HPV vaccine

Human papillomavirus (HPV) vaccines are vaccines intended to provide acquired immunity against infection by certain types of human papillomavirus. The first HPV vaccine became available in 2006. Currently there are six licensed HPV vaccines: three bivalent (protect against two types of HPV), two quadrivalent (against four), and one nonavalent vaccine (against nine) All have excellent safety profiles and are highly efficacious, or have met immunobridging standards.^: 668 All of them protect against HPV types 16 and 18, which are together responsible for approximately 70% of cervical cancer cases globally. The quadrivalent vaccines provide additional protection against HPV types 6 and 11. The nonavalent provides additional protection against HPV types 31, 33, 45, 52 and 58. It is estimated that HPV vaccines may prevent 70% of cervical cancer, 80% of anal cancer, 60% of vaginal cancer, 40% of vulvar cancer, and show more than 90% effectiveness in preventing HPV-positive oropharyngeal cancers. They also protect against penile cancer. They additionally prevent genital warts (also known as anogenital warts), with the quadrivalent and nonavalent vaccines providing virtually complete protection. The WHO recommends a one or two-dose schedule for girls aged 9–14 years, the same for girls and women aged 15–20 years, and two doses with a 6-month interval for women older than 21 years. The vaccines provide protection for at least five to ten years.

The primary target group in most of the countries recommending HPV vaccination is young adolescent girls, aged 9–14. The vaccination schedule depends on the age of the vaccine recipient. As of 2023, 27% of girls aged 9–14 years worldwide received at least one dose (37 countries were implementing the single-dose schedule, 45% of girls aged 9–14 years old vaccinated in that year). As of September 2024, 57 countries are implementing the single-dose schedule. At least 144 countries (at least 74% of WHO member states) provided the HPV vaccine in their national immunization schedule for girls, as of November 2024. As of 2022, 47 countries (24% of WHO member states) also did it for boys.^: 654 Vaccinating a large portion of the population may also benefit the unvaccinated by way of herd immunity.

The HPV vaccine is on the World Health Organization's List of Essential Medicines. The World Health Organization (WHO) recommends HPV vaccines as part of routine vaccinations in all countries, along with other prevention measures. The WHO's priority purpose of HPV immunization is the prevention of cervical cancer, which accounts for 82% of all HPV-related cancers and more than 95% of which are caused by HPV. 88% (2020 figure) of cervical cancers and 90% of deaths occur in low- and middle-income countries and 2% (2020 figure) in high-income countries.^: 650 The WHO-recommended primary target population for HPV vaccination is girls aged 9–14 years before they become sexually active.^: 669 It aims the introduction of the HPV vaccine in all countries and has set a target of reaching a coverage of 90% of girls fully vaccinated with HPV vaccine by age 15 years. Females aged ≥15 years, boys, older males or men who have sex with men (MSM) are secondary target populations. HPV vaccination is the most cost-effective public health measure against cervical cancer, particularly in resource-constrained settings.^: 666 Cervical cancer screening is still required following vaccination.