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Vaccination With Moderate Coverage Eradicates Oncogenic Human Papillomaviruses If a Gender-Neutral Strategy Is

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Gender-neutral human papillomavirus (HPV) vaccination significantly enhances herd effect and protective effectiveness, proving superior for eradicating oncogenic HPV types compared to girls-only strategies.

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Area of Science:

  • Public Health
  • Vaccinology
  • Epidemiology

Background:

  • High coverage of human papillomavirus (HPV) vaccination in girls can potentially eradicate oncogenic HPV types.
  • Achieving very high vaccination coverage (>90%) is challenging.
  • The herd effect (HE) of HPV vaccination is influenced by HPV type and vaccination strategy.

Purpose of the Study:

  • To compare the effectiveness of gender-neutral versus girls-only HPV vaccination strategies.
  • To assess the herd effect (HE) and protective effectiveness (PE) of different HPV vaccination approaches.
  • To model the potential for HPV eradication based on vaccination strategies.

Main Methods:

  • A community-randomized trial involving 33 Finnish communities.
  • Randomization into gender-neutral HPV16/18 vaccination, girls-only HPV16/18 vaccination, and hepatitis B virus vaccination arms.
  • Analysis of cervicovaginal samples from vaccinated and unvaccinated girls to estimate vaccine efficacy, HE, and PE.

Main Results:

  • Gender-neutral vaccination demonstrated significantly stronger HE and PE for HPV18/31/33 compared to girls-only vaccination.
  • Mathematical modeling predicted HPV18/31/33 eradication within 20 years with 75% gender-neutral vaccination coverage.
  • HPV16 eradication was also predicted with 75% gender-neutral coverage.

Conclusions:

  • Gender-neutral HPV vaccination strategies are more effective for eradicating oncogenic HPV types.
  • This approach offers a superior pathway towards achieving herd immunity and disease prevention.