In the period of a new coronavirus pandemic, we must not forget about vaccinations against other diseases. There has been a lot of interest in vaccinating against human papillomavirus (HPV) recently, and questions have arisen about how this vaccine is compatible with covid-19. HPV infection is one of the most common sexually transmitted infections, affecting about 80 percent of the sexually active population at least once in a lifetime.
Dr. Janja Schweiger Nemanič, a school doctor from the Šiška Health Center in Ljubljana, reports that HPV vaccination was carried out during the school year or until the end of June, so there are no reservations regarding the covid-19 vaccination. “The girls received the first dose in October at a systematic check-up in October, and the second or last dose after six months. If they were vaccinated after age 15, they received three doses at intervals of zero, two and six months.”
Regarding tick-borne meningoencephalitis (CME) vaccination, a 14-day interval between COVID-19 and KME vaccination is recommended. The same is true for other vaccinations, according to the National Institute of Public Health (NIJZ): “It is recommended that there is an interval of 14 days between different vaccinations, but mostly from the point of view of monitoring side effects.”
Vaccination with a bivalent vaccine aims to prevent precancerous anogenital changes (cervix, external genitalia, vagina and buttocks) and cervical and buttock cancer resulting from infection with certain oncogenic HPV genotypes at the age of nine. Vaccination is given with two or three doses of vaccine, depending on the age at the start of vaccination.
HPV vaccination is most effective in girls and women before first sexual intercourse and have not yet been exposed to HPV infection. At this age, the vaccine is also more immunogenic than in the elderly. An unvaccinated girl has a significantly higher risk of developing precancerous changes or cervical cancer, and a higher risk of other HPV-related diseases, as well as complications after their treatment. Vaccination for boys against HPV has so far paid for itself in Slovenia, but that will change in the next school year.
The HPV vaccine entered our national program 12 years ago and is the first voluntary vaccination recommended and paid for by the state, explains Dr. Schweiger Nemanič, adding that it took people a long time to get this vaccine.
“Initially, very few girls’ parents opted for vaccination, but with proper parental awareness in school at parent meetings and lectures, vaccination coverage has risen sharply. Interest in vaccination against tick-borne meningoencephalitis and pneumococcus was also very low at first.”
The pandemic had the effect of reducing vaccination coverage
Late last year, Slovenia joined the global strategy set by the World Health Organization, which pledged to achieve 90% vaccination of girls under 15 against HPV in the next decade, 70% screening of women in the screening program and appropriate treatment of 90% of women with precancerous lesions. changes and cervical cancer (RMV).
Our country has already achieved the last two goals with the ZORA program. The biggest challenge in this decade will be to ensure that 90% of girls under the age of 15 are vaccinated against HPV, currently 58.5%.
This was also affected by the pandemic. “The decline in HPV vaccination has been relative. Why? When the country closed in March 2020, many school doctors were not yet able to conduct systematic examinations of schoolchildren as well as children in 6th grade. In December and January 2020, many children were ill and we could start after the reopening of the school, ie in early May and June 2020. Some classes were examined in September.The interval between the first and second dose is six months so the girls were vaccinated but not included the real statistical time frame is August 31, the end of the school year, and those girls who decided to get vaccinated against HPV received the first dose in May and June, respectively, and the second in December, ”explains the doctor.
But already this year, the percentage will be able to improve, because school doctors and pediatricians were happy that after many years of efforts and efforts to achieve that HPV vaccination is recommended in the new school year 2021/22. state for both girls and boys ..
“This is new because we have so far vaccinated boys at their own expense. Human papillomavirus infection affects both girls and boys and can cause precancerous and cancerous changes in both sexes. Boys have different immunity and transmit the virus after infection. In recent years, demand for their vaccination has increased and parents have become aware of the necessity and importance of vaccinating boys. “
The NIJZ also collects data on vaccinations, which are published on their website under Vaccination Monitoring (proportion of vaccinated). Data are collected at the end of the year / season and published retroactively.
