Human Papillomavirus Vaccines: Successes and Future Challenges

Abstract

Over a decade has passed since the first human papillomavirus (HPV) vaccine was introduced. These vaccines have received unequivocal backing from the scientific and medical communities, yet continue to be debated in the media and within the public. The current review is an updated examination that the authors made 5 years ago on some of the key sociocultural and behavioral issues associated with HPV vaccine uptake and acceptability, given the changing vaccine policies and beliefs worldwide. We explore current worldwide HPV vaccination rates, outline HPV vaccine policies, and revisit critical issues associated with HPV vaccine uptake including: risk compensation, perceptions of vaccine safety and efficacy, age of vaccination, and healthcare provider (HCP) recommendation and communication. While public scrutiny of the vaccine has not subsided, empirical evidence supporting its safety and efficacy beyond preventing cervical cancer has amassed. There are conclusive findings showing no link that vaccinated individuals engage in riskier sexual behaviors as a result of being immunized (risk compensation) both at the individual and at the policy level. Finally, HCP recommendation continues to be a central factor in vaccine uptake. Studies have illuminated how HCP practices and communication enhance uptake and alleviate misperceptions about vaccination. Strategies such as bundling vaccinations, allowing nurses to vaccinate via "standing orders," and diversifying vaccination settings (e.g., pharmacies) may be effective steps to increase rates. The successes of vaccination outweigh the controversy, but as the incidence of HPV-related cancers rises, it is imperative that future research on HPV vaccine acceptability continues to identify effective and targeted strategies to inform HPV vaccination programs and improve HPV coverage rates worldwide.

HPV-Related Papillary Lesions of the Oral Mucosa: A Review

“…The US Department of Health and Human Services' Healthy People initiative set a target for 80% of male and female adolescents to complete the HPV vaccine schedule by the year 2020 [55]. In 2017, less than half (48.6%) of adolescents completed their vaccines in the US [56]. The current worldwide coverage is estimated at 6.1% in females [56].…”

Progress in Vaccination of Prophylactic Human Papillomavirus Vaccine

“…Deaths from oropharyngeal cancer (HPV-related cancers) are projected to increase in 2020, particularly in developed countries (90). Therefore, it is necessary to work toward the full implementation of the vaccination program globally, both for men and women, and to extend the coverage to all medically significant genotypes.…”

“…Canada has started pairing 9vHPV and 2vHPV (91). There are also studies comparing the effect of one dose of 2vHPV or 9vHPV vaccine with two doses of vaccine (90).These methods can reduce the cost of vaccination and induce a stronger immune response. In conclusion, the latest progress of the HPV vaccine in the immunogenicity, safety, efficacy, latest vaccination concepts, and strategies were reviewed and the prospect solutions were discussed.…”

Introductory Chapter: Immunization - Vaccine Adjuvant Delivery System and Strategies

“…In particular, as a multifunctional VADS, NPs modified with different materials with intrinsic and specific adjuvanticity, such as TLRas (e.g., MPL and CpG ODN), squalene, and saponin (e.g., water-soluble QS-21), though showing individually distinctive features, share some key characteristics in immune-boosting functions [37]. Summarily, these multifunctional Nps as a VADS trigger immunoresponses with features including, mainly, early activation, though at different levels, of innate immunity, which will subsequently translate into strong antibody and cellular responses to the delivered antigens [5]; a wide breadth of adaptive immunity is able to confer protections against heterovariants of pathogens; for example, vaccines delivered by liposomes containing MPL can defend against influenza viruses or human papillomavirus (HPV) strains that are not contained in the vaccines [38]; significant enhancement of the immunoresponses and the efficacy of vaccines in the elderly who show a waning immune responsiveness to infection and vaccination, as shown for vaccines formulated with MPL-liposomes against herpes zoster virus [39]. These results, together with the feasibility of large-scale manufacture and the track records of acceptable safety profiles of many liposomebased medications, pave the way for developing novel multifunctional liposomes to be used as a VADS for producing the vaccine products fitting humans of different age against infections with a high toll of morbidity and mortality.…”