“More than 80% of people are exposed to HPV”, Dr. Romanguera

The human papillomavirus vaccine can act by covering up to nine serotypes, says a specialist.

Doctor Josefina Romaguera, professor at the School of Medicine of the Medical Sciences campus and researcher of the human papilloma virus. Photo: Archive of the Journal of Medicine and Public Health.

“There are 18 diseases that can be prevented through vaccination, one of them being cancer associated with Human papilloma virus”, highlights Lilly Rodríguez, founder of VOCES, a coalition for immunization and health promotion in Puerto Rico, immunization week around the world.

In this regard, the Doctor Josefina Romaguera, Professor of the School of Medicine of the Medical Sciences Campus and researcher of human papilloma virusclarifies that this virus is associated with benign and malignant conditions, the most common being cancer of the cervix, as well as cancer of the vagina, vulva, penis, anus and oropharynx.

“It not only causes cancer, but also premalignant conditions,” points out Romaguera, noting that “the human papillomavirus vaccine remains the most important tool for preventing all these cancers that are associated with the virus.”

Discovery of the virus and evolution of the vaccine

The discovery of human papilloma virus it is recent. By 1980, it was thought that the cause of cervical cancer was other agents, but, after the discoveries, it was possible to directly associate the human papilloma virus with different cancers, starting with cervical cancer; In the year 2000, the first vaccine studies began in Puerto Rico and worldwide, of the vaccine that is currently available. It began with the bivalent, the quadrivalent and the nonavalent, the latter meaning that “it covers nine serotypes”, recalls specialist Romaguera.

The large clinical studies, worldwide, began around the year 2000 and by 2006 there was an approved vaccine that, little by little, was modified and recently there is what is known as the nonavalent vaccine, which is much broader . This vaccine has a lot of scientific evidence that it is safe and has a significant impact on all these conditions associated with human papilloma virus.

Romaguera also indicates that the first concept is that of primary prevention, which means that the vaccine must be used to prevent that first contact with the virus; that is, they should try to vaccinate the population so that when they are exposed they do not get the virus or have the conditions associated with it.

“Initial studies focused on using the vaccine as primary prevention and it is recommended between the ages of 11 and 12 years; the vaccine for prevention was approved between the ages of 9 and 26 in its origins, with the aim that patients be vaccinated before being exposed to the virus and they realized that if we administer it at younger ages, before 15 years, only two vaccines are needed, but it is very important that, between the first and the second vaccine, there must be at least six months, when using that scheme of only two vaccines”, points out Romaguera.

If the person is over 15 years old, three vaccines are recommended. The first vaccine, the second -two months after the first- and the third, six months after the first.

“Injecting the vaccine at an early age has two purposes: primary prevention and that the earlier, the better the immune reaction, that is why less vaccine is needed; therefore, boys and girls are given a more robust response that lasts longer”, adds Romaguera.

The specialist clarifies that: “Recently, we have had two new things: first, it was approved for the prevention of oropharyngeal cancer and, second, the age was extended to 45 years.” Well, these patients who have had high-grade premalignant conditions, which is known as severe dysplasia, if they get the vaccine, the probability of recurrence, both at the level of the cervix, vulva and vagina, decreases by more than 50%, so that this tool is also available for patients who have been exposed to the virus, who have had a premalignant condition and who can be protected in some way with this vaccine against future episodes of premalignant conditions, indicates the expert.

Romaguera points out that “it is estimated that, throughout life, more than 80% of us will be exposed to this virus”, since it is almost always considered to be something rare, but it is a very common virus and , worldwide, is the most frequent virus that we have, so the vaccine is very important because it also prevents cancer.

Secondary prevention is when the virus has already been had and proper follow-up must be done to prevent that virus from reaching cancer. Once the vaccination has begun, it is not necessary to repeat the dose, emphasizes the specialist.

Finally, the expert urges that the administration of the vaccine not be postponed and that those who have started complete the vaccination cycle. The vaccine is available, accessible and covered by health insurance, so the priority should be to vaccinate children early because the immune response will be better.

The call is to find the tools that are available to prevent a cancer that in Australia, for example, is estimated not to exist by 2030, so that goal can also be reached on the Island.

See the full program: