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Chapter 53 - HPV Immunization

from Section 11 - Public Health Issues in Gynaecology

Published online by Cambridge University Press:  24 November 2021

By
Antonios Athanasiou  and
Ilkka Kalliala
Edited by
Tahir Mahmood ,
Charles Savona-Ventura ,
Ioannis Messinis  and
Sambit Mukhopadhyay
Tahir Mahmood
Affiliation:
Victoria Hospital, Kirkcaldy
Charles Savona-Ventura
Affiliation:
University of Malta, Malta
Ioannis Messinis
Affiliation:
University of Thessaly, Greece
Sambit Mukhopadhyay
Affiliation:
Norfolk & Norwich University Hospital, UK
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Summary

Vaccines against HPV are highly efficacious in preventing infection and disease in the cervix, vulva, anus, oropharynx as well as the anogenital warts caused by HPV types included in the vaccine cocktail. The efficacy is optimal if vaccines are given in prepubertal girls and boys before coitarche, while it remains an individual choice for older women. Vaccination is efficacious in women who have been infected but cleared the infection, although the upper age of vaccination depends on cost-effectiveness and is country-specific. School-based gender-neutral vaccination optimizes coverage and herd immunity. Two doses suffice under the age of 15 with an interval of 6–12 months, while the standard three-dose regimen is recommended thereafter. Vaccine will modify screening strategies, possibly with longer screening intervals in vaccinated cohorts, but will not obviate them. Vaccination in low-resource setting is especially important as lack of infrastructure prevents screening, but affordability remains a major issue.

Keywords

HPVimmunizationcervical cancervaccineprevention
Type
Chapter
Information
The EBCOG Postgraduate Textbook of Obstetrics & Gynaecology
Gynaecology
 , pp. 457 - 466
Publisher: Cambridge University Press
Print publication year: 2021

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