Drugs

, Volume 70, Issue 9, pp 1079–1098 | Cite as

Human Papillomavirus Vaccines

Current Status and Future Prospects
Current Opinion

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.

Notes

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.

References

  1. 1.
    de Sanjosé S, Diaz M, Castellsagué X, et al. Worldwide prevalence and genotype distribution of cervical human papillomavirus DNA in women with normal cytology: a meta-analysis. Lancet 2007 Jul; 7: 453–9CrossRefGoogle Scholar
  2. 2.
    Smith JS, Lindsay L, Hoots B, et al. Human papillomavirus type distribution in invasive cervical cancer and high-grade cervical lesions: a meta-analysis update. Int J Cancer 2007 Aug 1; 121(3): 621–32PubMedCrossRefGoogle Scholar
  3. 3.
    Castellsague X, Diaz M, de Sanjosé S, et al. Worldwide human papillomavirus etiology of cervical adenocarcinoma and its cofactors: implications for screening and prevention. J Natl Cancer Inst 2006 Mar 1; 98(5): 303–15PubMedCrossRefGoogle Scholar
  4. 4.
    Clifford GM, Rana RK, Franceschi S, et al. Human papillomavirus genotype distribution in low-grade cervical lesions: comparison by geographic region and with cervical cancer. Cancer Epidemiol Biomarkers Prev 2005 May; 14(5): 1157–64PubMedCrossRefGoogle Scholar
  5. 5.
    Khan MJ, Castle PE, Lorincz AT, et al. The elevated 10-year risk of cervical precancer and cancer in women with human papillomavirus (HPV) type 16 or 18 and the possible utility of type-specific HPV testing in clinical practice. J Natl Cancer Inst 2005 Jul 20; 97(14): 1072–9PubMedCrossRefGoogle Scholar
  6. 6.
    Smith JS, Backes DM, Hoots BE, et al. Human papillomavirus type-distribution in vulvar and vaginal cancers and their associated precursors. Obstet Gynecol 2009 Apr; 113(4): 917–24PubMedGoogle Scholar
  7. 7.
    Hoots BE, Palefsky JM, Pimenta JM, et al. Human papillomavirus type distribution in anal cancer and anal intraepithelial lesions. Int J Cancer 2009; 124(10): 2375–83PubMedCrossRefGoogle Scholar
  8. 8.
    Backes DM, Kurman RJ, Pimenta JM, et al. Systematic review of human papillomavirus prevalence in invasive penile cancer. Cancer Causes Control 2009 May; 20(4): 449–57PubMedCrossRefGoogle Scholar
  9. 9.
    Bouvard V, Baan R, Sraif K, et al., WHO International Agency for Research on Cancer Monograph Working Group. A review of human carcinogens. Part B: biological agents. Lancet Oncol 2009; 10: 321–2PubMedCrossRefGoogle Scholar
  10. 10.
    D’Souza G, Kreimer AR, Viscidi R, et al. Case-control study of human papillomavirus and oropharyngeal cancer. N Engl J Med 2007 May 10; 356(19): 1944–56PubMedCrossRefGoogle Scholar
  11. 11.
    Shah KV. Do human papillomavirus infections cause oral cancer? J Natl Cancer Inst 1998 Nov 4; 90(21): 1585–6PubMedCrossRefGoogle Scholar
  12. 12.
    Department of Health and Human Services, Centers for Disease Control and Prevention. Genital HPV infection — CDC fact sheet [online]. Available from URL: http://www.cdc.gov/STD/HPV/STDFact-HPV.htm [Accessed 2010 Apr 17]
  13. 13.
    Schiffman M, Castle PE, Jeronimo J, et al. Human papillomavirus and cervical cancer. Lancet 2007; 370(9590): 890–907PubMedCrossRefGoogle Scholar
  14. 14.
    Collins S, Mazloomzadeh S, Winter H, et al. High incidence of cervical human papillomavirus infection in women during their first sexual relationship. BJOG 2002 Jan; 109(1): 96–8PubMedCrossRefGoogle Scholar
  15. 15.
    Ho G, Bierman R, Beardsley L, et al. Natural history of cervicovaginal papillomavirus infection in young women. N Engl J Med 1998; 338: 423–8PubMedCrossRefGoogle Scholar
  16. 16.
