HPV vaccination and cancer prevention

Prophylactic vaccines have been found to be highly effective in preventing infection and pre-invasive and invasive cervical, vulvovaginal and anal disease caused by the vaccine types. HPV vaccines contain virus-like particles that lack the viral genome and produce high titres of neutralising antibodies. Although the vaccines are highly effective in preventing infections, they do not enhance clearance of existing infections. Vaccination programmes target prepubertal girls and boys prior to sexual debut as efficacy is highest in HPV naïve individuals. School-based programmes achieve higher coverage, although implementation is country specific. Vaccination of older women may offer some protection and acceleration of impact, although this may not be cost-effective. HPV-based screening will continue for vaccinated cohorts, although intervals may increase. •The efficacy of HPV vaccines is higher in girls and boys prior to coitarche.•Its cost-effectiveness in older women is questionable.•Two doses are recommended for ages 9–14, while 3 doses are needed for older ages.•Coverage should be at least 80% in girls-only vaccination programmes.•Coverage should be at least 60% in sex-neutral vaccination programmes.