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Predicting optimal impact interventions in the post-HPV vaccination world.

Matti Lehtinen1,2, Marc Lipsitch3, Ville N Pimenoff2

  • 1Centre for Cervical Cancer Elimination, Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden.

International Journal of Cancer
|January 19, 2026
PubMed
Summary

Pneumococcal and human papillomavirus (HPV) vaccination significantly impact disease spread and public health. Strategies for HPV screening in vaccinated populations are crucial for managing cervical cancer risks effectively.

Keywords:
cervical cancerhuman papillomavirusscreeningtype‐replacementvaccination

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Area of Science:

  • Public Health
  • Vaccinology
  • Epidemiology
  • Oncology

Background:

  • Prophylactic vaccination is a key public health intervention reducing infection exposure and morbidity from preventable diseases.
  • Pneumococci and human papillomavirus (HPV) vaccinations have profound effects on pathogen population biology and public health outcomes.
  • Understanding vaccine impact requires analyzing pathogen type-replacement and interactions within communities.

Purpose of the Study:

  • To review the impact of pneumococcal and HPV vaccination on population biology and public health.
  • To analyze HPV type-replacement dynamics and their effect on cervical cancer risk.
  • To discuss strategies for cervical cancer screening in HPV-vaccinated populations, considering different coverage levels and birth cohorts.

Main Methods:

  • Review of data on HPV type-replacement in vaccinated communities.
  • Analysis of interactions between remaining HPV types and cervical cancer risk.
  • Application of comprehensive models for country-specific cervical screening strategies in HPV-vaccinated and unvaccinated women.

Main Results:

  • Vaccine-covered HPV types are nearly eliminated in some communities, with remaining types showing interactions affecting cervical cancer risk.
  • Modeling indicates varying effectiveness of cervical screening based on HPV vaccination coverage and strategies.
  • Balancing screening benefits and harms in vaccinated populations necessitates understanding cancer risks across different vaccinated birth cohorts.

Conclusions:

  • Effective public health strategies for HPV vaccination require achieving herd effect rapidly.
  • A risk-based design for HPV screening is essential for optimizing cervical cancer prevention in vaccinated populations.
  • Addressing the complexities of vaccination impact on disease and screening requires integrated approaches.