    Burchall AN, Tellier P-P, Hanley J, et al. Human papillomavirus infections among couples in new sexual relationships. Epidemiology 2010; 21(1): 31–7CrossRefGoogle Scholar
  17. 17.
    Carter JJ, Koutsky LA, Hughes JP, et al. Comparison of human papillomavirus types 16, 18, and 6 capsid antibody responses following incident infection. J Infect Dis 2000 Jun; 181(6): 1911–9PubMedCrossRefGoogle Scholar
  18. 18.
    Koshiol J, Lindsay L, Pimenta JM, et al. Persistent human papillomavirus infection and cervical neoplasia: a systematic review and meta-analysis. Am J Epidemiol 2008 Jul 15; 168(2): 123–37PubMedCrossRefGoogle Scholar
  19. 19.
    Belinson S, Smith JS, Myers E, et al. Descriptive evidence that risk profiles for cervical intraepithelial neoplasia 1, 2, and 3 are unique. Cancer Epidemiol Biomarkers Prev 2008; 17(9): 2350–5PubMedCrossRefGoogle Scholar
  20. 20.
    Castle PE, Stoler MH, Solomon D, et al. The relationship of community biopsy-diagnosed cervical intraepithelial neoplasia grade 2 to the quality control pathology-reviewed diagnoses: an ALTS report. Am J Clin Pathol 2007; 127(5): 805–15PubMedCrossRefGoogle Scholar
  21. 21.
    McCredie MR, Sharples KJ, Paul C, et al. Natural history of cervical neoplasia and risk of invasive cancer in women with cervical intraepithelial neoplasia 3: a retrospective cohort study. Lancet Oncol 2008 May; 9(5): 425–34PubMedCrossRefGoogle Scholar
  22. 22.
    Bosch F, Lorincz A, Munoz N, et al. The causal relation between human papillomavirus and cervical cancer. J Clin Pathol 2002; 55: 244–65PubMedCrossRefGoogle Scholar
  23. 23.
    Simonato L, Agudo A, Ahrens W, et al. Lung cancer and cigarette smoking in Europe: an update of risk estimates and an assessment of inter-country heterogeneity. Int J Cancer 2001; 91: 876–87PubMedCrossRefGoogle Scholar
  24. 24.
    Castellsague X, Munoz N. Chapter 3: cofactors in human papillomavirus carcinogenesis. Role of parity, oral contraceptives, and tobacco smoking. J Natl Cancer Inst Monogr 2003; (31): 20–8Google Scholar
  25. 25.
    Smith JS, Bosetti C, Munoz N, et al. Chlamydia trachomatis and invasive cervical cancer: a pooled analysis of the IARC multicentric case-control study. Int J Cancer 2004 Sep 1; 111(3): 431–9PubMedCrossRefGoogle Scholar
  26. 26.
    Smith JS, Herrero R, Bosetti C, et al. Herpes simplex virus-2 as a human papillomavirus cofactor in the etiology of invasive cervical cancer. J Natl Cancer Inst 2002 Nov 6; 94(21): 1604–13PubMedCrossRefGoogle Scholar
  27. 27.
    Garland SM, Steben M, Sings HL, et al. Natural history of genital warts: analysis of the placebo arm of 2 randomized phase III trials of a quadrivalent human papillomavirus (types 6, 11, 16, and 18) vaccine. J Infect Dis 2009 Mar 15; 199(6): 805–14PubMedCrossRefGoogle Scholar
  28. 28.
    Somers GR, Tabrizi SN, Borg AJ, et al. Juvenile laryngeal papillomatosis in a pediatric population: a clinicopathologic study. Pediatr Pathol Lab Med 1997 Jan; 17(1): 53–64PubMedCrossRefGoogle Scholar
  29. 29.
    Garland SM, Tabrizi S. HPV DNA testing: potential clinical applications. Int J Health Prom Edu 2006; 44: 107–12Google Scholar
  30. 30.
    Harper DM, Franco EL, Wheeler CM, et al. Sustained efficacy up to 4.5 years of a bivalent L1 virus-like particle vaccine against human papillomavirus types 16 and 18: follow-up from a randomised control trial. Lancet 2006 Apr 15; 367(9518): 1247–55PubMedCrossRefGoogle Scholar
  31. 31.
    Villa LL, Costa RL, Petta CA, et al. High sustained efficacy of a prophylactic quadrivalent human papillomavirus types 6/11/16/18 L1 virus-like particle vaccine through 5 years of follow-up. Br J Cancer 2006 Dec 4; 95(11): 1459–66PubMedCrossRefGoogle Scholar
