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Human Papillomavirus Vaccines

Current Status and Future Prospects

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Abstract

Worldwide, cervical cancer is the second most common cancer of women. Less-developed countries bear the greatest burden in terms of morbidity and mortality, largely due to the lack of organized screening programmes. Cervical cancer is the first cancer shown to be caused solely by virological agents: oncogenic genotypes of human papillomavirus (HPV). Two recently developed prophylactic cervical cancer vaccines, which are based on viral-like particle (VLP) technology of HPV, have the capacity to diminish a large proportion of cervical cancer cases worldwide. However, to be successful public health tools, they need to be widely implemented to the appropriate target population, preferably prior to first sexual intercourse. To increase vaccination coverage, national programmes in some countries have also included catch-up vaccination, for a limited time period, to young adult women aged up to 26 years. Despite the excellent efficacy for high-grade dysplasia due to vaccine-related HPV types (near to 100%) and immunogenicity induced against the HPV types 16 and 18 in females naive to those HPV types pre-vaccination, some form of cervical precancer screening will still be necessary. Immunity to HPV is primarily type specific, and thus protection induced by the current generation of vaccines, based on a limited number of HPV VLP types, cannot provide complete protection against all oncogenic HPV types. Both these vaccines translate to protection of cervical cancer in the order of 70–75%, which represents the percentage of invasive cancers attributable to HPV-16 and -18. Challenges to ensuring the successful control of this largely preventable disease include endorsement by governments and policy makers, affordable prices, education at all levels, overcoming barriers to vaccination and continued adherence to screening programmes.

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Acknowledgements

We would like to acknowledge Ms Yuli Chang (University of North Carolina, Gillings School of Global Public Health) for her assistance in the preparation of this manuscript. No sources of funding were used to assist in the preparation of this review. SMG has received advisory board fees and grant support from Commonwealth Serum Laboratories and GlaxoSmithKline (GSK), and lecture and consultancy fees from Merck and Co. SMG reports having previously owned stock in Commonwealth Serum Laboratories. SMG has received grant support through her institution from Merck and Co. and GSK to perform clinical trials for HPV/cervical cancer vaccines. SMG also reports being a member of the Merck Global Advisory Board and Scientific Advisory Committee. JSS has received advisory board fees from GSK, and grant support from GSK and Merck and Co.

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  1. Department of Microbiology and Infectious Diseases, Royal Women’s Hospital, Locked Bag 300, Parkville, Melbourne, Victoria, 3052, Australia

    Suzanne M. Garland

  2. Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia

    Suzanne M. Garland

  3. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA

    Jennifer S. Smith

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Garland, S.M., Smith, J.S. Human Papillomavirus Vaccines. Drugs 70, 1079–1098 (2010). https://doi.org/10.2165/10898580-000000000-00000

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