HPV Vaccine Uptake: Challenges and Opportunities

 

Welcome to the fourth episode of the STI BMJ 2021 Podcast series. Please join Dr. Fabiola Martin in interviewing Professors Anna Maria Geretti, Carlo Giaquinto, and Ian Frazer about human papillomavirus vaccines and vaccination programmes.

The first HPV vaccine was approved in 2006. Fifteen years later, more than 100 countries have added the vaccine to routine childhood vaccination schedules. Reflecting the high vaccine efficacy in preventing infection with cancer-inducing HPV types, the World Health Organization is aiming for the elimination of cervical cancer by 2030.

Is this target too ambitious?

Despite the established benefits and good tolerability of HPV vaccines, some countries are seeing sluggish uptake of the first dose, with coverage falling further for subsequent doses. In this podcast, we hear about the falling vaccine uptake in Italy and the successful vaccine roll-out in Australia. What can we learn from these experiences?

Join us in this episode of STI Podcast here!

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Facts:

  • Human papilloma virus consists of a DNA genome enclosed in a protein coat which is composed of the viral proteins L1 and L2. Available HPV vaccines are made of L1 proteins assembled to resemble empty virus particles. They are described as virus-like particles (VLP) but are not live virus and do not contain viral DNA.
  • There are over 100 HPV types. Some cause benign infections such as genital warts. Certain high-risk HPV types such as 16 and 18 can cause cancers of the uterine cervix (womb) in women, as well as cancers of the anal canal, vulva, penis, mouth and throat. Available vaccines all target HPV-16 and HPV-18, with one also targeting seven other HPV types.
  • Cancer registries report a decreased morbidity and mortality attributed to HPV-related cancers as a direct consequence of the introduction of HPV vaccination programmes. Many millions of doses have been administered without significant safety flags.
  • In Italy though there has been a decline in HPV vaccine uptake over the last years. Conversely, Australia reports excellent coverage in school-age girls and boys. Some simple, practical measures may be helpful in boosting coverage, such as ongoing information sharing with colleagues and the community about the benefits of vaccination, and for health care providers not to overlook opportunities to check that young people have received their complete vaccine series.
  • Meanwhile, work on HPV vaccine development continues. Current research focuses on new vaccine platforms (e.g., adenovirus-vectored DNA or mRNA) and broad-spectrum vaccines, thus overcoming two limitations of available HPV vaccines: high cost and restricted coverage of HPV types.

 

Additional Resources

Human papillomavirus (HPV) vaccination and oropharyngeal HPV in ethnically diverse, sexually active adolescents: community-based cross-sectional study

Epidemiology of genital warts in the British population: implications for HPV vaccination programmes

Baseline HPV prevalence in rectal swabs from men attending a sexual health clinic in Scotland: assessing the potential impact of a selective HPV vaccination programme for men who have sex with men

HPV vaccination of gay, bisexual and other men who have sex with men in sexual health and HIV clinics in England: vaccination uptake and attendances during the pilot phase

HPV16 and HPV18 seropositivity and DNA detection among men who have sex with men: a cross-sectional study conducted in a sexual health clinic in London.

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