be debilitating in those with compromised immune systems. The quadrivalent HPV vaccine offers protection from the two most common types of oncogenic HPVs and two types that cause genital warts; the bivalent vaccine covers only the two most common types of oncogenic HPVs.
January 7, 2014
January is National Cervical Health Awarenss Month. My friend Izumi Kajimoto writes today's post. I am writing this on my mother’s 77th birthday – a mark she missed by thirty years. “Preventable cancer” is something you don’t want to hear to describe what killed your mother young. I didn’t waste time bitter that tests were available, but under-publicized, to have caught it in time for her. But I figured I owed it to knowledge and sense to get my first colonoscopy at age 25 (an uncle died of it too: I have it on both sides) and every five years since. Nothing is more exhilarating than having a hose crawling up your butt for an hour – then being told you don’t have cancer. I am one of the few lucky ones who had to quit smoking only once, and it was easy. Keeping the weight down, running a lot, I thought I was doing my bit to prove the preventability of something that wiped out a chunk of my family.
The human papillomavirus (HPV) vaccine has been recommended as part of the routine vaccination schedule for girls aged 11-12 since 2006 for the prevention of cervical cancer. In 2009, the FDA licensed the vaccine for use in males aged 9-26 years for the prevention of genital warts caused by two types of HPV, but the vaccine was not yet recommended for boys as part of the routine immunization schedule.
Meeting today at the Centers for Disease Control and Prevention in Atlanta, the Advisory Committee on Immunization Practices voted to recommend routine immunization against HPV for boys at age 11-12. ACIP members, experts selected by the Secretary of the United States Department of Health and Human Services, develop the recommendations that are used in the U.S. Recommended Childhood, Adolescent and Adult Immunization Schedules.
October 4, 2011
A study published in the October 3, 2011, issue of the Journal of Clinical Oncology reveals a startling rise in the rate of head and neck cancers related to human papillomavirus (HPV). The study looked at specimens from 271 throat cancers (specifically oropharyngeal squamous cell carcinomas, or OPSCC) collected over 20 years. The researchers found that HPV prevalence in the cancers increased from 16.3% during 1984 to 1989 to 71.7% during 2000 to 2004. They note that “The overall rise in OPSCC incidence during 1984 to 2004 is largely explained by the increasing incidence of HPV-positive cancers, whereas incidence of HPV-negative cancers declined.” The decline in non-HPV related oropharyngeal cancers, which are usually related to tobacco or alcohol use, is likely a result of lower tobacco exposure. The HPV-related cancers, as opposed to the non-HPV-related cancers, were more likely to occur in younger, male, and white individuals. The authors speculate that the increased incidence “perhaps arises from increased oral sex and oral HPV exposure over calendar time.”
August 25, 2011
Human papillomavirus (HPV) is primarily known for its role in causing cervical cancer. Two strains of the virus – strains 16 and 18 – are estimated to be responsible for 70% of cervical cancer cases, leading to about 500,000 new cases and 270,000 deaths worldwide each year.
Both of the HPV vaccines available in the United States have been shown to be effective in preventing cervical infection with strains 16 and 18. The Gardasil quadrivalent vaccine also offers protection against two strains that cause genital warts. But HPV’s role in cancer is not limited to cervical cancer; the virus can also cause oral, anal, and penile cancer.
December 1, 2010
There are two vaccines, Gardasil (made by Merck) and Cervarix (made by GlaxoSmithKline), approved to prevent cervical cancer caused by HPV (human papillomavirus). Both vaccines protect against HPV strains 16 and 18, which are estimated to account for 70% of cervical and vaginal cancer cases. Gardasil (human papillomavirus [HPV] vaccine, quadrivalent) also offers protection against two strains that cause genital warts.
Gardasil was the first of the two vaccines to be introduced in the United States. In 2006, it was approved for use in preventing cervical cancer and genital warts for girls and women between nine and 26 years of age. Since then, based on additional data, it has also been approved for the prevention of vulvar and vaginal cancer, and for the prevention of genital warts in boys and men between nine and 26 years of age. Now, new data have led a Food and Drug Administration advisory panel to recommend expanding the vaccine's use to include the prevention of anal cancer, a disease whose incidence doubled in the United States between 1975 and 2007.