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Posted On : 05 Oct 2012

Sir,

Reg. H P V . Vaccine, is it indicated to all teenagers,

or optional_? How far it is protective_?complications of

the vaccine_? cost effectiveness_? pl. clarify.

I Would like to THANK to one and all for giving us

valuable solutions to our queries ,promptly.

Expert Answer :

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Answer 1

HPV vaccine is category 2 vaccine as per IAP COI. That means it is recommended to be used if economically feasible. Cervical cancer is either no 1 or 2 prevalent cancers in Indian women. What is disturbing about this cancer is a fact that it would kill a woman at her prime age of 40s. That would leave the family in trouble. Hence even if the chance of developing cervical cancer is small in infected women, impact is great. Further most of cervical cancers are caused by HPV virus strain 16 and 18 and so vaccine is considered to be very effective. Finally what we do not know as yet is the duration of protection as vaccine is only less than 10 years old and so studies so far avaialble are not long enough. However mathematical model suggests nearly life long protection. You may recall MMR vaccine was considered to be life long protection and after three decades of its existence, it is now considered to need second dose. Such modifications are always a possibility. So in fianl analysis, one has an option of waiting for long term protection evidence - that means wait for another 3-4 decades to decide about the worth of the vaccine or consider it today and follow scientific facts. So IAP COI recommends this vaccine to children who can afford. Finally there is always a debate whether we take care of affording population different than poor population. But the fact remains in every sphere that economy decides how individual can take advantage of scientific advances. And it is well known that once vaccine gets used in affordable population, prices come down and over time it may find place in EPI schedule as has happened in case of HBV and HiB vaccines that are now brought in EPI schedule by Government of India. Cost effectiveness is to be considered on individual basis. You may surprised to know that definitiion of affordability in the population as defined by economists of India is one who has a cell phone and , or TV is affordable and by that standard 20 percent of our population is affordable. Finally cost of life is not measured simply by rupees.

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