Human Papillomavirus Vaccination in Children

Introduction

Human Papillomavirus (HPV) is one of the most common virus infections of the reproductive tract. There are over forty different types of the virus that may affect the genital area of both males and females. Some types of HPV are harmless while others (i.e. types 16, 18, 6, and 11) may provoke the development of multiple oncologic diseases such as cervical cancer, pathological and precancerous changes of the cervix, the external genitalia cancers, and genital warts (Harper & Paavonen, 2008). Nowadays, several licensed HPV vaccines are elaborated for the predilection of HPV infections – Gardasil, Cervarix, etc. HPV vaccines contain the basic L1 capsid proteins that self-assemble into the virus-like particles (VLP) (Harper & Paavonen, 2008). These particles contain no viral genetic material and are, thus, not infectious. Both vaccines target HPV types 16 and 18, which are considered the cause of at least 70% of cervical cancer cases in the world (Laurence, 2008). Nowadays, HPV vaccines are extensively used in many countries of the world, and vaccination is included in the national immunization programs. In the USA, vaccination is usually carried out among all girls of 11-12 years old. Although the HPV vaccination among boys and men is not so common, it is suggested that the early vaccination in boys may provoke the direct benefits for health (“HPV vaccination of boys and girls beneficial,” 2015, p. 19). The usage of HPV vaccination proved to be a safe and effective method for the infection’s prevention. It is observed that after a full course of vaccination, the protective VLP antibodies are found in over 99% of the vaccinated population (Harper & Paavonen, 2008).

The purpose of this paper is the identification of HPV vaccination effectiveness among children of both genders from 9 to 18 years old. The effectiveness of the vaccine may be defined as the prevention of the severe clinical cases of HPV infections with oncologic symptoms causing hospitalization of patients. The analysis will be conducted based on the information provided by the qualitative and quantitative research studies associated with the subject. It is expected that the evaluation of the research procedures and the findings in the peer-reviewed articles will help to answer the main research question: does the early HPV vaccination have positive effects on the prevention of the HPV-related oncologic diseases development in male and female children of 9-18 years old.

Literature Review

The research question is formulated according to the PICO model and includes the variables of the population (children of 9-18 years old), indicator/intervention (HPV vaccination), control/comparison (the standard vaccination course), and outcome (effectiveness). And the research studies for the literature analysis were chosen according to the mentioned PICO variables. The literature search was conducted in the “ProQuest” database, and the total number of identified articles was 211. Among them, four study papers were selected as the most appropriate for answering the formulated research question because the synthesis of these papers’ findings allows covering all issues raised in this paper.

The analysis of the studies’ purposes revealed that the authors aimed at the identification of HPV vaccination benefits for the health of boys and girls (“HPV vaccination of boys and girls beneficial,” 2015); effectiveness of vaccination in cancer prevention (Laurence, 2008); the most appropriate age for vaccination in relation to receiving the most beneficial of the potential results (Harper & Paavonen, 2008); and the overall efficiency of national HPV vaccination programs for children (Ladner, Besson, Rodrigues, Audureau, & Saba, 2014). The analysis of the study purposes helped to detect the scope of the articles and its value for the current paper findings.

It is found that most of the HPV-related cancers (90%) primarily affect women while only a small percentage is associated with merely male cancer, and about 7% affects both genders (Harper & Paavonen, 2008, p. 8). The recent research findings make it clear that almost all cases of cervical cancer development are provoked by HPV infection, and the majority of the clinical cases can be prevented by an early HPV vaccination (Ladner et al., 2014, 670). HPV vaccines are composed of the organic substances, the structure of which is similar to the structure of the live viruses. The vaccine triggers the development of the immunity mechanisms aimed at the blockage of HPV integration into the organism (Laurence, 2008, p. 345). All the analyzed studies recognize a high effectiveness of the vaccination, but, at the same time, the researchers emphasize the preventive character of HPV vaccines (Ladner et al., 2014, 670). The vaccination can help the individuals to avoid infection only in case they didn’t have the contact with the virus, and since HPV is usually transmitted sexually, the vaccination before pubescence may significantly increase the effectiveness of cancer prevention in both males and females (Laurence, 2008). According to Harper and Paavonen (2008), the HPV vaccination in children is characterized by 100% efficacy in protection from HPV 16 and 18 for at least five years (p. 8). However, the total duration of the immunologic response is not estimated, and its dependence on the individual DNA characteristics and health condition is recognized.

The sample of the study conducted by Lander and colleagues (2014) consisted of the participants of 21 vaccination programs conducted in 14 countries (p. 670). The analysis included the variables of the uptake rates, vaccine adherence, and costs. The authors found that the school-based vaccination model was the most effective because it supports a higher level of control over vaccine initiation in the targeted populations, keeping up with the vaccination intervals, and avoidance of vaccination delays (Ladner et al., 2014). As it was mentioned before, HPV vaccines are regarded as primarily female, and it is observed that high pricing for medication contributes to the lack of gender neutrality associated with it (“HPV vaccination of boys and girls beneficial,” 2015, p. 19). Nowadays, the percentage of vaccine uptake by boys is significantly lower than among the younger female population. However, the preventive effect of HPV vaccines in the development of anal carcinomas in men, the HPV-related oral cancer, penile cancer, etc., is observed by many researchers (“HPV vaccination of boys and girls beneficial,” 2015, p. 19). The price decrease is regarded as the decisive factor for the increase of the male population engagement in the vaccination programs (Laurence, 2008, p. 345). The change of the policies at the national level and the elaboration of various school-based programs and their promotion among caregivers would help to raise awareness regarding multiple HPV issues and the positive effects of vaccination.

Conclusion

HPV infection is one of the risk factors for the development of different forms of cancer in both males and females; however, the early vaccination may help to prevent the transition of the virus into the organism. HPV vaccination cannot eliminate the disorder when it is already manifested in the body, but it is regarded as an effective method of HPV-related cancers prevention. Since the main function of the vaccine is the development of the immunity towards HPV virus, it is essential for the medicine to be injected before the first contact with the infection. The vaccination among the individuals who are not yet engaged in the sexual activity thus will be the most effective; therefore, it is recommended for the children from 9 to 18 years old.

References

Harper, D. M., & Paavonen, J. (2008). Age for HPV vaccination. Vaccine, 26, 7-11.

HPV vaccination of boys and girls beneficial. (2015). PharmacoEconomics & Outcomes News PharmacoEcon Outcomes News, 728(1), 19.

Ladner, J., Besson, M., Rodrigues, M., Audureau, E., & Saba, J. (2014). Performance of 21 HPV vaccination programs implemented in low and middle-income countries, 2009–2013. BMC Public Health, 14(1), 670.

Laurence, J. (2008). The AIDS Reader, 18(7), 345-346. Web.

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