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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Obstet Gynecol. Feb 10, 2016; 5(1): 5-15
Published online Feb 10, 2016. doi: 10.5317/wjog.v5.i1.5
Update on human papillomavirus vaccination: Where are we now?
Eloise Chapman-Davis, Lauren E Dockery, Kendall Griffith, Caroline Stroup
Eloise Chapman-Davis, Lauren E Dockery, Kendall Griffith, Caroline Stroup, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Tufts University School of Medicine, Tufts Medical Center, Boston, MA 02111, United States
Author contributions: Chapman-Davis E and Dockery LE contributed equally to this work with literature search, text and tables; Griffith K and Stroup C contributed to literature search and tables in certain sections of the review; Chapman-Davis E and Dockery LE made several critical corrections and revisions until the submitted version was achieved.
Conflict-of-interest statement: The above-mentioned authors of this manuscript hereby declare that they do not have any conflict-of-interest (including but not limited to commercial, personal, political, intellectual, or religious interests) related to the work submitted herein.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Eloise Chapman-Davis, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Tufts University School of Medicine, Tufts Medical Center, 800 Washington Street #232, Boston, MA 02111, United States. eloise.chapman@gmail.com
Telephone: +1-617-6366058 Fax: +1-617-6363258
Received: June 29, 2015
Peer-review started: July 3, 2015
First decision: September 22, 2015
Revised: October 16, 2015
Accepted: November 24, 2015
Article in press: November 25, 2015
Published online: February 10, 2016
Processing time: 216 Days and 8.1 Hours
Abstract

Infection with human papillomavirus (HPV) is the major cause of pre-invasive and invasive lesions of the urogenital tract, resulting in morbidity and mortality worldwide. HPV-related infection is responsible for most cases of cervical cancer, a leading cause of cancer death in women worldwide. Developed countries have screening programs in place to detect precancerous lesions at early stages; in resource-limited settings however, HPV related diseases are often identified in advanced stages. This is due to limitations in the availability and roll out of effective screening programs. The relatively recent availability of the HPV vaccine has provided a new public health opportunity to decrease the incidence of HPV-related disease. The high mortality rates seen in developing countries could be reduced through effective implementation of HPV vaccination programs. Large trials have proven the efficacy of bivalent, quadrivalent vaccine and most recently 9-valent vaccine. Uptake in vaccination remains low due to multiple barriers including lack of education, lack of access, and costs. New strategies are being assessed to increase access, increase knowledge and reduce costs that may result in feasible vaccination programs worldwide. The goal of this article is to review the effectiveness and safety of the current HPV vaccines available, vaccine delivery strategies, cost effectiveness, and efforts to improve the acceptability. A literature search was conducted through PubMed using the terms “HPV vaccination, and safety, and males, and acceptability and strategies, and cost effectiveness,”focusing on articles published between 2006 and 2015. The most relevant and larger scale trials were evaluated for discussion.

Keywords: Human papillomavirus; Vaccines; Cervical cancer; Cancer prevention; Public health

Core tip: Human papilloma virus (HPV) represents the major cause of pre-invasive and invasive lesions of the urogenital tract. This article will review the efficacy, safety and approval of the currently available vaccines against HPV including the bivalent, quadrivalent and nine-valent vaccines. Indications for use in men, immunocompromised individuals and older cohorts will also be discussed. Additionally a summary of worldwide vaccination practices, cost effectiveness, vaccination and methods to improve vaccination uptake and acceptance will be reviewed.