Current situation and influencing factors of HPV vaccine hesitancy among parents of primary and secondary school girls in Guangyuan / 公共卫生与预防医学

Objective To investigate HPV vaccine hesitancy and influencing factors among parents of primary and secondary schools in Guangyuan, and to provide scientific countermeasures for reducing the hesitancy rate of HPV vaccine in parents. Methods Using stratified multi-stage cluster random sampling, 1,018 parents of girls in primary and secondary schools in Guangyuan were selected for a questionnaire survey from March to July 2021. The data were analyzed by Chi-square test and multivariate logistic regression model. Results The hesitancy rate of HPV vaccine in parents was 42.95%. Multivariate logistic regression analysis showed that families with low economic income, parents who believed that HPV vaccination would have long-term side effects, and be unsafe and expensive, and parents who concerned with the effect of HPV vaccine on the prevention of cervical cancer and insufficient supply of first doses of vaccine, had positive effects on HPV vaccine hesitancy (OR = 2.02, 1.44, 3.13, 1.53, 3.76, and 2.43, respectively, P < 0.05). Conclusion HPV vaccine hesitancy rate is high among parents of primary and secondary schools in Guangyuan. It is necessary to fully promote school education and increase the publicity of HPV vaccine to improve parents' awareness of HPV vaccine. Government departments need to make an overall plan to reduce vaccine costs and ensure sufficient vaccine quantity, so as to reduce parents' hesitation to vaccinate their children with HPV vaccine.

Surveillance of adverse events following immunization with human papillomavirus vaccines in Hangzhou City from 2017 to 2021 / 预防医学

Objective@#To investigate the incidence of adverse events following immunization (AEFI) of human papillomavirus (HPV) vaccines in Hangzhou City from 2017 to 2021, so as to provide insights into safety monitoring and evaluation for HPV vaccines.@*Methods@#The AEFI caused by immunization of bivalent (HPV2), quadrivalent (HPV4) and nonavalent HPV vaccines (HPV9) reported in Hangzhou City from 2017 to 2021 were captured from the AEFI Surveillance Module of Chinese Disease Control and Prevention Information System, and HPV vaccination data were captured from the Zhejiang Municipal Immunization Information Management System. The incidence, temporal distributions and clinical symptoms of AEFI were analyzed.@*Results@#Totally 922 310 doses of HPV vaccines were immunized in Hangzhou City from 2017 to 2021, and 232 cases with AEFI were reported, with an overall incidence rate of 25.15/105 doses. The reported incidence rates of AEFI caused by HPV2, HPV4 and HPV9 vaccination were 31.13/105 doses, 25.93/105 doses and 22.01/105 doses, respectively. General reactions and abnormal reactions were predominant AEFI, and the reported incidence rates of general reactions and abnormal reactions were 21.58/105 doses and 2.60/105 dose, respectively. AEFI predominantly occurred 0 to 1 day post-immunization (165 cases, 71.12%), and the main clinical symptoms included local swelling of injection sites, hard tubercle and fever, with reported incidence rates of 10.30/105 doses, 5.96/105 doses and 6.18/105 doses, respectively. @*Conclusions@#Low incidence of AEFI was reported following HPV vaccination in Hangzhou City from 2017 to 2021, and all AEFI were mild. The safety of HPV2, HPV4 and HPV9 remains high.

Human papillomavirus vaccination behaviors among gynecological outpatients based on extended unified theory of acceptance and use of technology / 预防医学

Objective@#To investigate the factors affecting human papillomavirus (HPV) vaccination behaviors among gynecological outpatients based on extended unified theory of acceptance and use of technology (UTAUT2), so as to provide insights into the development of HPV vaccination behavioral interventions.@*Methods@# Patients at ages of 45 years and younger that were admitted to the outpatient department of gynecological of Shanxi Provincial People's Hospital from October 2021 to August 2022 were recruited, and the factors affecting HPV vaccination behaviors were identified using UTAUT2.@*Results@#A total of 431 female outpatients were enrolled, including 163 patients at ages of 36 to 45 years (37.82%), 272 cases with an educational level of college degree and above (63.11%) and 253 patients with per capita monthly household income of more than 3 000 Yuan (58.70%). The coverage of HPV vaccination was 24.36%, and the main cause of non-vaccination was difficulty in high-valent HPV vaccine appointment. Price value, social impact and efficacy expectation posed a positive impact on HPV vaccination behaviors via intention of vaccination (β=0.11, 0.08, 0.07, all P<0.05) and intention of vaccination and effort expectancy (β=0.10, 0.07, 0.06, all P<0.05), and effort expectancy played a mediating effect between intention of vaccination and vaccination behaviors (β=0.28, P<0.05).@*Conclusion@#Efficacy expectation, social impact, price value, intention of vaccination and effort expectancy may positively affect HPV vaccination behaviors.

