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Assessing the effectiveness of human papillomavirus (HPV) vaccination to prevent cervical cancer: perspectives from Germany
  1. Martina Dören
  1. Correspondence to Professor Martina Dören, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Clinical Research Center of Women’s Health, Hindenburgdamm 30, Berlin D-12200, Germany; martina.doeren{at}charite.de

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For approximately 2 years now, cervical cancer has been “converted” from an oncological disease to an infectious disease, which is said to be preventable by and large by two vaccines licensed in many countries. However, human papillomavirus (HPV) vaccines differ from existing others, as the former target a condition which only in a minute fraction of infections will lead to serious consequences, but after a long(er) latency period. Furthermore, it should be kept in mind that in clinical trials, the quadrivalent vaccine was tested in fewer than 1200 girls 16 years and younger.1

In Germany, as in many other countries, HPV vaccines targeting two of 15 oncogenic2 HPV types are being positioned by pharmaceutical companies and universities based clinicians and scientists as a single though profoundly effective medical measure to eradicate a substantial proportion of the burden of disease indeed constituted by the occurrence of cervical cancer for the individual woman and her family. HPV vaccines primarily target individuals and in this case female minors and their parents, particular mothers. However, published data for periods beyond 2 years were not available in spring 2009 as to what fraction of cervical intraepithelial lesions (CIN) grade 2 or worse and cancer incidence, respectively, are indeed prevented in young girls not infected with any HPV type prior immunisation with a vaccine targeting HPV types 16 and 18. In spring 2006, an analysis of vaccine efficacy against CIN 2+ due to any HPV type among subgroup of girls/women (per protocol population) for all four vaccine-relevant HPV …

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