Human papillomavirus vaccination: the population impact

F1000Res. 2017 Jun 12:6:866. doi: 10.12688/f1000research.10691.1. eCollection 2017.

Abstract

We currently have the knowledge and experience to prevent much of human papillomavirus (HPV)-related disease burden globally. In many countries where prophylactic HPV vaccination programs have been adopted as highly effective public health programs with good vaccine coverage, we are already seeing, in real-world settings, reduction of vaccine-related HPV-type infections, genital warts and cervical pre-cancers with potential reductions in vulvar, vaginal and anal pre-cancers. Moreover, we are seeing a change in cervical screening paradigms, as HPV-based screening programs now have strong evidence to support their use as more sensitive ways to detect underlying cervical abnormalities, as compared with conventional cervical cytology. This article describes the impact of prophylactic vaccination on these outcomes and in settings where these vaccines have been implemented in national immunisation programs. Given the successes seen to date and the availability of essential tools, there has been a global push to ensure that every woman has access to effective cervical screening and every girl has the opportunity for primary prevention through vaccination. A gender-neutral approach by offering vaccination to young boys has also been adopted by some countries and is worthy of consideration given that HPV-related cancers also affect males. Furthermore, vaccination of young boys has the advantage of reducing the risk of HPV transmission to sexual partners, lowering the infectious pool of HPV in the general population and ultimately HPV-related diseases for both genders. Therefore, it is appropriate that all countries consider and promote national guidelines and programs to prevent HPV-related diseases.

Keywords: HPV vaccination; cervical cancer; prevention; prophylactics.

Publication types

  • Review

Grants and funding

SG has received grants to her institution from the Commonwealth Department of Health for HPV genoprevalence surveillance post-vaccination, Merck and GlaxoSmithKline to perform phase 3 clinical vaccine trials, Merck to evaluate HPV in RRP post-vaccination program, Seqirus Australia for funding of the Australian Cervical Cancer Typing Study, and the Victoria Cancer Agency for a study on monitoring and effectiveness of the Australian cervical cancer program, a translation to reduction in vaccine-related HPV infection and pre-cancerous cervical lesions study (the Vaccine Against Cervical Cancer Impact and Effectiveness study) plus a study on associations and typing of early-onset cancers in young women.