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;6:271–278. 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

Adapted from Schwarz TF & Leo O. Gynecol Oncol 2008; 110: S1–S10
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 salt
+ (amorphous
aluminium
hydroxyphosphate
HPV 16 VLPs HPV 18 VLPs HPV 6 VLPs HPV 11 VLPs sulphate [AAHS])

AAHS-containing vaccine
 PEMBERIAN VAKSIN

Recommended schedule
Intramuscular injection (IM)

BIVALENT 0 1 2 3 4 5 6
Dosis 1 Dosis 2 Dosis 3

QUADRIVALENT
 Phase III study vs. HAV (PATRICIA): 3 years

BIVALENT efficacy against CIN regardless of HPV

type in lesion
Young women before
(TVC-naïve) 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

25–30 %2 CIN1+ 106 211 50.1 35.9–61.4 <0.0001

52%3 CIN2+ 33 110 70.2 54.7–80.9 <0.0001

up to 70%4 CIN3+ 3 23 87.0 54.9–97.7 <0.0001

End of study of PATRICIA5 CIN 3+ 93.2 78.9–98.7

1.Paavonen J, et al. Lancet 2009; 374:301–314; 2. Clifford GM, et al. Cancer Epi Biom. Prev 2005; 14:1157–1164; 3. Smith JS, et al. Int J Cancer 2007; 121:621–
632; 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 Quadrivalent %
6/11/16/18- Placebo 95% CI
Related Vaccine Efficacy

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.

Eliav Barr’s Presentation to ACIP (CDC) FEB 2007 Average follow up for 3 years
 Guidelines for HPV Vaccination

It’s 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

9 – 13 YEARS OLD

TWO DOSES

0, 6
 MALE HPV VACCINE

Quadrivalent Vaccine: 9-25 YEARS OLD

HPV RELATED CANCER (ANAL)

GENITAL WARTS
 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