HPV vaccines: a controversial issue?

A.F Nicol,D.W Provance Jr,L.L.S Rodrigues,C.V Andrade,F.B Russomano,N.S Oliveira

doi:10.1590/1414-431x20155060

Abstract

Controversy still exists over whether the benefits of the available HPV vaccines outweigh the risks and this has suppressed uptake of the HPV vaccines in comparison to other vaccines. Concerns about HPV vaccine safety have led some physicians, healthcare officials and parents to withhold the recommended vaccination from the target population. The most common reason for not administering the prophylactic HPV vaccines are concerns over adverse effects. The aim of this review is the assessment of peer-reviewed scientific data related to measurable outcomes from the use of HPV vaccines throughout the world with focused attention on the potential adverse effects. We found that the majority of studies continue to suggest a positive risk-benefit from vaccination against HPV, with minimal documented adverse effects, which is consistent with other vaccines. However, much of the published scientific data regarding the safety of HPV vaccines appears to originate from within the financially competitive HPV vaccine market. We advocate a more independent monitoring system for vaccine immunogenicity and adverse effects to address potential conflicts of interest with regular systematic literature reviews by qualified individuals to vigilantly assess and communicate adverse effects associated with HPV vaccination. Finally, our evaluation suggests that an expanded use of HPV vaccine into more diverse populations, particularly those living in low-resource settings, would provide numerous health and social benefits.

Highlights

Vaccination is the most successful method to control infectious diseases in terms of both cost and effectiveness
Two prophylactic Human papillomavirus (HPV) vaccines have been approved by the Food and Drug Administration (FDA) in the USA: the bivalent Cervarixs (GlaxoSmithKline, Middlesex, UK) for prevention of infection with HPV types 16 and 18 and the quadrivalent Gardasils (Merck Sharp & Dohme, USA) for HPV types 6, 11, 16, and 18
Considering that HPV vaccines, like all other vaccines, may not protect all vaccinated individuals, regular cancer screening programs should be maintained irrespective to whether or not a person receives HPV vaccination. It remains to be determined if the newer HPV vaccines against up to seven specific HPV genotypes associated with cancer increase the efficacy of preventing the onset of CIN and cervical cancer, which is already high with current vaccine formulations

Summary

Introduction

Vaccination is the most successful method to control infectious diseases in terms of both cost and effectiveness. Two prophylactic HPV vaccines have been approved by the Food and Drug Administration (FDA) in the USA: the bivalent Cervarixs (GlaxoSmithKline, Middlesex, UK) for prevention of infection with HPV types 16 and 18 and the quadrivalent Gardasils (Merck Sharp & Dohme, USA) for HPV types 6, 11, 16, and 18. Both HPV vaccines can protect females against cervical pre-cancers (CIN). There are several ongoing controversies surrounding compliance with the vaccination recommendation, which at times has involved government health agencies

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