Tuesday, March 9, 2010

New Data on Cervarix

**This post is written based upon the author's personal view, and not sponsored nor received any form of incentives by the respected pharmaceutical company.**

It has been known to be of utmost significance, at par in my opinion to the landing of the first human on the moon  back in 1969 as in the field of medicine, the discovery of the first ever vaccine against cancer. February 27 2006 marked as a milestone in the history of medicine when the first ever Cervical Cancer Vaccine, Gardasil, was launched. It was advertised as a tetravalent vaccine, which means it provides immunity against 4 subgroups of HPV virus,(Human Papilloma Virus)subunit 6,11,16, and 18. 
There are over 100 subgroups of HPV identified and each is given a number. 
Generally, HPV virus is divided into oncogenic and non oncogenic groups. HPV is transmitted through sexual contact. Based on a study conducted locally, more than 70% of women would have experienced sexual intercourse before the age of 25. While 70% of HPV resolves by the first year and 90% resolves by the second year, the other 10% stays within the skin and lays dormant for years. It does not travel within the bloodstream, hence undetectable by blood investigations. When Gardasil was launch, it was accepted worldwide, but not without controversy.Some school of thoughts claimed with the vaccine it gives a false sense of security that encourage sexual promiscuity amongst young women. 
As mentioned earlier, HPV is classified either oncogenic or non oncogenic. Subgroup 16,18,31,45 being the highest risk, 33,35,39,51,52,56,58,59 being high risk, and 26,53,66,68,73,and 82 being classified as probable high risk. 
The others cause genital,plantar,or anogenital warts.
In 2009, Pharmaceutical Giant, GSK launched Cervarix, a bivalent vaccine, that provides immunity against subgroup 16 and 18. Upon the launch of Cervarix, the cost per dose for Gardasil drastically dropped. 
Both vaccines are administered over a period of 6 months in 3 doses, difference being on the second dose where Cervarix is given 1 month after the first dose while Gardasil being 2 months. 
My personal preference would be undoubtedly Cervarix.
Based upon the formulation on which the vaccine are made, you'll notice that GSK's Cervarix is far more superior than Gardasil. Cervarix's formulation includes the use of AsO4  as adjuvant that gives the immune system a boost in formation of antibodies and is maintained at a higher level for a longer period of time. 
To date,a study continues to be conducted and has been 7 1/2 years now. Modeling of Cervarix long term antibody kinetics predicts it's immunity remain detectable for at least 20 years, while immunity by Gardasil  begin to dwindle by the 5th year upon administration. 

Study on Cervarix is still ongoing today. 

Aluminium Hydroxide as the "key factor" for its rapid and sustainability of high antibody level against oncogenic HPV strains. 
The other important factor being that the latest studies conducted by GSK on more than 18,000 women indicated Cervarix does more than only provide immunity against HPV 16, and 18, but cross protection against HPV 31,33, and 45 as well! 

Hence, it provides immunity against the top 5 oncogenic subtypes of HPV. While Gardasil gives protection against subtype 16 and 18, subtype 6 and 11 aren't oncogenic but instead causes genital warts, which is a curable condition.

Therefore, ladies and gentlemen, in that sense, Cervarix would be a pentavalent  vaccine while Gardasil being a bivalent vaccine. 

Which vaccine then would you chose then?
Insist upon the box to be opened right in front of you, just to make sure you receive the right vaccine since you have paid for it. 

Original packaging comes in a pre-filled syringe of 0.5ml of vaccine. Enclosed are two needles of different sizes. 

It would be unbelievable but as I've worked in a  clinic (a well established clinic in Sri Petaling) which is a panel clinic to many restaurants that regularly sends their workers for typhoid vaccination, and since they've ran out of stock, and to save money, instead of injecting typhoid vaccine, the owner actually pre filled an empty typhoid vaccine ampoule with normal saline, and started injected patient with it. Unbelievable, but its true.
Hence, ladies, please make sure that your doctor opens the box right in front of you, and the plastic container that holds the syringe and needles is sealed. Make sure the doctor opens the seal in front of you!

The colour of the vaccine would be slightly cloudy, and not entirely transparent. 
Being ranked number 2 killer among women in Malaysia, with more prevalence among the Chinese, please go to the nearest clinic to inquire about the vaccine. 
Though the recommended age of vaccination is between the age of 10-45, but since occurrence of Cervical Cancer among the elderly of age between 65-70 form a significant percentage out of the overall number, I would still recommend vaccination even in individual above the age of 45.(Remember that HPV is non detectable from blood investigation, but only through HPV DNA Genotype test that identifies not only the presence of HPV, but it's subtypes as well, upon discovering abnormality in Pap smear. 

Love yourself, ladies. Don't think it won't happen to you. The fact that it is ranked 2nd as the cause of morbidity in Malaysia speaks for itself. 
Current market cost per dose is RM230-250. As part of our effort to promote this life saving 
revolutionary vaccine, Klinik Wan dan Keluarga, Bandar Sri Damansara charges only RM165 per dose or RM480 if paid together for the three doses. 

Call us at 62722678 (working hours Mon-Sat 9am - 7pm) for an appointment. It is part of our clinic policy to create an awareness among community on latest development in medicine that is available today.
Wondering why only RM165? No, we don't use fake or "other substitute". It's original Cervarix from GSK. 
Ever heard of cases where woman who regularly goes for annual Pap smear and was told to be normal, but died few months later of Cervical Cancer? Ever wonder why? Look out for out next post!

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