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Pediatrics:美国使用HPV疫苗前后HPV的患病率变化,仍需大力推广

2016-04-18 MedSci MedSci原创

在美国,HPV疫苗从2006年起广泛推荐女性使用,男性从2011年起。疫苗流通数据显示大多数患者接受了4价HVP(4vHPV) 疫苗。流行病学数据表明了疫苗的使用情况不是很理想,只有稍微超过50%的女性接受了一次注射,少于40%的女性完成了3次注射。

在美国,HPV疫苗从2006年起广泛推荐女性使用,男性从2011年起。疫苗流通数据显示大多数患者接受了4价HVP(4vHPV) 疫苗。流行病学数据表明了疫苗的使用情况不是很理想,只有稍微超过50%的女性接受了一次注射,少于40%的女性完成了3次注射。

这项研究寻求提供一个基于人群的HPV疾病的患病率评估,鉴于我们大力推行普及疫苗而言是个重要的结果。数据来源疾病控制和预防中心的国家健康和营养调查,提供了代表国家的评估,比较了使用疫苗前的2003-2006年和2009-2012年HPV疾病的患病率。使用4vHPV疾病的患病率和疫苗接种史评估疫苗的有效性。

在两个时间段的研究里,分别有超过2000名女性调查人员提供了自我收集的宫颈阴道HPV DNA检测和其它分析报告。在使用疫苗之前,14-19岁中52.4%的女性和20-24岁中32.6%的女性接受了至少1次HPV疫苗注射。

HPV DNA检测结果表明在使用疫苗之前,14-19岁女性4vHPV感染患病率为11.5%。疫苗使用之后,4vHPV感染患病率为4.3%。20-24岁女性患病率下降结果相似,从18.5% 到 12.1%。在较高年龄组,无明显统计学变化,但这部分女性很多没有接种疫苗。当不包括4vHPV毒株时,使用疫苗前后患病率没有明显下降,包括现在9价的疫苗。

评估疫苗的有效性,研究人员关注了性活跃的,结合年龄在14-24岁的女性。整体而言,4vHPV 毒株患病率在接种疫苗的女性中明显要低,为2.1%vs16.9%(未接种女性),估计在性活跃的女性中疫苗有效性89%。疫苗对其它HPV毒株的有效性在性活跃的女性中没有差距。

研究人员总结道,14-19岁女性接种疫苗后,4vHPV 毒株下降了64%,20-24组下降了34%。值得注意且意料之中的是,这两组是接种4vHPV 疫苗最多的年龄组。

专家观点:


描述疫苗基于人群的有效性是非常重要的。尽管对像这个试验中自我收集的样本有担忧,但具有国家代表性的自然数据和大量的年轻人是这个研究的优势。

如果增加疫苗覆盖率和减少疫苗特异性毒株能产生群众效应的话是非常好的,但研究人员提到,美国的疫苗接种和覆盖率比那些已产生群众效应的国家要低。这预示着,如果我们能提高疫苗接种率,在美国可能就能经历接种HPV疫苗产生群众效应的好处。

原始出处:

HPV Prevalence: Before and After the HPV Vaccine Era medscape,April 14, 2016

Markowitz LE; Liu G; Hariri S; Steinau M; Dunne EF; Unger ER,Prevalence of HPV After Introduction of the Vaccination Program in the United States.Pediatrics. 2016;137:1-9


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authenticateStatus=null, createdAvatar=, createdBy=240a1683959, createdName=李继凯, createdTime=Tue Apr 19 19:07:00 CST 2016, time=2016-04-19, status=1, ipAttribution=)]
    2016-07-17 hbwxf
  2. 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authenticateStatus=null, createdAvatar=, createdBy=240a1683959, createdName=李继凯, createdTime=Tue Apr 19 19:07:00 CST 2016, time=2016-04-19, status=1, ipAttribution=)]
    2017-02-21 feather89
  3. 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    2016-10-03 1e10c84am36(暂无匿称)

