Evaluating the impact of human papillomavirus vaccines

• Published in: Vaccine 2009-07, Vol.27 (32), p.4355-4362
• Main Authors: Chang, Yuli, Brewer, Noel T, Rinas, Allen C, Schmitt, Karla, Smith, Jennifer S
• Format: Article
• Language: English
• Subjects: Allergy and Immunology; Applied microbiology; Biological and medical sciences; Cervical abnormalities; Cervical cancer; Female; Fundamental and applied biological sciences. Psychology; HPV vaccine effectiveness; Human papillomavirus; Humans; Immunization; Medical sciences; Microbiology; Miscellaneous; Papillomaviridae - classification; Papillomaviridae - immunology; Papillomaviridae - isolation & purification; Papillomavirus Infections - epidemiology; Papillomavirus Infections - immunology; Papillomavirus Infections - prevention & control; Papillomavirus Vaccines - immunology; Tumors; Uterine Cervical Neoplasms - epidemiology; Uterine Cervical Neoplasms - immunology; Uterine Cervical Neoplasms - prevention & control; Vaccines; Vaccines, antisera, therapeutical immunoglobulins and monoclonal antibodies (general aspects); Virology
• ISSN: 0264-410X; 1873-2518
• DOI: 10.1016/j.vaccine.2009.03.008

Abstract While two prophylactic HPV vaccines have been proven notably efficacious in clinical trials, the effectiveness of these vaccines at the population level remains to be evaluated. To lay the foundation for understanding the strengths and limitations of different endpoints for future effectiveness research, we present a comprehensive review of HPV-related clinical outcomes, including: (i) HPV type-specific positivity and persistence, (ii) Pap diagnoses (ASC-US, LSIL, and HSIL), (iii) histologic cervical cancer precursor lesions (i.e., CIN1, CIN2, and CIN3), (iv) invasive cervical cancer (ICC), (v) anogenital warts, (vi) recurrent respiratory papillomatosis (RRP), and (vii) other HPV-associated cancers (vulvar, vaginal, anal, penile, and oropharyngeal). While research on the vaccines’ effects on these HPV clinical outcomes in the general population is presently limited, numerous large trials will soon be completed, making a priori discussion of these potential outcomes especially urgent. Furthermore, population level systems to track HPV-associated clinical outcomes may need to be developed for HPV vaccine effectiveness evaluation.