Most HPV infections are asymptomatic because they are usually not accompanied by visible clinical signs. Low- and high-risk HPV virus genotypes are known. The latter cause 90 percent of cervical cancer (RMV) cases in women, 70 to 90 percent of vaginal and butt cancers, which also affect men, and 47 percent of penile cancers. Men do not have the systemic supervision we know of women and are poorly acquainted with the problem of HPV. Men also have weaker natural immunity to HPV, meaning they produce fewer antibodies than women. Infections most commonly occur at the beginning of the sexually active phase of life and are most common in adolescents and young adults aged 15 to 25 years. That’s why every summer doctors stress that we should be protected during intercourse.
There is no complete protection against HPV infection. Experts advise girls and boys to strictly adhere to the rules of healthy sexuality (ABC).
A: Refrain or postponing the first sexual intercourse to a period of greater maturity and with a partner they know and trust.
B: Be faithful,,
C: use a condom. Using a condom reduces the likelihood of infection, but does not prevent it completely, as contact with the skin or mucous membranes of an infected person is sufficient for it. The best protection against HPV infection is certainly timely vaccination, ie before the first sexual intercourse.
“People need time to think about a new vaccine”
Asked if she thought vaccination against any other disease could be reduced, the doctor said no. “This would be a step backwards, apart from the covid-19 epidemic, I don’t want any other epidemic. In 2019, we discovered an extensive flu in December and January, the flu epidemic was never declared, but in February 2020, SARS -CoV -2.”
This winter we were a little worried about how it would be with the flu so we were ready for that too. It is obvious that wearing masks, disinfection, physical distance and restricting public life prevented the flu.
He notes that at the beginning of the epidemic, patients were very grateful for any advice, they were patient, and now a kind of anger and dissatisfaction has settled among them. “People find it very difficult to accept these restrictions.”
Vaccination is a very sensitive area and it might be correct to distinguish between new and old vaccines, he says, explaining that “old vaccines are the ones that people know very well, some still remember the consequences of having children who have not been vaccinated.” .
Vaccines of the new age are vaccination against tick-borne meningoencephalitis (CME), HPV, pneumococcus and in the last year vaccination against COVID-19 disease. “I myself notice that people need time to think about a new vaccine to internalize information. It is very important that they get professionally clear information that is told to them repeatedly and in an understandable way. The decision is ultimately on their side. Also responsibility for consequences of non-vaccination. “
Recently, fake news has done great damage. People who are first questioned by this news later develop fear and then anger.
Most of the suspicions are caused by the disunity of the professional public, he notes, “so people start to doubt, so unrest and fear are introduced among the people.” He emphasizes that “positions are very important for people to talk to their personal doctor and clarify ambiguities and dilemmas.”
We have to ask ourselves if we want a normal life in the fall
Dr. During the new coronavirus pandemic, Schweiger Nemanič emphasizes that we must protect risk groups of all ages and clarify and ask ourselves: “Do we want a normal life in the fall, without closing schools and kindergartens, without stopping public life so we can visit our parents.” our side. We’ll have to decide for ourselves. “
Personally, I think we got off the reins too quickly and didn’t pay attention to the mask, disinfection, and physical distance. I was abroad in early June. The severe limitations I experienced and saw were never with us, even in the worst pandemic. Do we want life back on track, old, renewed?
“If we want to, we will have to accept and adhere to the restrictions and we have to consider what works in order to get back to a roughly normal life as soon as possible,” he points out. “Are we happy that someone next to us has a cold and coughs? How many times have we put on a mask? Rarely. Don’t parents hesitate when they bring a healthy child to school, and there are many children who cough or have a cough? Infected?”
When we get sick, it’s okay to stay home, say hello, and get back to a healthy work environment. Maybe we were a little careless with some hygiene measures in general.
Finally, he emphasizes that health must become a value that we ourselves are obliged to take care of and protect if we can. “Enough exercise, a healthy diet and basic hygiene measures, disinfection, distance and mask, and vaccinations.”
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