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This cinema crosses the boundaries between such classifications as male and female, gay and bisexual, normal and pathological, insisting that such transgressions cannot be entirely tamed, regulated, or closeted. Although the impact of immunization on cervical and other HPV-related cancers will be evident in the next decades, a marked decrease of prevalent HPV infections, precancerous lesions and genital warts is already dramatic in the vaccinated cohorts, and also in their sexual partners, thus providing clear evidence of the effectiveness of HPV vaccination, including a herd-protection effect. Girls aged 9—13 years were randomized 1: Previous scholarship, reading this national cinema as sociopolitical commentary, has tended to ignore what falls outside a realist, hetero-normative paradigm. All Nordic countries have implemented a long-term surveillance system to follow up women vaccinated in the first vaccine trials of the quadrivalent HPV vaccine. As such, their effectiveness will be measurable only in the long term, when sufficiently numerous cohorts of immunized adolescents will have reached the age when cancers are more frequently diagnosed. Extension of immunization offer to young women and to adolescent male subjects has become an important additional opportunity for several countries, with a special focus needed on homosexual men with HIV infection who are at particularly increased risk of HPV-related diseases.
Effectiveness of HPV vaccination: Evidence of the early impact of HPV vaccination is available not only from Australia, but also from northern European countries. A first positive indication of the potential role of HPV immunization comes from a recent study performed during a clinical trial of the bivalent vaccine in Costa Rica. Studies have been committed by regulatory agencies to exclude the possibility that, under immunological pressure in highly vaccinated populations, types of HPV not included in vaccines might emerge as a cause of precancerous and cancerous lesions, thus filling an ecological niche left open by immunization programmes. At month 24, noninferiority was maintained for the two-dose M0,6 schedules in girls 9—14 years versus the three-dose schedule in women 15—25 years [ Goldie et al. Girls aged 9—13 years were randomized 1: As a matter of fact, monitoring prevalent infections implies sampling, detecting and genotyping HPV from the infection site, and the recent changes occurring in many countries in the recommendations on the age of initiation of screening, its intervals and tests to be used can affect the possibility of detection of infections and lesions, especially when methodological changes occur during the follow-up time. In a study evaluating the trend of Australian national surveillance data between and in more than 85, subjects, a dramatic decline was observed in the proportions of women younger than 21 years and those aged 21—30 years diagnosed with genital warts which, respectively, changed from Countries with limited resources are presently involved in demonstration projects and, in some cases, have launched national programmes with the help of international agencies and alliances. In this review, we aim to provide evidence of the first results of the effectiveness of HPV immunization on HPV-related diseases, outline different recommendations from around the world, and also identify priority subjects to whom vaccination is proposed and administered. The new two-dose vaccination schedule The opportunity to reduce the number of doses needed to confer protection against HPV-related diseases has a double potential advantage: Papers on impact models of HPV vaccination are continuously being produced to explore new possible target groups, such as adolescent males [ Smith and Canfell, ] or, recently, the use of a reduced number of doses [ Jit et al. By contrast, no significant decrease in genital warts diagnoses was registered in women older than 30 years. Since all women in the placebo arm of the Future II vaccine trial were immunized after 60 months of observation for ethical reasons [ Olsson et al. Previous scholarship, reading this national cinema as sociopolitical commentary, has tended to ignore what falls outside a realist, hetero-normative paradigm. Extension of immunization offer to young women and to adolescent male subjects has become an important additional opportunity for several countries, with a special focus needed on homosexual men with HIV infection who are at particularly increased risk of HPV-related diseases. A quantitative comparison of linear trends also showed a significant decrease in HGA incidence after the introduction of the vaccination programme in individuals aged 17 years or younger, but no significant decrease in those aged 18—20 years. Based on the presentation of the comparative results with the two-dose schedule in 9—year-old girls versus the three-dose schedule in young women, on 27 February , the Committee for Human Medicinal Products of the EMA granted a positive opinion on the possibility of adopting a two-dose schedule with the quadrivalent HPV vaccine in girls in the age range 9—13 years. Although the impact of immunization on cervical and other HPV-related cancers will be evident in the next decades, a marked decrease of prevalent HPV infections, precancerous lesions and genital warts is already dramatic in the vaccinated cohorts, and also in their sexual partners, thus providing clear evidence of the effectiveness of HPV vaccination, including a herd-protection effect. A comparative study on HPV-type prevalence in Pap smears in Australian women aged 18—24 years in the prevaccination period — and in the postvaccination period — using the same recruitment and testing strategies showed that the prevalence of vaccine HPV genotypes 6, 11, 16 and 18 was significantly lower in the postvaccine sample than in the prevaccine sample 6. Proportion of cancers attributable to persistent human papilloma virus infection. No decline in wart diagnoses was registered in heterosexual men over 30 years of age [ Ali et al. Different modelling approaches were used e. The GMT ratios were noninferior for girls two doses to girls three doses: In particular, a randomized, phase III postlicensure noninferiority study was conducted in Canada on age-stratified female subjects [ Dobson et al. Austria was the first country to issue national recommendations in November , but never publicly funded the programme. An ecological study on the impact of the bivalent vaccine on genital warts incidence in the UK seems to confirm the trial data.
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