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

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 short- and medium-term effectiveness of HPV vaccination.

The economic damage of HPV in the Khanty-Mansiysk Autonomous Region-Ugra is about \$5,730,000 per year.

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


**15**

nurses.

*The Importance of the Problem of HPV-Associated Diseases in KhMAO-Ugra: Vaccination…*

When analyzing the incidence of HPV-associated diseases in KhMAO-Ugra, it was found that since 2011, the incidence of anogenital warts in adolescent girls has decreased both by the results of preventive examinations and by the incidence in the offices of a gynecologist. The incidence of HPV-associated diseases was monitored in a group of young women 8 and 10 years after vaccination. We examined 871 girls aged 20–22 who received vaccination at the age of 12 years old, and we did not register clinical manifestations of HPV infection (anogenital warts, CIN). In addition, we noted the general population effect. The rate of primary incidence of anogenital warts in the adult population in KhMAO-Ugra for the period

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

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.

• Achieve vaccination coverage for at least 70% of girls aged 12–13.

including short-, medium-, and long-term indicators.

• Consider the possibility of protection against the largest range of HPVassociated cancer and other diseases, that is, use at least quadrivalent HPV vaccine with inclusion in the vaccination program for boys aged 12–14.

• Implement a system to monitor the effectiveness of the vaccination program,

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

We see the need to continue to work to provide the public with reliable and

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

• Conduct field meetings with parents, representatives of schools, and children's

• Continue explanatory work in mass media in connection with high activity of

• Prepare booklets with questions on reproductive health, develop volunteer movement among students, and conduct surveys of young people.

also be included in the Russian national vaccination calendar.

*DOI: http://dx.doi.org/10.5772/intechopen.90668*

2009–2008 decreased by 39%.

During vaccination, we should:

objective information on vaccination.

anti-vaccine agitation on the Internet.

immunization program:

clinics.

**8. Conclusion**

• HPV vaccination will save 11,015 bed occupancy per year and prevent 101 deaths from malignant neoplasms per year.

### *The Importance of the Problem of HPV-Associated Diseases in KhMAO-Ugra: Vaccination… DOI: http://dx.doi.org/10.5772/intechopen.90668*

When analyzing the incidence of HPV-associated diseases in KhMAO-Ugra, it was found that since 2011, the incidence of anogenital warts in adolescent girls has decreased both by the results of preventive examinations and by the incidence in the offices of a gynecologist. The incidence of HPV-associated diseases was monitored in a group of young women 8 and 10 years after vaccination. We examined 871 girls aged 20–22 who received vaccination at the age of 12 years old, and we did not register clinical manifestations of HPV infection (anogenital warts, CIN).

In addition, we noted the general population effect. The rate of primary incidence of anogenital warts in the adult population in KhMAO-Ugra for the period 2009–2008 decreased by 39%.
