HPV vaccination offers long-term protection against cervical pre-cancer

The human papillomavirus (HPV) vaccine provides sustained protection against cervical pre-cancer over a decade after vaccination, a new population study has shown.

The study by Public Health Scotland, conducted in collaboration with The University of Strathclyde and The University of Edinburgh, included data from over 270,000 women in the Scottish cervical cancer screening system (SCCSS) to assess the impact of the HPV vaccination programme.

Vaccination against high-risk HPV infection, the main cause of cervical cancer, has been shown to have long-term effectiveness in clinical trials. The researchers say their new findings confirm that HPV vaccination of women under 18 provides stable long-term protection in a real-world setting.

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The evaluation included women who were born between 1988 and 1990 and not eligible for HPV vaccination, women born between 1991 and 1994 who were offered HPV vaccination at ages 14–18 as part of a catch-up programme in 2004-5, and women born between 1995 and 1996 who were offered HPV vaccination at 12-13 as part of the routine programme from 2008 onwards. All women received the bivalent HPV vaccine.

The results showed that vaccination was associated with an overall significant reduction in pre-cancerous cervical changes.

Further statistical analysis by age, number of doses received and socio-economic deprivation showed that the HPV vaccine provided protection for at least 12 years after vaccination, and was most effective when the vaccine was given at 12-13 years of age and the full schedule of doses was completed.

Vaccine effectiveness was also highest in women from the most deprived areas of Scotland.

The authors concluded: ‘This population based analysis confirms the long-term effectiveness of the bivalent HPV vaccine, greatest in women from the most deprived areas and reinforces the importance of ensuring high vaccine uptake rates at an early age.’

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Dr Tim Palmer, Scottish clinical lead for cervical screening at The University of Edinburgh, said: ‘This study shows conclusively that the HPV vaccine prevents the changes that can develop into cancer.

‘It also emphasises the need for continued high uptake of the vaccine in schools as vaccination at older ages is much less effective. Screening is still important to prevent disease caused by HPV types not covered by the vaccine.’

Dr Kirsty Roy, consultant in public health at Public Health Scotland, said: ‘This study showcases both the effectiveness and impact of the HPV vaccine in preventing cervical disease, especially as the strong community protection demonstrated by the data may also be contributing to reductions in cervical disease among women in more deprived areas where vaccine uptake is lower.

‘Vaccination against HPV is effective in preventing cervical cancer and, along with regular screening for early detection and treatment, it is possible to make cervical cancer a rare disease.’

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In Scotland, the HPV vaccine is offered to all children aged 11 to 13 as part of the school-based program.

In England, the HPV vaccine is offered to all young people aged 12 to 13, with catch-up available for those up to age 25 who missed their initial vaccination.