  32. 32.
    Brown DR, Garland SM. Cervical cancer vaccines. PPO Updates; Principles and Practice of Oncology 2008; 22(4): 1–12Google Scholar
  33. 33.
    Villa LL, Ault KA, Giuliano AR, et al. Immunologic responses following administration of a vaccine targeting human papillomavirus types 6, 11, 16, and 18. Vaccine 2006 Jul 7; 24(27–28): 5571–83PubMedCrossRefGoogle Scholar
  34. 34.
    Hagensee ME, Yaegashi N, Galloway DA, et al. Self-assembly of human papillomavirus type 1 capsids by expression of the L1 protein alone or by coexpression of the L1 and L2 capsid proteins. J Virol 1993; 67(1): 315–22PubMedGoogle Scholar
  35. 35.
    Rose RC, Bonnez W, Reichman RC, et al. Expression of human papillomavirus type 11 L1 protein in insect cells: in vivo and in vitro assembly of viruslike particles. J Virol 1993; 67(4): 1936–44PubMedGoogle Scholar
  36. 36.
    Garland SM, Hernandez AM, Wheeler CM, et al. Quadrivalent vaccine against human papillomavirus to prevent anogenital diseases. N Engl J Med 2007; 356(19): 1928–43PubMedCrossRefGoogle Scholar
  37. 37.
    Ault KA. Effect of prophylactic human papillomavirus L1 virus-like-particle vaccine on risk of cervical intraepithelial neoplasia grade 2, grade 3, and adenocarcinoma in situ: a combined analysis of four randomised clinical trials. Lancet 2007; 369(9576): 1861–8PubMedCrossRefGoogle Scholar
  38. 38.
    Muñoz N, Kjaer SK, Sigurdsson K, et al. Impact of human papillomavirus (HPV)-6/11/16/18 vaccine on all HPV-associated genital diseases in young women. J Natl Cancer Inst 2010; 102(5): 325–39PubMedCrossRefGoogle Scholar
  39. 39.
    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 Jul 29; 374(9686): 301–14PubMedCrossRefGoogle Scholar
  40. 40.
    Paavonen J, Jenkins D, Bosch FX, et al. Efficacy of a prophylactic adjuvanted bivalent L1 virus-like-particle vaccine against infection with human papillomavirus types 16 and 18 in young women: an interim analysis of a phase III double-blind, randomised controlled trial. Lancet 2007 Jun 30; 369(9580): 2161–70PubMedCrossRefGoogle Scholar
  41. 41.
    Joura EA, Kjaer SK, Wheeler CM, et al. HPV antibody levels and clinical efficacy following administration of a prophylactic quadrivalent HPV vaccine. Vaccine 2008 Dec 9; 26(52): 6844–51PubMedCrossRefGoogle Scholar
  42. 42.
    FUTURE II Study Group. Quadrivalent vaccine against human papillomavirus to prevent high-grade cervical lesions. N Engl J Med 2007; 356: 1915–27CrossRefGoogle Scholar
  43. 43.
    Joura EA, Leodolter S, Hernandez-Avila M, et al. Efficacy of a quadrivalent prophylactic human papillomavirus (types 6, 11, 16, and 18) L1 virus-like-particle vaccine against high-grade vulval and vaginal lesions: a combined analysis of three randomised clinical trials. Lancet 2007; 369(9574): 1693–702PubMedCrossRefGoogle Scholar
  44. 44.
    Ceravix prescribing information [online]. Available from URL: http://us.gsk.com/products/assets/us_cervarix.pdf [Accessed 2010 May 20]
  45. 45.
    Olsson S-E, Kjaer SK, Sigurdsson K, et al. Evaluation of quadrivalent HPV 6/11/16/18 vaccine efficacy against cervical and external anogenital disease in subjects with prior vaccine HPV type infection. Hum Vaccin 2009; 5(10): 696–704PubMedCrossRefGoogle Scholar
  46. 46.
    Haupt RM, Sattler C. HPV vaccine continues to be safe and effective, and its benefits continue to outweigh its risks [letter]. Expert Rev Vaccines. In pressGoogle Scholar
  47. 47.
    Muñoz N, Manalastas R, Pitisuttithum P, et al. Safety, immunogenicity, and efficacy of quadrivalent human papilloma virus (types 6, 11, 16, 18) recombinant vaccine in women aged 24–45 years: a randomised, double-blind trial. Lancet 2009; 373: 1949–57PubMedCrossRefGoogle Scholar
