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Immunizig Agents. Active immunizing antigens Conjugating agents Suspending fluid Preservatives, stabilizers, antimicrobials . Administration. Site and route Pain management Scheduling Blood products & MMRV. Safety. Dr Sears messages. Doctors do not understand vaccines

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immunizig agents
Immunizig Agents
  • Active immunizing antigens
  • Conjugating agents
  • Suspending fluid
  • Preservatives, stabilizers, antimicrobials
administration
Administration
  • Site and route
  • Pain management
  • Scheduling
  • Blood products & MMRV
dr sears messages
Dr Sears messages
  • Doctors do not understand vaccines
  • Public Health Agencies and Pharma companies are not Trustworthy
  • Vaccine Mandates or Optional
  • Vaccine preventable diseases are not so bad
  • Hide in the herd
dr sears messages1
Dr Sears messages
  • Vaccination as a cause of chronic diseases
  • Safety testing is insufficient
the problem
The problem
  • Decision making
  • Bad science vs good science
  • VAERS reports overestimate adverse effects
  • Risks from vaccine preventable diseases
  • Thimerosal (Thompson et al NEJM 2007;357(13):1281-1292
  • Coincidence vscasuality
what are human papillomaviruses
What are Human Papillomaviruses?
  • Group of viruses belonging to Papillomarividae family
  • Double stranded DNA viruses
    • Non-enveloped capsid consisting of 72 pentavalent capsomeres
  • Up to 200 different genotypes identified
  • Classified according to:
    • Tropism: Cutaneous or Mucosal

≈ 30–40 anogenital mucosal HPV

    • Risk of neoplasia: Low risk or High risk

≈ 20 HPV cause cervical cancer

Syrjänen and Syrjänen. Papillomavirus infections in human pathology. Wiley & Sons, Chichester; 2000. p.11–46

clearly defined pathogenic types and related diseases
Clearly Defined Pathogenic Types and Related Diseases

1. Wieland et al. Papillomaviruses in human pathology: Epidemiology, pathogenesis and oncogenic role. In: Gross, Barasso Eds. Human papillomavirus infection: A clinical atlas. Ullstein-Mosby; 1997. p.1–18.

2. Von Krogh.Eur J Dermatol. 2001; 11:598–603. 3. Munoz et al.N Engl J Med. 2003;348:518–527

slide29
נוגדנים מנטרלים הכרחיים להגנה מפני הדבקה

Nonneutralizing antibodies do not neutralize HPV

Neutralizing antibodies prevent HPV infection

No antibodies – viral infection

Cell surface receptors

Adapted from Chen XS et al. Molecular Cell. 2000;5:557–567.

5

hpv and vaccines gardasil and cervarix
HPV and Vaccines (Gardasil and Cervarix)
  • Seroconversion: 100% neutralising antibody
  • Antibody titers higher than natural antibody titers
  • Duration at least 5 years, expected 10y+
  • Excellent efficacy and safety profile
slide32

גיל התנסות מינית ראשונה בארץ

הראל י, קני ד, רהב ג. נוער בישראל. רווחה חברתית, בריאות והתנהגויות סיכון במבט בינלאומי. ג'וינט – מכון ברוקדייל, ירושלים, 1997

vaccination at a younger age resulted in higher response for neutralizing antibodies

Immunogenicity Bridge

Efficacy Program

1600

1500

1300

1100

Serum cLIA GMT with 95% CI, mMU/mL

900

700

500

9

10

11

12

13

14

15

16

17

18

19

20

21

22

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Vaccination at a Younger Age Resulted in Higher Response for Neutralizing Antibodies

Per-protocol immunogenicity (PPI) population (ages 9–26)*

Neutralizing anti-HPV 6 GMTs at month 7

Age at Enrollment (Years)

*Inclusive of five study protocols; all GMTs measured using cLIA.

cLIA = competitive Luminex® immunoassay; CI = confidence interval

10

slide34
הדילמות בחיסון נגד HPV
  • בעיות אתיות
    • חיסון ילדות נגד מחלות המועברות במגע מיני (STI )
    • שיחה בנושא יחסי מין עם הורי הילדות
    • הסכמת ההורים לחסן את בנותיהן
  • בעיות תרבותיות
    • חיסון כנגד מחלות מין יגרום לירידה בערכים משפחתיים ועלול לעודד ירידה במוסר מיני
    • אמונות ודיעות לגבי חיסונים ויעילות חיסונים
slide35
הדילמות בחיסון נגד HPV (המשך)
  • תוכניות חיסון למתבגרות
    • מתן 3 מנות חיסון למתבגרות?
  • מחיר
    • מי צריך לשלם עבור החיסון?
  • השפעה אפשרית של חיסונים נגד HPV על בדיקות סקר למשטח צוואר הרחם והיענות לבדיקה
    • החיסון אינו תחליף לביצוע משטח צוואר הרחם (pap )
  • מי צריך לחסן?