SUS: less than 4 out of 10 boys receive the HPV vaccine despite it being free

Known for its close relationship with cervical cancer, human papillomavirus infection is also the cause of the emergence of other malignant tumors. O Center for Disease Control (CDC) recalls that 63% of cases of penile cancer are attributable to HPV. The association of the virus with the development of cancer of the vagina (75%), vulva (69%), anus (91%) and oropharynx (70%) is also high. Also according to the CDC, of ​​the cancers caused by HPV, 92% are attributable to the types of HPV that are included in the list. HPV vaccine and could be avoided if there is adequate vaccination coverage.

Data from the Brazilian Society of Vaccinations (SBIm), meanwhile, indicates that from 2013 to 2020, the minimum level of 80% was only reached at the first dose for girls aged 9 to 14, achieving 83.4% coverage. The second dose in girls was 55.6%, while in boys aged 11-14 years the rates were 57.9% for the first dose and 36.4% for the second dose.

“For the fight against cancer, it is very negative not to have ideal vaccination coverage against the HPV virus. For the action to be effective, we must also immunize the boys, because only then can we avoid the entire chain of transmission”, underlines the clinical oncologist Andréa Gadêlha Guimarães, of the Institute of Urology , Oncology and Robotic Surgery (IUCR ).

The quadrivalent vaccine (which protects against HPV types 6, 11, 16 and 18) is distributed free of charge by the SUS and is indicated for girls aged 9 to 14 and boys aged 11 to 14, people living with HIV and transplant recipients in the age group of 9 to 26 years. According to the SBIm, the probability of HPV infection at some point in life is 91.3% for men and 84.6% for women, with more than 80% of people of both sexes contracting the virus before the age of 45.

11 MYTHS AND TRUTHS ABOUT HPV AND CANCER

Alluding to March 4, World HPV Awareness Day, clinical oncologist Andréa Gadêlha Guimarães answers key questions about cancer and HPV infection.

HPV is a sexually transmitted infection
Truth. HPV is a Sexually Transmitted Infection (STI) which in 90% of cases is contracted through sexual, genital or oral contact. HPV is so widespread that it affects nearly 80% of sexually active people.

HPV is a unique virus
Myth. There are over 150 different types of HPV, 40 of which can infect the genital area and cause certain types of cancer (cervix, vulva, vagina, penis, anus and oropharynx) and others can cause genital warts. There are 12 types identified as high risk (HPV types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, and 59) that are more likely to persist and be associated with lesions precancerous. Types 16 and 18 are responsible for most cases of cervical cancer.

HPV is silent, has no symptoms
Truth. HPV infection has no symptoms in most people. The first manifestations appear between 2 and 8 months after contact, but it can take up to 20 years before a sign of infection appears. In most cases, the infection resolves spontaneously by the body itself within 24 months.

Using condoms during sex protects you from HPV
Myth. Despite the importance of using condoms during sex to prevent STIs, their use may not prevent HPV infection, as the virus may be present in areas not protected by condoms (vulva, pubic region , perineum or scrotum).

HPV only affects women
Myth. HPV can also infect men and in addition to being an agent of transmission of the virus for women. HPV in men is a risk factor for developing cancer of the penis, anus, mouth and throat. Therefore, boys should also receive the HPV vaccine.

HPV is the leading cause of cervical cancer
Truth. Human papillomavirus (HPV) infection is the main risk factor for the development of cervical cancer. There are over 150 different types of HPV, 40 of which can infect the genital area and cause certain types of cancer (cervix, vulva, vagina, penis, anus and oropharynx) and others can cause genital warts. There are 12 types identified as high risk (HPV types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, and 59) that are more likely to persist and be associated with lesions precancerous. Types 16 and 18 are responsible for most cases of cervical cancer.

There is a vaccine that can prevent HPV
Truth. The HPV vaccine exists and is the main way to prevent cervical cancer. The vaccine is available free of charge at health posts or can also be taken at private clinics. The vaccine offered by the Brazilian Ministry of Health is the quadrivalent vaccine which protects against viruses 6, 11, 16 and 18, cervical cancer and genital warts. After taking the vaccine, the body produces the necessary antibodies to fight the viruses covered by the vaccine and if the person is infected with these viruses, they do not develop the disease.

The vaccine is indicated for girls 9 to 14 years old and boys 11 to 14 years old. For this group, 02 doses of the vaccine are recommended, with intervals of six months between them.

In addition to this group, it is also recommended for a special group: HIV-positive men aged 9-26 and women aged 9-45; transplanted from solid organs, bone marrow or cancer patients. In this case, three doses are recommended, with the second dose given 2 months after the first dose and the third dose given six months after the first dose. The vaccine is not a treatment, it is a form of prevention and its effectiveness is lower in people who have already started their sex life, because they may have already been in contact with the virus.

The vaccine protects against all types of HPV
Myth. The vaccine offered by the Brazilian Ministry of Health is the quadrivalent vaccine which protects against viruses 6, 11, 16 and 18, cervical cancer and genital warts.

All women with HPV will get cancer
Myth. Most of the time this will not be the case. In most cases, the immune system clears the virus, however, some types of HPV can lead to the formation of genital warts and/or pretumoral changes in the cervix. If these abnormal cells are left untreated, they can lead to cancer, which can take years to develop. Early detection and treatment are therefore very important.

My partner/partner said he has HPV, I have the virus too
Myth. It’s not a rule, but HPV infection usually affects the couple. If there are signs of HPV, it is important for the couple to see a doctor. There is no approved test to screen for HPV in men, but women should have regular Pap tests and, in some cases, cervical HPV tests.

Is the HPV vaccine safe for my son and daughter
Truth. All scientific evidence shows that the vaccine is extremely safe. The World Health Organization (WHO) and virtually every country in the world recommends vaccination. Most reactions are temporary and limited to the injection site.

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