Protection efficiency and vaccination strategy of single-dose HPV vaccine: opportunity and challenges
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摘要: 接种人类乳头瘤病毒(human papilloma virus, HPV)疫苗可预防HPV感染和HPV相关癌症。目前大多数国家采用2剂次HPV疫苗接种方案,但越来越多的研究发现接种单剂次HPV疫苗具有潜在的保护效果。鉴于宫颈癌的巨大全球疾病负担及因HPV疫苗供应紧张而造成国家或地区间的供应日益严重不平等现象,世界卫生组织免疫策略咨询专家组(Strategic Advisory Group of Experts on Immunization, SAGE)在2022年4月相关会议上表明,单剂次HPV疫苗与2剂次或3剂次疫苗接种方案的保护作用相当。本文就HPV疫苗接种现状和单剂次HPV疫苗保护作用的相关研究进行综述,并分析未来实施单剂HPV疫苗接种策略的机遇和挑战。Abstract: Vaccination against human papilloma virus (HPV) prevents HPV infections and HPV - related cancers. Most countries currently use a two - dose HPV vaccination schedule, but a growing number of studies have found potential effectiveness of single - dose HPV vaccine, sparking a debate about the feasibility of switching from a two - dose regimen to a single - dose regimen in the global vaccine community. Given the large global disease burden of cervical cancer and inequality between countries and regions due to the tight HPV vaccine supply, World Health Organization Strategic Advisory Group of Experts on Immunization (SAGE) stated that single - dose schedules provide comparable protection to the two - or three - dose schedules at a relevant meeting in April 2022. In this article, we review current status of HPV vaccination and researches on the single - dose HPV vaccine protection, and analyze the opportunity and challenges for single - dose HPV vaccination strategy in the future.
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Key words:
- human papilloma virus vaccine /
- protective effect /
- vaccination strategy /
- opportunity /
- challenge
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表 1 单剂次HPV疫苗的保护效力
研究地点 研究对象 HPV疫苗 随访时间(月) 相关指标 保护效力 VE(%) 95 % CI 肯尼亚[23] 15~20岁女性 单剂次九价Gardasil®9 18 HPV16/18持续性感染率 97.5 81.7 ~ 99.7 单剂次二价Cervarix® 97.5 81.6 ~ 99.7 坦桑尼亚[24] 9~14岁女性 Cervarix®、Gardasil®9 24 HPV16/18 IgG抗体阳性率 — a 印度[25] 10~18岁女性 单剂次四价Gardasil® 120 HPV16/18持续性感染率 95.4 85.0 ~ 99.9 2剂次四价Gardasil® 93.1 77.3 ~ 99.8 3剂次四价Gardasil® 93.3 77.5 ~ 99.7 哥斯达黎加[26] 18~25岁女性 单剂次二价Cervarix® 135.6 HPV16/18持续性感染率 82.1 40.2 ~ 97.0 2剂次二价Cervarix® 83.8 19.5 ~ 99.2 3剂次二价Cervarix® 80.2 70.7 ~87.0 注:a 接种单剂次Cervarix®、Gardasil®9后,HPV16 IgG抗体阳性率不劣于2剂次和3剂次同种HPV疫苗。 -
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