Human papillomavirus (HPV) vaccine

Anwardeen Sirajuddin*

Clinical Pharmacist-CST, Kauvery Hospitals, India

*Correspondence: +91 9578038232 ; clinical.cst@kauveryhospital.com

Human papillomavirus (HPV) is a viral infection that’s passed between people through skin-to-skin contact. There are over 100 varieties of HPV, more than 40 Trusted Source of which are passed through sexual contact and can affect your genitals, mouth, or throat. According to the Centers for Disease Control and Prevention (CDC) Trusted Source, HPV is the most common sexually transmitted infection (STI). It’s so common that most sexually active people will get some variety of it at some point, even if they have few sexual partners. Some cases of genital HPV infection may not cause any health problems. However, some types of HPV can lead to the development of genital warts and even cancers of the cervix, anus, and throat.

WHO, CDC have different recommendations when it comes to HPV vaccine schedule. WHO and CDC recommend protection with the vaccine in different doses for HPV.

Back in December 2022, the WHO updated its recommendations for the HPV vaccine dosing schedule. At the time, it was announced that a single-dose schedule, referred to as an alternative, off-label single-dose schedule can provide a comparable efficacy and durability of protection to a two-dose regimen.

It’s important to note that the CDC did not recently update their vaccine schedule. Though in October 2022, the Advisory Committee on Immunization Practices (ACIP) approved the Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger for the 2023 year. The immunization schedule includes other vaccine approvals recommended by ACIP and approved by the CDC.

The December update of the WHO’s HPV vaccine recommendation schedule is expected to improve access to the vaccine, offering countries the opportunity to expand the number of girls who can be vaccinated and alleviating the burden of the often complicated and costly follow-up required to complete the vaccination series, according to the Organization. The WHO shared that there’s been a decline in HPV vaccination coverage globally. Between 2019 and 2021, coverage of the first dose of HPV vaccination fell by 25% to 15%. This means 3.5 million more girls missed out on HPV vaccination in 2021 compared to 2019. A turn around in HPV vaccination and increasing access could combat the development of cervical cancer, which is the fourth most common type of cancer in women, according to the WHO. More than 95% of cervical cancer is caused by sexually transmitted HPV.

The chief medical officer, Professor Sir Michael McBride announced that, From 1st September 2023 there will be a change in the HPV vaccine schedule from 2 doses to 1 dose in the routine adolescent programme and GBMSM programme for everyone under the age of 25 years of age.

This policy change is outside the terms of the Gardasil 9 vaccine product licence but is based on advice from the Joint Committee on Vaccination and Immunisation (JCVI) who have concluded that single-dose schedules provide comparable efficacy to the 2- or 3- dose regimens.

There is no change to the eligibility criteria for the programme. Key points about the change to the programme are:

- From September 2023, those individuals who would have been eligible to receive 2 doses of HPV vaccine (i.e., anyone in school year 9 to under 25 years of age, including GBMSM) who are completely unvaccinated), will only require

1 dose to be considered fully vaccinated.

A 2-dose schedule from the age of 25 in the GBMSM programme will continue.
A 3-dose schedule for individuals who are immunosuppressed or those known to be HIV-positive will continue.

Various existing marketed cervical cancer vaccines are:

Name	Type	Effective Against	Manufacturer
Gardasil	Quadrivalent	HPV types 6, 11, 16, and 18	Merck
Gardasil 9	Nonavalent	HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58	Merck
Cervarix	Bivalent	HPV types 16 and 18	GlaxoSmithKline
Cecolin	Bivalent	HPV types 16 and 18	Innovax Biotech Co.
Walvax	Bivalent (Recombinant)	HPV types 16 and 18	Watson Bio.
CERVAVAC(Made-In-India) First Indian HPV Vaccine from Serum Institute, Pune, India. It will be ready for market circulation by May -June this year (2023).	Quadrivalent	HPV types 6, 11, 16, and 18	Serum Institute, Pune, India

Anwardeen Sirajuddin

Clinical Pharmacist-CST

Human papillomavirus (HPV) vaccine