  48. 48.
    Pagliusi SR, Teresa AM. Efficacy and other milestones for human papillomavirus vaccine introduction. Vaccine 2004 Dec 16; 23(5): 569–78PubMedCrossRefGoogle Scholar
  49. 49.
    Brown DR, Kjaer SK, Sigurdsson K, et al. The impact of quadrivalent human papillomavirus (HPV; types 6, 11, 16, and 18) L1 virus-like particle vaccine on infection and disease due to oncogenic nonvaccine HPV types in generally HPV-naive women aged 16–26 years. J Infect Dis 2009 Apr 1; 199(7): 926–35PubMedCrossRefGoogle Scholar
  50. 50.
    Skinner R, Apter DL, Chow SN, et al., for the HPV PATRICIA Study Group. Cross protective efficacy of CERVARIX against oncogenic HPV types beyond HPV-16/18 [abstract no. O-29.01]. 25th International Papillomavirus Conference; 2009 May 8–14; MalmoGoogle Scholar
  51. 51.
    Garland SM, Steben M, Hernandez-Avila M, et al. Non-inferiority of antibody response to human papillomavirus type 16 in subjects vaccinated with monovalent and quadrivalent L1 virus-like particle vaccines. Clin Vaccine Immunol 2007 Jun; 14(6): 792–5PubMedCrossRefGoogle Scholar
  52. 52.
    Wheeler CM, Bautista OM, Tomassini JE, et al. Safety and immunogenicity of co-administered quadrivalent human papillomavirus (HPV)-6/11/16/18 L1 virus-like particle (VLP) and hepatitis B (HBV) vaccines. Vaccine 2008 Jan 30; 26(5): 686–96PubMedCrossRefGoogle Scholar
  53. 53.
    Zoler ML. Vaccine combinations appear safe, effective. Pediatric News 2009 Dec [online]. Available from URL: http://findarticles.com/p/articles/mi_hb4384/is_12_43/ai_n47564588/ [Accessed 2010 May 11]
  54. 54.
    Lehtinen M, Idanpaan-Heikkila I, Lunnas T, et al. Population-based enrolment of adolescents in a long-term follow-up trial of human papillomavirus vaccine efficacy. Int J STD AIDS 2006 Apr; 17(4): 237–46PubMedCrossRefGoogle Scholar
  55. 55.
    Lehtinen M, Apter D, Dubin G, et al. Enrolment of 22,000 adolescent women to cancer registry follow-up for long-term human papillomavirus vaccine efficacy: guarding against guessing. Int J STD AIDS 2006 Aug; 17(8): 517–21PubMedCrossRefGoogle Scholar
  56. 56.
    Stanley M. Immune responses to human papillomavirus. Vaccine 2006 Mar 30; 24 Suppl. 1: S16–22PubMedCrossRefGoogle Scholar
  57. 57.
    Rowhani-Rahbar A, Mao C, Hughes JP, et al. Longer term efficacy of a prophylactic monovalent human papillomavirus type 16 vaccine. Vaccine 2009; 27(41): 5612–9PubMedCrossRefGoogle Scholar
  58. 58.
    Olsson SE, Villa LL, Costa RL, et al. Induction of immune memory following administration of a prophylactic quadrivalent human papillomavirus (HPV) types 6/11/16/18 L1 virus-like particle (VLP) vaccine. Vaccine 2007 Jun 21; 25(26): 4931–9PubMedCrossRefGoogle Scholar
  59. 59.
    Banatvala J, Van DP, Oehen S. Lifelong protection against hepatitis B: the role of vaccine immunogenicity in immune memory. Vaccine 2000 Nov 22; 19(7–8): 877–85PubMedCrossRefGoogle Scholar
  60. 60.
    McMahon BJ, Dentinger CM, Bruden D, et al. Antibody levels and protection after hepatitis B vaccine: results of a 22-year follow-up study and response to a booster dose. J Infect Dis 2009; 200: 1390–6PubMedCrossRefGoogle Scholar
  61. 61.
    Ferguson M, Heath A, Johnes S, et al. Results of the first WHO international collaborative study on the standardization of the detection of antibodies to human papillomaviruses. Int J Cancer 2006 Mar 15; 118(6): 1508–14PubMedCrossRefGoogle Scholar
  62. 62.
    Einstein MH, Baron M, Levin MJ, et al. Comparison of the immunogenicity and safety of Cervarix™ and Gardasil® human papillomavirus (HPV) cervical cancer vaccines in healthy women aged 18–45 years. Hum Vaccin 2009; 5(10): 705–19PubMedCrossRefGoogle Scholar