Effectiveness of interventions for human papillomavirus vaccine hesitancy among female university students based on the precaution adoption process model / 预防医学

Objective @#To evaluate the effectiveness of interventions for human papillomavirus ( HPV ) vaccine hesitancy among female university students based on the precaution adoption process model (PAPM), so as to provide the evidence for improving the coverage of HPV vaccine in this population. @*Methods @#HPV vaccine hesitant female students were selected using a cluster sampling method from Zhejiang Chinese Medical University, and randomly assigned to the PAPM group and control group. Students in the PAPM group received PAPM-based interventions for HPV vaccine hesitancy, while students in the control group were given routine interventions. The HPV-related knowledge, HPV vaccine-related knowledge and HPV vaccine hesitancy scores were collected from both groups prior to interventions ( T0 ), 0 ( T1 ), 1 ( T2 ) and 3 months post-interventions ( T3 ), and the effectiveness of interventions was evaluated using analysis of variance for repeated measures.@*Results @#There were 147 students in the PAPM group and 141 students in the control group. In the PAPM group, 36.73% of the students majored in medical sciences, and 48.23% were freshmen; in the control group, 39.72% majored in medical sciences, and 50.35% were freshmen. The mean scores of HPV- and HPV vaccine-related knowledge were significantly greater in the PAPM group than in the control group, respectively ( T1, 5.29 vs. 4.91; T2, 4.27 vs. 4.22; T3, 4.22 vs. 4.04; P<0.05 ); however, no significant differences were detected in the HPV vaccine hesitancy scores between the two groups, respectively ( T1, 2.98 vs. 2.95; T2, 3.07 vs. 3.07; T3, 3.08 vs. 2.97; P>0.05 ). The mean scores of the confidence dimension ( T1, 3.37 vs. 3.23; T2, 3.48 vs. 3.40; T3, 3.38 vs. 3.25 ) and the dimension of influence by others ( T1, 3.44 vs. 3.33; T2, 3.42 vs. 3.37; T3, 3.46 vs. 3.27 ) were significantly greater in the PAPM group than in the control group (P<0.05), while the mean scores of the complacency dimension were significantly lower in the PAPM group than in the control group ( T1, 1.98 vs. 2.03; T2, 2.06 vs. 2.20; T3, 2.18 vs. 2.15; P<0.05 ).@*Conclusions @#PAPM-based interventions for HPV vaccine hesitancy may effectively improve the awareness of HPV and HPV vaccines, reduce complacency, and enhance the influence by others among female university students.

Organ transplantation and vaccination / 器官移植

Organ transplant recipients are at a high risk of infection with high hospitalization rate, critical rate and fatality, due to low immune function caused by taking immunosuppressants for a period of long time after organ transplantation. Currently, vaccination is recognized as an effective approach to prevent infection. Organ transplant recipients may be vaccinated according to individual conditions. However, the sensitivity to vaccines may decline in organ transplant recipients. The types, methods and timing of vaccination have constantly been the hot spots of clinical trials. In this article, the general principles, specific vaccines and SARS-CoV-2 vaccines of vaccination in organ transplant recipients were briefly reviewed, aiming to provide reference for the vaccination of organ transplant recipients. Moreover, current status of SARS-CoV-2 vaccination for organ transplant recipients was illustrated under the global outbreak of novel coronavirus pneumonia pandemic.

Status of Human Papillomavirus Vaccination and Knowledge,Attitudes, and Influencing Factors towards Human Papillomavirus and Its Vaccines among University Students in Western China / 中国医学科学院学报

Objective To investigate the knowledge about human papillomavirus(HPV)and its vaccines,HPV vaccination status,and vaccination willingness among the freshmen majoring in liberal arts,sciences,and medicine in western China,so as to provide evidence-based suggestions for health education among university students and to increase their vaccination. Methods By convenience sampling,stratified sampling,and cluster sampling,an online questionnaire survey was conducted among freshmen in a comprehensive university in Chengdu.The differences among the groups were compared by

Awareness and willingness to vaccinate daughters with human papillomavirus vaccines among parents of primary and middle school students / 预防医学