    深度好文,值得关注

    0

  4. 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topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Thu Feb 02 02:48:00 CST 2017, time=2017-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=82977, encodeId=2f1a829e75c, content=挺不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=171, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160421/IMG5718DA7F3A12A6443.jpg, createdBy=3d9f1716031, createdName=1deb5047m95(暂无匿称), createdTime=Wed Apr 27 00:49:00 CST 2016, time=2016-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79896, encodeId=bf1be9896d7, content=依照预防的成果与疫苗不良反应发生率相比较,好象打疫苗比较危险。大家可以自己算算看, beContent=null, objectType=article, channel=null, level=null, likeNumber=165, replyNumber=0, topicName=null, 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  5. 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topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Thu Feb 02 02:48:00 CST 2017, time=2017-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=82977, encodeId=2f1a829e75c, content=挺不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=171, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160421/IMG5718DA7F3A12A6443.jpg, createdBy=3d9f1716031, createdName=1deb5047m95(暂无匿称), createdTime=Wed Apr 27 00:49:00 CST 2016, time=2016-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79896, encodeId=bf1be9896d7, content=依照预防的成果与疫苗不良反应发生率相比较,好象打疫苗比较危险。大家可以自己算算看, beContent=null, objectType=article, channel=null, level=null, likeNumber=165, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=75901667839, createdName=1de03db9m76(暂无匿称), createdTime=Thu Apr 21 10:31:00 CST 2016, time=2016-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1250430, encodeId=621512504301a, content=<a href='/topic/show?id=7d6f52988e1' target=_blank style='color:#2F92EE;'>#患病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52988, encryptionId=7d6f52988e1, topicName=患病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f49517, createdName=xinmeili, createdTime=Wed Apr 20 12:48:00 CST 2016, time=2016-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1587320, encodeId=5f48158e32099, content=<a href='/topic/show?id=7e9a56e67a0' target=_blank style='color:#2F92EE;'>#推广#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56767, encryptionId=7e9a56e67a0, topicName=推广)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=dff417466583, createdName=zhangxingru, createdTime=Wed Apr 20 12:48:00 CST 2016, time=2016-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79690, encodeId=16b1e9690d0, content=文章不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=183, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=240a1683959, createdName=李继凯, createdTime=Tue Apr 19 19:07:00 CST 2016, time=2016-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79691, encodeId=b4a6e96914e, content=持续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=155, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=240a1683959, createdName=李继凯, createdTime=Tue Apr 19 19:07:00 CST 2016, time=2016-04-19, status=1, ipAttribution=)]
    2016-04-27 1deb5047m95(暂无匿称)