  63. 63.
    Pastrana DV, Buck CB, Pang YY, et al. Reactivity of human sera in a sensitive, high-throughput pseudovirus-based papillomavirus neutralization assay for HPV16 and HPV18. Virology 2004 Apr 10; 321(2): 205–16PubMedCrossRefGoogle Scholar
  64. 64.
    Quint W, Molijn A, Colau B, et al. One HPV virus, one lesion as determined by LCM/PCR technology [abstract no. O-06.05]. 25th International Papillomavirus Conference; 2009 May 8–14; MalmoGoogle Scholar
  65. 65.
    Andrus JK, Sherris J, Fitzsimmons JW, et al. Introduction of human papillomavirus vaccines into developing countries: international strategies for funding and procurement. Vaccine 2008 Aug 19; 26 Suppl. 10: K87–92PubMedCrossRefGoogle Scholar
  66. 66.
    Block SL, Nolan T, Sattler C, et al. Comparison of the immunogenicity and reactogenicity of a prophylactic quadrivalent human papillomavirus (types 6, 11, 16, and 18) L1 virus-like particle vaccine in male and female adolescents and young adult women. Pediatrics 2006 Nov; 118(5): 2135PubMedCrossRefGoogle Scholar
  67. 67.
    Pedersen C, Petaja T, Strauss G, et al., HPV Vaccine Adolescent Study Investigators Network. Immunization of early adolescent females with human papillomavirus type 16 and 18 L1 virus-like particle vaccine containing AS04 adjuvant. J Adolesc Health 2007; 40(6): 564–71PubMedCrossRefGoogle Scholar
  68. 68.
    ACIP provisional Recommendations for HPV vaccine. Date of ACIP vote: October 21, 2009. Date of posting of provisional recommendations: December 1, 2009 [online]. Available from URL: http://www.cdc.gov/vaccines/recs/provisional/downloads/hpv-vac-dec2009-508.pdf [Accessed 2010 May 12]
  69. 69.
    Wright Jr TC, Huh WK, Monk BJ, et al. Age considerations when vaccinating against HPV. Gynecol Oncol 2008 May; 109 (2 Suppl.): S40–7PubMedCrossRefGoogle Scholar
  70. 70.
    Shefer A, Markowitz L, Deeks S, et al. Early experience with human papillomavirus vaccine introduction in the United States, Canada and Australia. Vaccine 2008 Aug 19; 26 Suppl. 10: K68–75PubMedCrossRefGoogle Scholar
  71. 71.
    Brotherton JM, Deeks SL, Campbell-Lloyd S, et al. Interim estimates of human papillomavirus vaccination coverage in the school-based program in Australia. Commun Dis Intell 2008; 32: 457–61PubMedGoogle Scholar
  72. 72.
    Garland SM, Brotherton JM, Skinner SR, et al. Human papillomavirus and cervical cancer in Australasia and Oceania: risk-factors, epidemiology and prevention. Vaccine 2008 Aug 19; 26 Suppl. 12: M80–8PubMedCrossRefGoogle Scholar
  73. 73.
    Fairley C, Hocking J, Chen M, et al. Rapid decline in warts after national quadrivalent HPV vaccine program. Sex Transm Infect 2009; 85: 499–502PubMedCrossRefGoogle Scholar
  74. 74.
    Centers for Disease Control and Prevention. National, state, and local area vaccination coverage among adolescents aged 13–17 years: United States 2008. MMWR Morb Mortal Wkly Rep 2009; 58(36): 997–1001Google Scholar
  75. 75.
    Immunization Action Coalition. State mandates on immunization and vaccine-preventable diseases [online]. Available from URL: http://www.immunize.org/laws [Accessed 2010 Apr 16]
  76. 76.
    Virginia Department of Health. School requirements: school and day care minimum immunization requirements [online]. Available from URL: http://www.vdh.state.va.us/epidemiology/immunization/requirements.htm [Accessed 2010 Apr 16]
  77. 77.
    Gottlieb SL, Brewer NT, Sternberg MR, et al. Availability of human papillomavirus vaccine at medical practices in an area with elevated rates of cervical cancer. J Adolescent Health 2009 Nov; 45(5): 438–44CrossRefGoogle Scholar