Objective @#To investigate the awareness of human papillomavirus ( HPV ) vaccine and willingness to vaccinate daughters among parents of primary and middle school students, so as to provide the reference for the promotion of HPV vaccine in primary and middle school girls.@*Methods @#Using multi-stage stratified cluster sampling method, the parents of girls in in Grade Four to Nine from schools in Gongshu District of Hangzhou, Xiuzhou District of Jiaxing and Wuxing District of Huzhou were selected. A questionnaire survey was conducted to collect demographic information, HPV vaccine related knowledge and willingness to vaccinate daughters with HPV vaccines. The multivariate logistic regression model was used to analyze the influencing factors for the willingness to vaccinate daughters with HPV vaccines among parents. @*Results @#Totally 1 500 questionnaires were sent out, and 1 466 were effectively collected, with an effective rate of 97.73%. There were 313 fathers responded, accounting for 21.35%; and 1 153 mothers responded, accounting for 78.65%. The awareness rate of HPV vaccine was 16.81%. The rate of willing to vaccinate daughters with HPV vaccines was 49.86%. The multivariate logistic regression analysis showed that the patients who ever vaccinated daughters with self-paid vaccines ( OR=1.935, 95%CI: 1.473-2.541 ), knew cervical cancer ( OR=1.424, 95%CI: 1.065-1.904 ), knew HPV vaccine dose ( OR=1.672, 95%CI:1.216-2.301 ), knew the best vaccination period ( OR=1.392, 95%CI: 1.032-1.876 ), knew the need of cervical cancer screening even after vaccination ( OR=1.596, 95%CI:1.227-2.075) were more willing to vaccinate daughters with HPV vaccines, while the parents who thought HPV vaccine expensive ( OR=0.154, 95%CI: 0.099-0.240 ) were less willing to vaccinate daughters with HPV vaccines. @*Conclusions @#The rates of HPV vaccine awareness and willingness to vaccinate daughters are 16.81% and 49.86% among parents of primary and middle school students. Their knowledge of HPV vaccine and the price of the vaccine may affect their willingness to vaccinate daughters.

Multidisciplinary Prevention and Control of Cervical Cancer:Application and Prospects / 中国医学科学院学报

Cervical cancer is the second most common malignant tumor in women worldwide.The burden of cervical cancer is particularly heavy in less developed countries as the malignancy brings huge pain to the patients and their family members and causes huge losses to social development and global health.However,cervical cancer is a preventable and curable disease.While screening and human papillomavirus vaccination in developed countries have remarkably lowered the incidence and mortality of cervical cancer,there is still a far way to go to achieve the prevention and treatment of this disease.The multidisciplinary prevention and control programs slightly differ in different countries due to diverse economic and health conditions.The general principle is to vaccinate the young females and to implement a comprehensive strategy including human papillomavirus vaccine vaccination,screening,early diagnosis,and early treatment in adults.

A Review of the Relief System for Adverse Drug Reaction Caused by the HPV Vaccine / 医薬品情報学

Objective: The Relief System for Sufferers from Adverse Drug Reactions was created for the purpose of remedying issues such as medical expenses for people who experience an adverse drug reaction despite the proper use of a medicine.Methods: We used “decision data on adverse drug reaction payments” released by the Pharmaceuticals and Medical Devices Agency to investigate the payment of all medical supplies for adverse drug reactions associated with the HPV vaccine over the 7-year period between 2011 and 2017.Results: The HPV vaccine had a lower rate of supply than all other medical supplies. Medical costs and medical allowance accounted for the majority of supplies for the HPV vaccine. The most common response was “A causal linkage between adverse reactions and the HPV vaccine cannot be confirmed”, followed by “It is not recognized as medical care requiring hospitalization”.Conclusion: Many patients with an adverse drug reaction received no medical supplies, mainly for the reason of “undecidable”. With regard to these patients, it may be necessary to carry out a survey so that they can be judged rather than classifying them as ‘undecidable’.

