Voluntary school-based human papillomavirus vaccination: an efficient and acceptable model for achieving high vaccine coverage in adolescents.

摘要

Recently published data from large efficacy studies suggest that human papillomavirus (HPV) vaccines can substantially reduce anogenital neoplasia and warts overall when administered to young women with no previous exposure to most high- and low-risk HPV types [1,2]. These data refer to young women who were naive to HPV and therefore considered similar to female adolescents before their sexual debut. Most countries have centered HPV vaccination recommendations on this particular age group.Mathematical models predict that vaccination of young adolescent females will dramatically reduce HPV infection and associated disease in the population offered vaccination [3-5], and that this is a cost-effective intervention [6]. These studies have generally assumed vaccination uptake to be in the range consistent with previously published data on uptake for adolescent vaccinations offered through school vaccination programs or programs with mandated vaccination for school entry (70%-80%), and have further assumed that lower levels of uptake predict a lesser effect on infection and disease [7]. As several countries have now implemented HPV vaccination programs, the first data on coverage are beginning to emerge. It is concerning, but also intriguing, that there is such a vast range in HPV vaccine coverage across these countries, from very high to very low [8-13].