Abstract
Background: A National human papilloma virus (HPV) Vaccination Programme for the prevention of HPV infection and associated disease using the quadrivalent HPV vaccine (4vHPV) has been funded and implemented in Australia since 2007, initially for girls only and extended to boys in 2013, with uptake rates among the highest observed worldwide. Aim: We report on the impact of this national programme on HPV prevalence and associated disease burden and estimate the potential impact of adopting a nonavalent HPV (9vHPV) vaccine. Methods: We performed a non-systematic literature review of studies measuring the burden of HPV-associated disease and infection in Australia before and after introduction of HPV vaccination. We also included key national reports with estimates of HPV-related disease burden. Results: Substantial declines in high-grade cervical disease and genital warts among vaccine-eligible women have been observed. Reductions in genital warts incidence and HPV prevalence among heterosexual men of similar age were observed before introduction of the male vaccination programme, indicating a substantial herd effect. 9vHPV vaccine is expected to prevent up to 90% of cervical and 96% of anal cancers. Of an estimated 1,544 HPV-associated cancers in 2012, 1,242 would have been preventable by the 4vHPV vaccine and an additional 187 anogenital cancers by the 9vHPV vaccine. Conclusions: Vaccination using 4vHPV vaccine has had a large demonstrable impact on HPV-related disease in Australia. A switch to 9vHPV could further reduce the HPV-associated cancer burden. With continued high coverage among both males and females, elimination of vaccine-type HPV disease seems achievable in Australia.
Highlights
A National human papilloma virus (HPV) Vaccination Programme for the prevention of HPV infection and associated disease using the quadrivalent HPV vaccine (4vHPV) has been funded and implemented in Australia since 2007, initially for girls only and extended to boys in 2013, with uptake rates among the highest observed worldwide
In 2013, the funded programme was expanded to boys, making Australia one of 22 countries and territories that have implemented or announced their intention to implement a gender-neutral HPV vaccination programme
We report on the progress made in the decade following commencement of the National HPV Vaccination Programme, and provide an estimate of the further impact achievable
Summary
Human papillomavirus (HPV) infections result in a substantial burden of disease globally as cervical cancer, anogenital and oropharyngeal malignancies and anogenital warts in both men and women. Vaccination for the prevention of HPV infection has been available for more than a decade. In 2007, Australia became one of the first countries to fund and implement a National HPV Vaccination Programme. In 2013, the funded programme was expanded to boys (aged 12–13 years, with catchup for 14–15-year-olds available till end-2014), making Australia one of 22 countries and territories (including nine countries in Europe, namely Austria, Croatia, the Czech Republic, Germany, Italy, Liechtenstein, Norway, Switzerland and, most recently, the United Kingdom) that have implemented or announced their intention to implement a gender-neutral HPV vaccination programme. We report on the progress made in the decade following commencement of the National HPV Vaccination Programme, and provide an estimate of the further impact achievable
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