Vaccination for Human Papilloma Virus (HPV)

choi

(1) Ministry of Health and Welfare 衛生福利部 in Taiwan announces that starting in November 2018, female in Taiwan aged 9-26 may receive two doses (saying two are good enough, though three doses are recommended), free, of vaccination for human papilloma virus (HPV) -- tentatively four valent against types 6, 11, 16, 18 of HPV.

(2) Breaking News: 國一女將全面施打子宮頸癌疫苗. In 育兒生活 07月號, 2017, at page 88
https://books.google.com/books?i ... 16%2018&f=false
("國內包含新北市、桃園市、新竹縣市、嘉義縣市、金門縣及台中市等八縣市自行補助經費接種, 尚未普及全國。其中嘉義市採用九價子宮頸癌疫苗")

Currently 八縣市 (named above; though 联合报 on Feb 24 in a report penned by 陳雨鑫 said 九 without listing them: "有九縣市運用地方預算替國一女學生接種疫苗，接種率約為四成") are paying for THREE doses of four-valent HPV vaccine (same types as mentioned above).

(3)
(a) United States Food and Drug Administration (FDA) in 2006 approved Merck's Gardasil® (four-valent, against the aforesaid 4 types). In 2014, FDA approved Gardasil®9 (nine-valent; against the previous four types, plus types 31, 33, 45, 52, and 58).
(b) Gardasil 9. FDA, undated.
https://www.fda.gov/BiologicsBlo ... ducts/ucm426445.htm
("Indicated in girls and women 9 through 26 years of age for the prevention of the following diseases:
• Cervical, vulvar, vaginal, and anal cancer caused by Human Papillomavirus (HPV) types 16, 18, 31, 33, 45, 52, and 58.
• Genital warts (condyloma acuminata) caused by HPV types 6 and 11")

(4) Eric Sagonowsky, GSK Exits US market with Its HPV Vaccine Cervarix. FiercePharma, Oct 21, 2016
https://www.fiercepharma.com/pha ... pv-vaccine-cervarix
("Facing 'very low market demand,' GlaxoSmithKline has decided to pull out of the US market with the HPV vaccine Cervarix, a spokesperson told FiercePharma. It's a move that gives Merck a stranglehold on the market")

GSK's Cervarix is two-valent, against types 16 and 18.

(5)
(a) Lisa Fayed, Cost and Insurance Coverage for the HPV Vaccine Gardasil. Verywell health, Aug 29, 2017
https://www.verywell.com/how-muc ... vaccine-cost-582021

Quote:

"Under the Affordable Care Act (ACA), the Gardasil 9 vaccine should be provided without cost for both males and females in the recommended age groups by all covered private insurance plans and the insurance obtained through the health exchanges as of 2017.

"The vast majority of health insurance providers cover Gardasil, but that varies from [health insurance] company to company.

"Gardasil is covered under the Vaccines for Children program, a federal program available to children through age 18 who are uninsured, Medicaid-eligible, American Indian, Alaska Native, or underinsured. This makes the vaccine free to eligible children. Those over age 18 may be covered by Medicaid and it may vary by state. In states where the Children's Health Insurance Program (CHIP) is separate from Medicaid, the vaccine is covered.

"A patient paying out of pocket for Gardasil may pay over $190 per dose as of 2017. Three doses are required over a six-month period, making the total cost for the HPV vaccine $570 or more. On top of that, some doctors charge office visit fees when the vaccine is given.

(b) Gardasil 9 became available in Taiwan in 2016. A dose of Gardasil (4-valent, that is) and Gardasil 9 costs about NT$4.3k and $5.4k, respectively, so three doses for the latter cost ~US$520.

(6)
(a) HPV Vaccines: Vaccinating Your Preteen or Teen. Center for Disease Control and Prevention (CDC), undated.
https://www.cdc.gov/hpv/parents/vaccine.html
(b) HPV and Oropharyngeal Cancer. CDC, undated.
https://www.cdc.gov/cancer/hpv/basic_info/hpv_oropharyngeal.htm
(i) Oropharyngeal Cancer is not the same as nasopharyngeal cancer 鼻咽癌.
(ii) a pharynx 咽 is divided into naso- 鼻咽, oro- 口咽, and laryngopharynx 喉咽 (from the top down).

(c) "About 1 in 100 sexually active adults in the United States have genital warts at any given time." CDC, undated.