Immunogenicity of quadrivalence recombinant human papillomavirus vaccine (6, 11, 16 and 18 types) (Hansenulapolymorpha): results from phaseⅠ clinical trial / 中华微生物学和免疫学杂志

Objective@#To make a preliminary assessment on the immunogenicity of a quadrivalence recombinant human papillomavirus (HPV) vaccine (6, 11, 16 and 18 types) (Hansenulapolymorpha) in healthy women aged 18-45 years in phaseⅠclinical study.@*Methods@#It was a single-center, double-blind, randomized, placebo-controlled phaseⅠ clinical study. Women aged 18-45 years were randomized (2∶1) to receive HPV vaccine (n=60) or placebo control (n=30) at months 0, 2 and 6. Antibodies against HPV6/11/16/18 were detected by pseudovirus-based neutralisation assay in serum samples collected at 0 d, 180 d and 210 d. Seroconversion rates and geometric mean titres (GMT) of antibodies against the four types of antigens were calculated.@*Results@#Seroconversion rates of the vaccination group at 180 d (before the third dose) and 210 d (one month after the third dose) were generally similar and between 85%-100% for all types of antibodies. The GMT of antibodies at one month after the last dose improved significantly compared with those before immunization.@*Conclusions@#These results showed that the HPV vaccine had good immunogenicity in the population of healthy women aged 18-45 years. Higher antibody titers were elicited by the vaccine compare with the tites before the first dose and in the placebo control group.

Immunogenicity of quadrivalence recombinant human papillomavirus vaccine ( 6, 11, 16 and 18 types) ( Hansenulapolymorpha):results from phaseⅠ clinical trial / 中华微生物学和免疫学杂志

Objective To make a preliminary assessment on the immunogenicity of a quadriva-lence recombinant human papillomavirus (HPV) vaccine (6, 11, 16 and 18 types) (Hansenulapolymor-pha) in healthy women aged 18-45 years in phaseⅠclinical study. Methods It was a single-center, doub-le-blind, randomized, placebo-controlled phaseⅠclinical study. Women aged 18-45 years were randomized (2 : 1) to receive HPV vaccine (n=60) or placebo control (n=30) at months 0, 2 and 6. Antibodies against HPV6/11/16/18 were detected by pseudovirus-based neutralisation assay in serum samples collected at 0 d, 180 d and 210 d. Seroconversion rates and geometric mean titres ( GMT) of antibodies against the four types of antigens were calculated. Results Seroconversion rates of the vaccination group at 180 d ( be-fore the third dose) and 210 d ( one month after the third dose) were generally similar and between 85％-100％ for all types of antibodies. The GMT of antibodies at one month after the last dose improved signifi-cantly compared with those before immunization. Conclusions These results showed that the HPV vaccine had good immunogenicity in the population of healthy women aged 18-45 years. Higher antibody titers were elicited by the vaccine compare with the tites before the first dose and in the placebo control group.

Research progress on influencing factors for awareness of HPV vaccines among college students / 预防医学

@#Persistent infection of high-risk human papillomavirus（HPV）is an important factor for cervical cancer. HPV vaccination is an important measure for prevention of cervical cancer. College students are the susceptible population of HPV and the target population of HPV vaccination. Their awareness of HPV and HPV vaccines could their behaviors of HPV vaccination and prevention. This paper reviewed the literature related to the awareness of HPV and HPV vaccines and its influencing factors among college students,in order to provide reference for health education of HPV and propaganda on HPV vaccines.

Detection of High-Risk Human Papillomavirus in Cervix Sample in an 11. 3-year Follow-Up after Vaccination against HPV 16/18 / Detecção de papilomavírus humano de alto risco em amostras de colo uterino em 11. 3 anos de acompanhamento após vacinação contra HPV 16/18

Abstract Purpose the aim of this study was to evaluate the pattern of human papillomavirus (HPV) detection in an 11.3-year post-vaccination period in a cohort of adolescent and young women vaccinated or not against HPV 16/18. Methods a subset of 91 women from a single center participating in a randomized clinical trial (2001-2010, NCT00689741/00120848/00518336) with HPV 16/18 AS04- adjuvanted vaccine was evaluated. All women received three doses of the HPV vaccine (n = 48) or a placebo (n = 43), and cervical samples were collected at 6-month intervals. Only in this center, one additional evaluation was performed in 2012. Up to 1,492 cervical samples were tested for HPV-DNA and genotyped with polymerase chain reaction (PCR). The vaccine group characteristics were compared by Chi-square or Fisher exact or Mann-Whitney test. The high-risk (HR)-HPV 6-month-persistent infection rate was calculated. The cumulative infection by HPV group was evaluated by the Kaplan-Meier method and the log-rank test. Results the cumulative infection with any type of HPV in an 11.3-year period was 67% in the HPV vaccine group and 72% in the placebo group (p = 0.408). The longitudinal analysis showed an increase of 4% per year at risk for detection of HR-HPV (non-HPV 16/ 18) over time (p = 0.015), unrelated to vaccination. The cumulative infection with HPV 16/18 was 4% for the HPV vaccine group and 29% for the placebo group (p = 0.003). There were 43 episodes of HR-HPV 6-month persistent infection, unrelated to vaccination. Conclusions this study showed themaintenance of viral detection rate accumulating HR-HPV (non-HPV-16-18) positive tests during a long period post-vaccination, regardless of prior vaccination. This signalizes that the high number of HPV-positive testsmay be maintained after vaccination.

