Human papillomavirus vaccination: current indications and future directions

Abstract

Human papillomavirus (HPV) is one of the most common sexually transmitted infections affecting both men and women worldwide. The development of the prophylactic HPV vaccines is a significant pharmaceutical innovation with potential to reduce HPV-related morbidity. However, barriers to the universal use and acceptability of the HPV vaccines continue to exist in both economically privileged and disadvantaged countries. It may be decades before the impact of preventive vaccines on HPV-related diseases caused by the considerable burden of HPV infections will be seen. Collaborative efforts must continue to promote vaccine implementation.

Figure 1

Prevalence of low-risk and high-risk HPV among female respondents 14 to 59 years of age. (Data from Hariri S, Unger ER, Sternberg M, et al. Prevalence of genital human papillomavirus among females in the United States, the National Health And Nutrition Examination Survey, 2003–2006. J Infect Dis 2011;204(4):566–73.)

Figure 2

Pathogenesis of HPV infection.

Figure 3

Timeline of HPV VLP vaccine licensure and approved indications for use.

Figure 4

National immunization survey-Teen, United States, 2006–2011. Estimated vaccination coverage with selected vaccines and doses among adolescents aged 13 to 17 years, by survey year. ^a On or after age 10 years. ^b Among females. ^c Among males. Adolescent vaccination coverage increased from 2006 to 2011, although the rate of increase differed by vaccine. MenACWY, meningococcal conjugate vaccine; Tdap, tetanus toxoid, diphtheria toxoid, acellular pertussis vaccine. (Data from Morbidity and Mortality Weekly Report (MMWR). National and state vaccination coverage among adolescents aged 13–17 years — United States, 2011. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6134a3.htm?s_cid5mm6134a3_e%0d%0a#fig. Accessed February 28, 2013.)