[Vaccine prevention of HPV-associated diseases]

Early prophylactic human papillomavirus (HPV) vaccination of girls and boys leads to long-lasting sterile immunity against the HPV types covered by the respective vaccine. Both in clinical trials and in population-based studies, virus-like particle (VLP)-based HPV vaccines have exceeded all expectations regarding immunogenicity and efficacy. In clinical trials, HPV vaccines induced protection rates of 95-100% against high-grade cervical intraepithelial neoplasia (CIN) caused by vaccine-covered types, and nearly 100% against HPV6/11-induced anogenital warts. Numerous studies have demonstrated that early age at vaccination is crucial for the effectiveness of HPV vaccination. The duration of vaccine-induced protection against high-grade CIN and cervical cancer, as documented by long-term studies, currently ranges between 15 and 18 years. In addition to cervical cancer and anogenital warts, early HPV vaccination can also prevent precursor lesions of anal cancer as well as vulvovaginal precancerous lesions at the population level. Several countries have already introduced a single-dose vaccination schedule in line with the WHO recommendation. Given the lack of long-term data and data on HPV infections outside the cervix, Germany and other countries are still maintaining a 2-dose vaccination schedule. The WHO aims to eliminate cervical cancer. To this end, all countries should achieve HPV vaccination rates of 90% among 15-year-old girls by 2030. Due to herd effects, vaccination rates of around 80% may also be sufficient. In Germany, currently only 55% of 15-year-old girls and 36% of boys have completed the full HPV vaccination series. To increase HPV vaccination rates, a national HPV vaccination year is planned to be held in Germany in 2028.