Single-Dose HPV Vaccine Recommendation Is A "Game Changer" For Cervical Cancer Elimination

Just one dose of the human papillomavirus (HPV) vaccine is enough to provide sufficient protection against cervical cancer, according to a panel of experts from the World Health Organization (WHO).

Previously, the WHO recommended two- or three-dose regimens for the HPV vaccine, but they now say there’s enough evidence to show that one dose is sufficiently effective.

They argue this is a “game-changer” for the prevention of the disease and could bring the elimination of cervical cancer one step closer.

“I firmly believe the elimination of cervical cancer is possible,” Dr Princess Nothemba (Nono) Simelela, WHO Assistant Director-General, said in a statement.

“In 2020 the Cervical Cancer Elimination Initiative was launched to address several challenges including the inequity in vaccine access. This single-dose recommendation has the potential to take us faster to our goal of having 90 percent of girls vaccinated by the age of 15 by 2030,” she added.

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The overwhelming majority of cervical cancer — the fourth most common type of cancer in women globally — is caused by certain strains of sexually transmitted HPV. Nearly everyone will get some form of HPV at some point in their lives, but two types in particular, HPV 16 and HPV 18, are responsible for nearly 70 percent of high-grade cervical pre-cancers.

Having strong vaccination rates against HPV has already been shown to reduce cervical cancer rates in some countries. Australia is on track to becoming the first country in the world to eradicate cervical cancer. Thanks to a massive vaccination program targeting this common infection, HPV prevalence among Australian women aged 18 to 24 has dropped from 22.7 percent to just 1.5 percent over the last 10 years.

However, global uptake of the HPV vaccine has been slower than the WHO wished, primarily due to issues with supply, as well as the challenges and costs related to delivering two regimens to older girls who are not typically part of childhood vaccination programs.

Now that the option of a single-dose vaccine that appears to provide robust protection is available, it will mean there are fewer costs, supply issues, and practical concerns with covering the population with a sufficient level of protection against HPV-related cervical cancer.

Following a review of the evidence, the WHO’s Strategic Advisory Group of Experts on Immunization (SAGE) now recommends updating dose schedules for HPV vaccines as follows:

• one or two-dose schedule for the primary target of girls aged 9-14
• one or two-dose schedule for young women aged 15-20
• Two doses with a six-month interval for women older than 21.
• People with weakened immune systems, including those with HIV, should receive at least two doses and three doses if possible.

“SAGE urges all countries to introduce HPV vaccines and prioritize multi-age cohort catch up of missed and older cohorts of girls. These recommendations will enable more girls and women to be vaccinated and thus preventing them from having cervical cancer and all its consequences over the course of their lifetimes," added Dr Alejandro Cravioto, Chair of WHO's SAGE from the Faculty Of Medicine of the Universidad Nacional Autónoma de México.

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