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PRIMARY PREVENTION

HPV VACCINE
Teknologi Vaksin HPV

Empty Shell formed by


recombinant biotechnology
to mimic the viral 3D shape.

Does not contain


Real
infectious DNA Virus
Vaccine

Does not contain mercury


(thimerosal)

GARDASIL is a trademark of Merck & Co., Inc., Whitehouse Station, NJ, USA.
*VLP = Virus-like particle.
1. Villa LL, Costa RL, Petta CA, et al. Lancet Oncol. 2005;6:271278. 2
Image courtesy of Dr. Ian Frazer
ID/CER/0015/13 AD 26/07/13 ED 26/07/2015

Mekanisme perlindungan vaksin


HPV
3. Infeksi baru dicegah
1. Turunnya virus
2. Infeksi pada tempat setelah tumpahan
lain dicegah

IgG antibodies
Adapted from Schwarz TF & Leo O. Gynecol Oncol 2008; 110: S
PROPHYLACTIC VACCINE
Antigens AS04 adjuvant

+ Aluminium
salt
(Al(OH)3)
+ MPL
Immunostimulant

HPV 16 VLPs HPV 18 VLPs

AS04-containing vaccine

QUADRIVALENT
Antigens Adjuvant

+
Aluminium
Aluminium salt
salt
(amorphous
(amorphous
aluminium
aluminium
hydroxyphosphate
hydroxyphosphate
HPV 16 VLPs HPV 18 VLPs HPV 6 VLPs HPV 11 VLPs sulphate
sulphate [AAHS])
[AAHS])

AAHS-containing vaccine
PEMBERIAN VAKSIN

Recommended schedule
Intramuscular injection (IM)

BIVALENT
0 1 2 3 4 5 6
Dosis Dosis Dosis
1 2 3
QUADRIVALENT
Phase III study vs. HAV (PATRICIA): 3 years

BIVALENT efficacy against CIN regardless of


HPV type in lesion
Young women
(TVC-nave) before sexual
debut, 1 dose
Vaccine Placebo
Estimated Vaccine efficacy1
prevalence Endpoint N = 5,449 N = 5,436 P-value
HPV 16/18
n n % 95 % CI

2530 %2 CIN1+ 106 211 50.1 35.961.4 <0.0001

52%3 CIN2+ 33 110 70.2 54.780.9 <0.0001

up to 70%4 CIN3+ 3 23 87.0 54.997.7 <0.0001

End of study of PATRICIA5 CIN 3+ 93.2 78.998.7

1.Paavonen J, et al. Lancet 2009; 374:301314; 2. Clifford GM, et al. Cancer Epi Biom. Prev 2005; 14:11571164; 3. Smith JS, et
al. Int J Cancer 2007; 121:621632; 4. Cervical cancer data. Available at: www.who.int/hpvcentre/statistics (Accessed 1 May
2009); 5. Paavonen J, et al. 26th IPvC, Montreal, 3-8 July 2010, abstract 689.
Vaccine Efficacy
Per-Protocol Efficacy Population - Protocols 007, 013, 015
(n=18780)
HPV Quadrivalen
t %
6/11/16/18- Placebo 95% CI
Related Efficacy
Vaccine
CIN 2/3 or
AIS 1 73 99 92, 100
Vulval and
Vaginal
Lesions (incl. 2 189 99 96, 100
Genital
Warts)
VIN 2/3 or
VaIN 2/3 0 15 100 72, 100
PP = received 3 vaccinations within 1 year; no major protocol violations; HPV 16/18 sero(-) at day 1 and HPV
16/18 DNA(-) day 1 to month 7; cases counted starting after month 7. CIN = cervical intraepithelial neoplasia;
AIS = adenocarcinoma in situ.
Average follow up for 3 years
Guidelines for HPV Vaccination

Its our responsibility to


protect our patients

9
INDONESIAN HPV VACCINE GUIDELINE

PROPHYLACTIC VACCINE

IM DELTOID MUSCLE 10-55 YEARS OLD


0,1-2,6
0-6
SEXUAL (-)
LACTATION
HPV VACCINE
SEXUAL (+)
NO PREGNANCY PAP SMEAR (-)

PRECANCER LESION HPV INFECTION


IN THE PAST IN THE PAST

NO HPV INFECTION NO PRECANCER LESION


VACCINATION + PAP SMEAR
POGI (HOGI)-IDAI
SPECIFIC DOSE
MALE HPV VACCINE
Program Vaksinasi Nasional
HOGI mengakselerasi program
nasional vaksinasi
Program vaksinasi nasional ditujukan
pada anak perempuan usia 12 tahun
ATAU kelas 6 Sekolah Dasar dengan
pemberian 2 dosis
RINGKASAN

KANKER SERVIKS
MERUPAKAN SALAH
SATU MASALAH DALAM
KESEHATAN
KANKER SERVIKS
DAPAT DICEGAH
VAKSIN HPV
MERUPAKAN
PENCEGAHAN PRIMER