Vaccination against human papillomavirus Implementation and efficacy against cervical cancer control

The two new HPV vaccines (Gardasil (R) quadrivalent and Cervarix (R) bivalent 16,11) are both effective against HPV types 16 and 18, which are responsible for 70% of cervical cancers, and the quadrivalent vaccine is effective against HPV 6 and 11, responsible for genital warts. Their efficacy is 100 l if they are administered before exposure to HPV 16,18. The proven duration of protection against high-grade cervical lesions is currently 5 years, and the need for boosters is unknown. Cervical cancer screening programs must continue, as only 70% of the 15 high-risk HPV types are targeted. The best age for primary vaccination appears to be 11-12 or 14 years, before the outset of sexual activity. Vaccination of older women is less efficacious, and vaccination of males is being discussed. HPV vaccines should be useful in developing countries, if they can be made available. HPV vaccination campaigns require adequate public information.