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Does HPV vaccination prevent cervical carcinoma?

It is now 12 years ago that the first girls were vaccinated against human papilloma virus (HPV) under the Dutch government’s national vaccination programme, and by now more research has been undertaken into the efficacy of HPV vaccination. Both the vaccine against two high-risk HPV types (bivalent vaccine) and that against four high-risk HPV types (quadrivalent vaccines) appear to be effective for the prevention of precursor lesions of cervical carcinoma. It is not yet clear whether a vaccine against a total of nine high-risk HPV types (nonavalent vaccine) offers any added value compared to the bivalent and quadrivalent vaccines. The vaccines appear to be especially effective when administered before the infection with HPV has occurred. Observational studies concerning direct efficacy and population effects corroborate the evidence from the efficacy studies. No difference in the incidence of mild or serious adverse events has been found between HPV vaccination and placebo.

  • Randomised research and observational studies have yielded solid evidence for the efficacy of both the bivalent and quadrivalent vaccines in preventing precursor lesions of cervical carcinoma.
  • No conclusions can as yet be drawn regarding the hard endpoint of cervical carcinoma, as this can as yet not be adequately assessed, due to the slow development of these carcinomas.
  • Since the studies have mostly been funded by the industry, there is a need for more publicly funded research.
  • The adverse effects of the HPV vaccine and the vaccination differ little from those of other vaccinations. One study has concluded that migraine might be more frequent after HPV vaccination, but this requires further investigation.

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  • MariĆ«lle van Avendonk
  • Marielle A.E. Nieuwhof, pharmacist
  • Frans M. Helmerhorst, prof. dr