Brazil adopts single-dose scheme for HPV vaccination

In a video released on social media this Monday, the 1st, the Minister of Health, Nísia Trindade, revealed a new strategy for vaccination against the virus. HPV (acronym for papillomavirus), the main causative agent of cervical cancer: from now on, the vaccine will be administered in a single dose. Previously, two doses were recommended.

According to the minister, the decision to adopt single-dose vaccination was based on scientific studies that indicate greater adherence to the vaccine, as recommended by the World Health Organization (WHO).

Who can get vaccinated free of charge through SUS:

1. Girls and boys aged 9 to 14;
2. People aged 9 to 45 with special clinical conditions such as HIV/AIDS, solid organ or bone marrow transplant recipients, cancer patients (immunosuppressed);
3. Victims of sexual abuse;
4. People with recurrent respiratory papillomatosis (PPR).

Furthermore, Nísia encouraged states and municipalities to carry out an active search for people up to 19 years of age who have not received any dose of the HPV vaccine, so that they can update their vaccination schedule.

The minister also took the opportunity to highlight the progress in vaccination rates, with more than 5 million doses applied in 2023, the highest number since 2008. Compared to 2022, the increase was 42%. “We now have more vaccines to protect our population,” she said.

Although HPV is also associated with other types of cancer, such as the anus, vulva, vagina, penis and oropharynx, doctor Isabella Ballalai, director of the Brazilian Society of Immunizations (SBIm), highlights that the scientific studies that support the dose decision only do not demonstrate their effectiveness in protecting against these types of neoplasia.

Despite this, countries like Great Britain and Australia were the first to change their policies and establish single-dose vaccination. According to Isabella, the expectation is that there will be epidemiological surveillance in these places, so that there will soon be evidence on the effectiveness of the single dose against other types of cancer in addition to cervical cancer.

“Brazil monitors the circulation of the virus, but not precursor lesions. In other words, when a person goes to the gynecologist and pre-cancerous lesions are detected, there is no notification. Therefore, the expectation is that there will be monitoring of the single dose in other countries, such as Australia”, says Isabella.

Even recognizing this gap, the director of SBIm states that, from a public health point of view, the decision can contribute to greater vaccination adherence and, consequently, significantly change the HPV scenario in Brazil.

“By vaccinating against the virus, the person not only protects themselves, but also contributes to reducing the circulation and prevalence of HPV. This is the strategic basis behind the change in the vaccination schedule, together with the objective of eliminating HPV cancer. cervix”, explains Isabella.

According to the WHO, widespread implementation of the single-dose strategy could prevent 60 million cases of cervical cancer and 45 million deaths worldwide over the next 100 years.

What is HPV?

The acronym refers to the human papillomavirus, responsible for the most common sexually transmitted infection (STI) in the world, according to the Ministry of Health. According to the ministry, HPV transmission occurs through direct contact with infected skin or mucosa, that is, by touching, vaginal or anal penetration, or contact of the virus with the mouth. More than 200 subtypes of the virus have been identified.

Around 70% to 80% of the population comes into contact with HPV at some point in their lives, mainly through sexual activity. Although most virus infections are resolved by the immune system, some persist, which can result in the development of lesions and, eventually, the development of cancer.

What are the ways to prevent HPV?

According to Mariana Scaranti, from Hospital Nove de Julho, in São Paulo, the main strategy in this regard is vaccination. The vaccine against HPV has been available free of charge in the Unified Health System (SUS) for ten years.

In addition to vaccination, another fundamental strategy in combating HPV is the use of condoms. However, as this method is not 100% effective in combating the disease, according to the Ministry of Health, it is important to combine the use of condoms with vaccination.

To specifically avoid cervical cancer caused by HPV, another strategy is to have a regular Pap smear. This is a gynecological exam that identifies infections in the cervix and can detect the disease before it turns into a tumor. According to the oncologist, the frequency of carrying out this exam must be decided together with the gynecologist.