Assoc. Dr. Milko Sirakov is the head of the Third Gynecology Clinic at the Mother’s Home Medical University. He has been working at the university hospital since 1978. He is a specialist with many years of experience in the field of pediatric and adolescent gynecology, gynecological endocrinology and infertility. Specializes in France, Germany, Great Britain, Japan. There are 68 publications in Bulgarian and foreign scientific journals. Assoc. Dr. Milko Sirakov is the general secretary of the Bulgarian Society of Obstetrics and Gynecology and the chairman of the Bulgarian Society of Pediatric and Adolescent Gynecology. He was elected as the next president of the European Association of Pediatric and Adolescent Gynecology. First part of the interview How often should a woman have a preventive examination at a gynecologist? In Bulgaria, it is recommended once a year. One smear is about BGN 20, the amount is not that big. There are some countries that hold them less frequently. In the US, they take place once every three years. For example, if a woman is group I twice in a row, the next pap smear may be after 3 years. In my opinion, from a purely practical point of view, this system is more complicated. The woman must remember when she last did the examination, it is possible that in a three-year period she will forget when the next one should be. It is easier to remember that it is desirable to have an examination every year, with a pap smear. What are the ways of infection with the papilloma virus? Mainly the way is sexual. Through oral, vaginal or anal sex. There is also a risk of infection during masturbation, during foreplay, even without sexual contact. Therefore, the condom does not protect 100%. Papilloma viruses can also be present on the hands, on the surface of the condom. The man, while inserting the condom, touches it with his hands, the woman also touches it. It should not be assumed that the partner must necessarily have been infected with something. In fact, in men, except those already affected by penile cancer, there is no sign of having human papillomavirus. It can be located on the surface of the member, not in some material substrate, in a wart or sore, for example. I mean the oncogenic types of viruses, the ones that cause cancer. Otherwise, 6 and 11 types, those in which the so-called “genital warts” – they have changes. You participated in the working group on the creation of the National Program for Primary Prevention of Cervical Cancer. What activities does it include and when is it expected to launch? The program is expected to start from September this year, with the start of the school year. Preventive examinations of schools usually begin in the fall. Until then, the public must be informed about what the vaccine is, why immunization is necessary, how it is carried out. A purely practical decision was made to immunize 12-year-old girls. The vaccine includes three doses and is available from two pharmaceutical companies. In one, the second and third doses are given one and six months after the first, and in the other – two and six months after the first. People personally choose which of the two to use.The idea is for the girl to visit the GP who writes a prescription. You go to the pharmacy with it, get the vaccine without paying anything and then the jeep puts it in. The pharmacy settles the issue of payment with the NHIF. That is the idea, and all of us in the working group were unanimous that it should be. But it is not yet known whether the health fund will agree to this option, it is not clear in what percentage it will reimburse the vaccine – whether 100% or less. NEWS_MORE_BOX What do the latest scientific data show about the effectiveness of the HPV vaccine? I have followed the development of vaccines since the very beginning. I have participated in several major international congresses on the subject. Everywhere all the data on them is good. The only thing is that it is not yet known how long the immunity from vaccination will last. Vaccines have been monitored for 9 years. There is a mathematical model that, according to the data available to the researchers, the vaccine gives good immunity for 20 years. After that, the strength of immunity begins to decline. Reimmunization can then take place. At what age does immunization give the best effect? Recommended for ages 12 to 25. It’s not that it can’t be done at the age of 35, for example, but at that age the immune response already weakens. It is strongest between the ages of 12 and 16. Is the vaccine safe? So far, there has not been a single serious publication of any serious side effect from the vaccine. Only at the site of the sting may appear slight redness, pain. The idea of ​​immunization is one of the greatest ideas ever in medicine. Millions of people have been saved by vaccines. In this way, some diseases have been eradicated. Especially for the cervical cancer vaccine, it is recombinant, the virus envelope protein is completely artificially created. There is no DNA in the vaccine, because it does not contain killed viruses, but artificially created envelopes. It is absolutely impossible for a person to become infected with something after immunization. In addition, the vaccine is a protein, and if a person is not allergic to it, and he has nowhere to be allergic, there is no risk of any other reaction.Reimmunization can then take place. At what age does immunization give the best effect? Recommended for ages 12 to 25. It’s not that it can’t be done at the age of 35, for example, but at that age the immune response already weakens. It is strongest between the ages of 12 and 16. Is the vaccine safe? So far, there has not been a single serious publication of any serious side effect from the vaccine. Only at the site of the sting may appear slight redness, pain. The idea of ​​immunization is one of the greatest ideas ever in medicine. Millions of people have been saved by vaccines. In this way, some diseases have been eradicated. Especially for the cervical cancer vaccine, it is recombinant, the virus envelope protein is completely artificially created. There is no DNA in the vaccine, because it does not contain killed viruses, but artificially created envelopes. It is absolutely impossible for a person to become infected with something after immunization. In addition, the vaccine is a protein, and if a person is not allergic to it, and he has nowhere to be allergic, there is no risk of any other reaction.Reimmunization can then take place. At what age does immunization give the best effect? Recommended for ages 12 to 25. It’s not that it can’t be done at the age of 35, for example, but at that age the immune response already weakens. It is strongest between the ages of 12 and 16. Is the vaccine safe? So far, there has not been a single serious publication of any serious side effect from the vaccine. Only at the site of the sting may appear slight redness, pain. The idea of ​​immunization is one of the greatest ideas ever in medicine. Millions of people have been saved by vaccines. In this way, some diseases have been eradicated. Especially for the cervical cancer vaccine, it is recombinant, the virus envelope protein is completely artificially created. There is no DNA in the vaccine, because it does not contain killed viruses, but artificially created envelopes. It is absolutely impossible for a person to become infected with something after immunization. In addition, the vaccine is a protein, and if a person is not allergic to it, and he has nowhere to be allergic, there is no risk of any other reaction.