Greatest effect of HPV vaccination from school-based programmes

Abstract

Human papillomavirus (HPV) vaccination programmes have been in use in many countries since 2007 following licensing of the bivalent and quadrivalent HPV vaccines. 1 WHOCountries using HPV vaccine. http://www.who.int/immunization/diseases/hpv/decision_implementation/en/ Google Scholar Clinical trials have shown that HPV vaccines have more than 90% efficacy in preventing high-grade cervical lesions caused by human papillomavirus types 16 and 18, 2 Garland SM Hernandez-Avila M Wheeler CM et al. Quadrivalent vaccine against human papillomavirus to prevent anogenital diseases. N Engl J Med. 2007; 356: 1928-1943 Crossref PubMed Scopus (1550) Google Scholar , 3 Paavonen J Naud P Salmeron J et al. Efficacy of human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine against cervical infection and precancer caused by oncogenic HPV types (PATRICIA): final analysis of a double-blind, randomised study in young women. Lancet. 2009; 374: 301-314 Summary Full Text Full Text PDF PubMed Scopus (1337) Google Scholar which are the two HPV types known to cause 70–80% of cervical cancers and large proportions of other anogenital and oropharyngeal cancers. The quadrivalent vaccine has shown similar efficacy in the prevention of anogenital warts caused by HPV types 6 and 11. Furthermore, both vaccines have shown lower—but still substantial—efficacy against related non-vaccine oncogenic human papillomavirus types. 4 Bonanni P Boccalini S Bechini A Efficacy, duration of immunity and cross protection after HPV vaccination: a review of the evidence. Vaccine. 2009; 27: A46-A53 Crossref PubMed Scopus (62) Google Scholar , 5 Malagon T Drolet M Boily MC et al. Cross-protective efficacy of two human papillomavirus vaccines: a systematic review and meta-analysis. Lancet Infect Dis. 2012; 12: 781-789 Summary Full Text Full Text PDF PubMed Scopus (309) Google Scholar Therefore, since rollout of these vaccination programmes began, there has been great anticipation to see whether these promising trial results will translate into substantial reductions in HPV-related disease at the population level. 6 Stanley M Prophylactic human papillomavirus vaccines: will they do their job?. J Intern Med. 2010; 267: 251-259 Crossref PubMed Scopus (17) Google Scholar In The Lancet Infectious Diseases, Mélanie Drolet and colleagues present the findings of a timely systematic review and meta-analysis assessing the population-level and herd effects of HPV vaccination programmes so far. 7 Drolet M Bénard É Boily M-C et al. Population-level impact and herd effects following human papillomavirus vaccination programs: a systematic review and meta-analysis. Lancet Infect Dis. 2015; (published online March 3.)http://dx.doi.org/10.1016/S1473-3099(14)71073-4 PubMed Google Scholar Population-level impact and herd effects following human papillomavirus vaccination programmes: a systematic review and meta-analysisOur results are promising for the long-term population-level effects of HPV vaccination programmes. However, continued monitoring is essential to identify any signals of potential waning efficacy or type-replacement. Full-Text PDF