Update on Human Papillomavirus Vaccines: Life Saver or Controversy Magnet?

Abstract

Two vaccines are now available for the prevention of human papillomavirus (HPV) infection in the United States. The quadrivalent vaccine protects from HPV genotypes most likely to cause genital warts and cervical cancer, HPV 6, HPV 11, HPV 16, and HPV 18. The bivalent vaccine provides immunity for only the HPV genotypes highly associated with a high oncogenic risk, HPV 16 and HPV 18. Both vaccines have proven to be safe and efficacious at reducing the rates of persistent infection and Pap smear abnormalities from HPV in large-scale clinical trials, but the long-term impact on cervical cancer and death remains to be seen. Since these vaccines are most effective when administered before a person is sexually active, the ideal age group is girls from 12 to 13 years of age. This young target age for preventing a sexually transmitted disease, combined with the high costs and heavy marketing of these vaccines, has led to a certain amount of controversy.