  78. 78.
    Kahn JA, Cooper HP, Vadaparampil ST, et al. Human papillomavirus vaccine recommendations and agreement with mandated human papillomavirus vaccination for 11-to-12-year-old girls: a statewide survey of Texas physicians. Cancer Epidemiol Biomarkers Prev 2009 Aug; 18(8): 2325–32PubMedCrossRefGoogle Scholar
  79. 79.
    UK Department of Health. Immunisation [online]. Available from URL: http://www.dh.gov.uk/en/Publichealth/Healthprotection/Immunisation/index.htm [Accessed 2010 May 20]
  80. 80.
    Smith JS, Melendy A, Rana RK, et al. Age-specific prevalence of infection with human papillomavirus in females: a global review. J Adolesc Health 2008 Oct; 43 (4 Suppl.): S5–25PubMedCrossRefGoogle Scholar
  81. 81.
    Hildesheim A, Herrero R, Wacholder S, et al. Effect of human papillomavirus 16/18 L1 viruslike particle vaccine among young women with preexisting infection: a randomized trial. JAMA 2007 Aug 15; 298(7): 743–53PubMedCrossRefGoogle Scholar
  82. 82.
    Pitts MK, Dyson SJ, Rosenthal DA, et al. Knowledge and awareness of human papillomavirus (HPV): attitudes towards HPV vaccination among a representative sample of women in Victoria, Australia. Sex Health 2007 Sep; 4(3): 177–80PubMedCrossRefGoogle Scholar
  83. 83.
    Giles M, Garland S. A study of women’s knowledge regarding human papillomavirus infection, cervical cancer and human papillomavirus vaccines. Aust N Z J Obstet Gynaecol 2006 Aug; 46(4): 311–5PubMedCrossRefGoogle Scholar
  84. 84.
    Pitts M, Smith A, Croy S, et al. Singaporean men’s knowledge of cervical cancer and human papillomavirus (HPV) and their attitudes towards HPV vaccination. Vaccine 2009; 27(22): 2989–93PubMedCrossRefGoogle Scholar
  85. 85.
    Pitts M, Smith A, Croy S, et al. Singaporean women’s knowledge of human papillomavirus (HPV) and attitudes toward HPV vaccination. Women Health 2009; 49(4): 334–51PubMedCrossRefGoogle Scholar
  86. 86.
    Garland SM, Quinn MA. How to manage and communicate with patients about HPV? Int J Gynecol Obstet 2006; 90: S104–10Google Scholar
  87. 87.
    Descamps D, Hardt K, Spiessens B, et al. Safety of human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine for cervical cancer prevention: a pooled analysis of 11 clinical trials. Hum Vaccin 2009 May 20; 5(5): 332–40PubMedCrossRefGoogle Scholar
  88. 88.
    Brotherton JM, Gold MS, Kemp AS, et al. Anaphylaxis following quadrivalent human papillomavirus vaccination. CMAJ 2008 Sep 9; 179(6): 525–33PubMedCrossRefGoogle Scholar
  89. 89.
    Kang LW, Crawford N, Tang ML, et al. Hypersensitivity reactions to human papillomavirus vaccine in Australian schoolgirls: retrospective cohort study. BMJ 2008; 337: a2642PubMedCrossRefGoogle Scholar
  90. 90.
    World Health Organization. Weekly epidemiological record. 2009 Jan 30 [online]. Available from URL: http://www.who.int/wer/2009/wer8405.pdf [Accessed 2010 Apr 16]
  91. 91.
    Slade BA, Leidel L, Vellozzi CWE, et al. Postlicensure safety surveillance for quadrivalent human papillomavirus recombinant vaccine. JAMA 2009; 302(7): 750–7PubMedCrossRefGoogle Scholar

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© Adis Data Information BV 2010

Authors and Affiliations

  1. 1.Department of Microbiology and Infectious DiseasesRoyal Women’s HospitalMelbourneAustralia
  2. 2.Department of Obstetrics and GynaecologyUniversity of MelbourneMelbourneAustralia
  3. 3.Department of Epidemiology, Gillings School of Global Public HealthUniversity of North CarolinaChapel HillUSA

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