HPV, Cancer and the Vaccination Programme

Transcription

1 HPV, Cancer and the Vaccination Programme Dr Brenda Corcoran Consultant in Public Health Medicine HSE National Immunisation Office

2 What is HPV? Human papillomavirus Over 200 types identified Spread by direct contact (usually sexual) Most asymptomatic Affects males and females

3 How common is HPV infection? The most common sexually transmitted disease worldwide About 80% women are infected usually in their late teens and early 20s In the US 79 million infected with HPV 14 million new cases every year

4 What does HPV infection cause? Some HPV types cause common warts (veruccae) High risk HPV types cause cervical cancer other genital cancers anal cancer head and neck cancer Most infections clear naturally Some progress to pre cancer Some progress to cervical cancer

5 Worldwide 500,000 new cases 270,000 deaths Ireland Cervical cancer one of the highest rates in Western Europe every year 90 women die 280 women get cancer surgery/ chemotherapy/ radiotherapy infertility 4 in 10 die 6,500 need treatment for precancer

6 HPV vaccine Recommended by World Health Organization Ireland National Immunisation Advisory Committee (independent expert committee) Recommendation in 2008 All girls age years Vaccine most effective at this age

7 HPV vaccination programme Commenced in 2010 Gardasil HPV vaccine used 2-3 doses required over 6-12 months Protects against 7 out of 10 cervical cancers and pre cancers School based programme year old girls (1st year of second level school)

8 HPV vaccination age in girls in Western Europe Iceland 12 yo girls Finland 11/12 yo girls Norway 12 yo girls Sweden yo girls Denmark 12 yo girls The Netherlands 12 yo girls Update: November 2015 United Kingdom yo girls Ireland yo girls Belgium Flemish community: 12 yo girls French community : 13 yo girls Austria 9 yo girls and boys Spain yo girls Germany girls 9-17 yo Switzerland yo girls Portugal 10 yo girls Greece yo girls France Italy yo girls 12 yo girls and boys in some areas

9 HPV vaccine uptake 2010/ /15 Uptake Target target 80% 80% Highest uptake achieved in 2014/15 Excellent cohort retention 97% girls who started dose 1 completed the course

10 Timeline of Influential Events Japan suspends vaccine recommendation Danish TV documentary Minister questioned in parliament American College of Pediatrics Joint Committee on Health & Children Irish TV documentary 2013 June Mar May Jun Jul Nov Dec 2016 Jan Jun Sept Anti-vaccine leaflet R.E.G.R.E.T EMA review Go fund me video High Court Action Anti Vaccine Group actions Anti-vaccine media coverage

11 HPV vaccine uptake 2010/ /2017 Target 80% ~15,000 girls not vaccinated in 2016/17 Estimated uptake 1 st dose only

12 Concerns Is HPV vaccine safe? Does HPV vaccine causes serious side effects? What about cervical screening? Does HPV vaccine work?

13 What about cervical screening? Cervical screening detects pre cancers or cancer of the cervix disease already present requires treatment HPV vaccine prevents 7 out of 10 pre cancers and cancers developing Cervical screening still required after vaccination

14 Does HPV vaccine work? Pre cancers reduced by up to 75% in countries with high vaccine uptake rates (e.g. Australia and Scotland) The number of new cases of cervical cancer has halved in Australia

15 Actions Social Video National Media Local Pharmacists Social Workers Nurses Schools Parents GPs Information Politicians Steering group National Immunisation Office Irish Cancer Society HSE Communications CervicalCheck World Health Organization Interested bodies Meetings Public National Parents Council Dept. of Education

16 Information for parents Actions Offer vaccine again in March/April Information to parents in April/May Short information videos Revised parents leaflet (with quotes)] Offer vaccine to unvaccinated girls

17 Impact Uptake stabilising No decline in HPV2 ~1-5% increase in HPV1?

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