J Korean Med Assoc.  2008 Feb;51(2):144-157. 10.5124/jkma.2008.51.2.144.

Human Papillomavirus Vaccine

Affiliations
  • 1Department of Pediatrics, Ewha Womans University College of Medicine, Korea. kaykim@ewha.ac.kr

Abstract

Vaccination has had a major effect on protection of humans against disease. The human papillomavirus (HPV) vaccine is the most recent breakthrough in the vaccine development, which provides an exceptional opportunity for cancer prevention through vaccination. The prophylactic quadrivalent vaccine using L1 virus-like particles (VLPs) of HPV 6, 11, 16, and 18 is now available in Korea, and the bivalent vaccine containing VLPs of HPV16 and HPV18 is available in other countries. Results from the phase IIb and III trials show that these two HPV vaccines are safe and well-tolerated. They offer HPV-naive women a very high level of efficacy against persistent infection and cervical intra-epithelial lesions associated with the HPV types included in the vaccine. The quadrivalent vaccine has also been shown to protect against vulvar and vaginal lesions and genital warts caused by types 6 and 11. Recent studies on both vaccines indicate there is a high level of cross-protection against infections associated with other related oncogenic HPV types, which are responsible for a further 10% of cervical cancers globally. The Korean Society of Pediatrics has developed guidelines for the use of the prophylactic HPV vaccine for the prevention of cervical intraepithelial neoplasia and cervical cancer. They address the use of prophylactic HPV vaccines, including who should be vaccinated and at what age, as well as a summary of policy and implementation issues. With the introduction of the vaccines, general issues have to be raised such as duration of protection after vaccination, data on different immunization schedules, data on infants and young children, cross-protection, impact on cervical cancer screening, vaccination of males, potential replacement infection and vaccine compatibility. This review provides an up-to-date summary of recent studies and available information concerning HPV vaccination.

Keyword

Papillomavirus vaccines; Guideline

MeSH Terms

Cervical Intraepithelial Neoplasia
Child
Condylomata Acuminata
Female
Human papillomavirus 6
Humans
Immunization Schedule
Infant
Korea
Male
Mass Screening
Papillomavirus Vaccines
Pediatrics
Uterine Cervical Neoplasms
Vaccination
Vaccines
Papillomavirus Vaccines
Vaccines

Figure

  • Figure 1 Serum anti-HPV 6 antibody titers after quadrivalent HPV vaccination by age at enrollment. Immunogenicity bridge study was done in female 9~15 year of age and efficacy program was done in female 16~23 year of age. Abbreviation: GMT; geometric mean titer, CI; confidence interval Source: Merck, unpublished data, Presented at ACIP meeting, February 2006

  • Figure 2 Papillomavirus phylogenetic tree.


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