    挺不错

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1958466, encodeId=405d19584665b, content=<a href='/topic/show?id=766713993a1' target=_blank style='color:#2F92EE;'>#Pediatric#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13993, encryptionId=766713993a1, topicName=Pediatric)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Sun Jul 17 23:48:00 CST 2016, time=2016-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1726080, encodeId=9ac11e260809f, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Tue Feb 21 17:48:00 CST 2017, time=2017-02-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=139410, encodeId=acaa13941085, content=深度好文,值得关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Mon Oct 03 09:39:06 CST 2016, time=2016-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1637316, encodeId=61a0163e3161c, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Thu Feb 02 02:48:00 CST 2017, time=2017-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=82977, encodeId=2f1a829e75c, content=挺不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=171, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160421/IMG5718DA7F3A12A6443.jpg, createdBy=3d9f1716031, createdName=1deb5047m95(暂无匿称), createdTime=Wed Apr 27 00:49:00 CST 2016, time=2016-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79896, encodeId=bf1be9896d7, content=依照预防的成果与疫苗不良反应发生率相比较,好象打疫苗比较危险。大家可以自己算算看, beContent=null, objectType=article, channel=null, level=null, likeNumber=165, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=75901667839, createdName=1de03db9m76(暂无匿称), createdTime=Thu Apr 21 10:31:00 CST 2016, time=2016-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1250430, encodeId=621512504301a, content=<a href='/topic/show?id=7d6f52988e1' target=_blank style='color:#2F92EE;'>#患病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52988, encryptionId=7d6f52988e1, topicName=患病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f49517, createdName=xinmeili, createdTime=Wed Apr 20 12:48:00 CST 2016, time=2016-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1587320, encodeId=5f48158e32099, content=<a href='/topic/show?id=7e9a56e67a0' target=_blank style='color:#2F92EE;'>#推广#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56767, encryptionId=7e9a56e67a0, topicName=推广)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=dff417466583, createdName=zhangxingru, createdTime=Wed Apr 20 12:48:00 CST 2016, time=2016-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79690, encodeId=16b1e9690d0, content=文章不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=183, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=240a1683959, createdName=李继凯, createdTime=Tue Apr 19 19:07:00 CST 2016, time=2016-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79691, encodeId=b4a6e96914e, content=持续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=155, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=240a1683959, createdName=李继凯, createdTime=Tue Apr 19 19:07:00 CST 2016, time=2016-04-19, status=1, ipAttribution=)]
    2016-04-21 1de03db9m76(暂无匿称)

    依照预防的成果与疫苗不良反应发生率相比较,好象打疫苗比较危险。大家可以自己算算看

    0

  7. 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topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Thu Feb 02 02:48:00 CST 2017, time=2017-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=82977, encodeId=2f1a829e75c, content=挺不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=171, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160421/IMG5718DA7F3A12A6443.jpg, createdBy=3d9f1716031, createdName=1deb5047m95(暂无匿称), createdTime=Wed Apr 27 00:49:00 CST 2016, time=2016-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79896, encodeId=bf1be9896d7, content=依照预防的成果与疫苗不良反应发生率相比较,好象打疫苗比较危险。大家可以自己算算看, beContent=null, objectType=article, channel=null, level=null, likeNumber=165, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=75901667839, createdName=1de03db9m76(暂无匿称), createdTime=Thu Apr 21 10:31:00 CST 2016, time=2016-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1250430, encodeId=621512504301a, content=<a href='/topic/show?id=7d6f52988e1' target=_blank style='color:#2F92EE;'>#患病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52988, encryptionId=7d6f52988e1, topicName=患病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f49517, createdName=xinmeili, createdTime=Wed Apr 20 12:48:00 CST 2016, time=2016-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1587320, encodeId=5f48158e32099, content=<a href='/topic/show?id=7e9a56e67a0' target=_blank style='color:#2F92EE;'>#推广#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56767, encryptionId=7e9a56e67a0, topicName=推广)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=dff417466583, createdName=zhangxingru, createdTime=Wed Apr 20 12:48:00 CST 2016, time=2016-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79690, encodeId=16b1e9690d0, content=文章不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=183, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=240a1683959, createdName=李继凯, createdTime=Tue Apr 19 19:07:00 CST 2016, time=2016-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79691, encodeId=b4a6e96914e, content=持续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=155, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, 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  8. 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  9. 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topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Thu Feb 02 02:48:00 CST 2017, time=2017-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=82977, encodeId=2f1a829e75c, content=挺不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=171, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160421/IMG5718DA7F3A12A6443.jpg, createdBy=3d9f1716031, createdName=1deb5047m95(暂无匿称), createdTime=Wed Apr 27 00:49:00 CST 2016, time=2016-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79896, encodeId=bf1be9896d7, content=依照预防的成果与疫苗不良反应发生率相比较,好象打疫苗比较危险。大家可以自己算算看, beContent=null, objectType=article, channel=null, level=null, likeNumber=165, replyNumber=0, topicName=null, 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    2016-04-19 李继凯

    文章不错

    0

  10. 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    2016-04-19 李继凯

    持续关注

    0

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