**8. Conclusion**

*Human Papillomavirus*

1.Accounting of vaccine coverage, age, and sex of the vaccinated. The ability to

2.Efficacy in reducing precancerous, cancerous, and other HPV-associated diseases: HPV infection; cervical and other HPV-associated genital neoplasia (CIN, AIN, VIN, VaIN); cervical cancer, adenocarcinoma in situ (AIS), anal

3.Monitoring adverse events related to vaccination time and distant in time

4.Modeling or correcting existing cervical cancer prevention screening programs

The average age of development of cervical cancer and other HPV-associated cancers is 45 years, but it should be understood that cancer of the cervix, vulva, vagina, and anal canal is preceded by precancerous lesions, namely, cervical intraepithelial neoplasia 1/2/3 degree (CIN), adenocarcinoma in situ, vulvar and vaginal intraepithelial neoplasia (VIN, VaIN), and anal intraepithelial neoplasia (AIN), which occur at a younger age. The time required to develop cervical, vulvar, vaginal, and anal cancer from CIN, VIN, VaIN, AIN can take 9–15 years [1, 2]. International experts, including experts from the World Health Organization, agree that the ethical and time frame necessitates the use of precancerous lesions rather than cancer as the endpoint of HPV vaccination effectiveness. The ability of vaccination to effectively reduce precancerous lesions of the anogenital region in men and women suggests the absence of anogenital cancers in the future. Thus, the reduction of precancerous lesions of the anogenital region and the development of genital warts in women and men is recognized as the main marker for assessing the

The economic damage of HPV in the Khanty-Mansiysk Autonomous Region-

• will be prevented by infection with human papillomavirus 6, 11, 16, and 18 types, which is not less than 99% of vaccinated teenagers due to development of postvaccinal immunity; this will prevent about 70% of all cervical cancer cases, 80% of cases of anal cancer, 60% of oropharyngeal cancer cases, 55% of cases of vaginal cancer, 48% of vulvar cancer cases, and 48%

• The incidence of genital warts will be reduced by at least 90% in the cohort

• HPV vaccination will prevent costs by reducing the incidence of HPV in the

amount of \$2,300,000, provided 70% vaccination coverage for girls 12 years in

• Positive economic effect will be provided for the period of 5 years in the

• HPV vaccination will save 11,015 bed occupancy per year and prevent 101

(compared with unvaccinated groups) in the future 3–5 years.

the Khanty-Mansiysk Autonomous Region-Ugra

deaths from malignant neoplasms per year.

Predicted effect of HPV-associated disease vaccination in KhMAO-Ugra:

cancer, vulvar cancer, and vaginal cancer; and anogenital warts

call adolescents for missed doses of the vaccine

**7. First results and expected effect of vaccination**

short- and medium-term effectiveness of HPV vaccination.

Ugra is about \$5,730,000 per year.

of cases of penile cancer.

amount of \$3,900,000.

**14**

The lack of national HPV vaccination programs is not due to the lack of relevance of HPV-associated disease prevention but to the lack of sufficient financial resources to implement it. We hope that in the coming years, HPV vaccination will also be included in the Russian national vaccination calendar.

Factors that prevent the formation of recognition of vaccination are ignorance about HPV and cancer, lack of awareness of the risks of cancer, fears of undesirable consequences, and uncertainty about long-term vaccine protection. The effectiveness of HPV vaccination programs depends on the level of vaccination coverage, which in turn depends on the recognition of the importance of HPV vaccination by the government, health authorities, doctors, vaccinees, and their parents.

During vaccination, we should:


It is necessary to work on the improvement of professional training of health workers in preventing communicable diseases—organization of thematic conferences and round tables and development of thematic improvement of doctors and nurses.

We see the need to continue to work to provide the public with reliable and objective information on vaccination.

In order to promote vaccination and improve its effectiveness, further activities should be undertaken with the involvement of the pediatric care service under the immunization program:


*Human Papillomavirus*