Resumo Objetivos avaliar o padrão de detecção do papilomavírus humano (HPV) em um período de 11.3 anos após a vacinação em uma coorte de adolescentes e mulheres jovens vacinadas ou não contra HPV 16/18. Métodos avaliou-se um subgrupo de 91 mulheres de um único centro, participantes de ensaio clínico randomizado (2001-2010, NCT00689741/00120848/00518336) com a vacina contra HPV 16/18 com adjuvante AS04. Todas as mulheres receberam três doses de vacina contra HPV (n = 48) ou placebo (n = 43), e tiveram amostras cervicais coletadas em intervalos de 6 meses. Somente neste centro, uma avaliação adicional foi realizada em 2012. Um total de 1.492 amostras cervicais foram testadas para DNA-HPV e genotipadas com reação em cadeia da polimerase (RCP). As características dos grupos de vacina contra HPV ou placebo foram comparadas pelo teste de Qui-quadrado ou teste exato de Fisher ou teste de Mann-Whitney. A infecção persistente por 6meses pelo HPV de alto risco (AR) foi calculada. A infecção cumulativa por grupo foi avaliada pelo método de Kaplan-Meier e pelo teste log-rank. Resultados a infecção cumulativa com qualquer tipo de HPV em11.3 anos foi de 67% no grupo vacina contra HPV e de 72% no grupo placebo (p = 0,408). A análise longitudinal mostrou um aumento de 4% ao ano no risco de detecção de HR-HPV (não-HPV 16/18) ao longo do tempo (p = 0,015), não relacionado com a vacinação. A infecção cumulativa com HPV 16/18 foi de 4% para o grupo vacina contra HPV e 29% para o grupo placebo (p = 0,003). Houve 43 episódios de infecção persistente por 6 meses por HR-HPV, não relacionados com a vacinação. Conclusões este estudo mostrou a manutenção da taxa de detecção viral, acumulando testes positivos de HR-HPV (não HPV-16-18) durante longo período pósvacinação, independentemente da vacinação prévia. Isto sinaliza que a alta positividade dos testes de HPV pode ser mantida após a vacinação.

Preventive vaccination against cervical cancer: Korean Society of Gynecologic Oncology Guideline / 부인종양

After human papillomavirus (HPV) vaccine guidelines published by Korean Society of Gynecologic Oncology (KSGO) in 2011, new studies have been published, leading to additional data regarding efficacy, safety, number of vaccination rounds, and ideal age of vaccine administration. We searched and reviewed the literatures focused on the efficacy of 2-dose schedule vaccination, the efficacy of 3-dose schedule vaccination in middle-aged women, the ideal age of 3-dose schedule vaccination, the safety of HPV preventive vaccine, and the ability of cross-protection of each HPV preventive vaccine. The KSGO has revised the previous guideline based on the results of the above studies.

Controversias en torno a la utilización de la vacuna contra el virus del papiloma humano / Controversy regarding the use of the vaccine against human papillomavirus / Controvérsias sobre o uso da vacina contra o vírus do papiloma humano

La vacuna contra el virus del papiloma humano (HPV) se presenta como una medida de prevención primaria del cáncer de cuello de útero (CCU), segunda causa de muerte de las mujeres a nivel mundial. Esta vacuna genera una dicotomía a nivel social que obliga a pensar si verdaderamente es necesario administrarla. En este artículo se desarrollan las posibles causas de esta contrariedad con la finalidad de colaborar en la toma de decisión informada sobre la administración de la misma. Se revisan las vacunas disponibles, las recomendaciones para su uso y las controversias en cuanto a eficacia, seguridad, número de dosis requeridas, eficiencia en la prevención y participación ciudadana. Las vacunas contra el HPV ofrecen un enfoque prometedor para la prevención del CCU y las afecciones asociadas a estos virus, pero no reemplazan a otras estrategias de prevención debido a que no protegen contra todos los tipos de virus de HPV.

The Human Papillomavirus (HPV) vaccine is presented as a primary preventive measure of cervical cancer (CC), the second cause of women deaths in the world. This vaccine generates such social dichotomy that makes us consider whether its administration is really necessary. The possible causes of this controversy are developed in this article, with the aim of helping to make an informed decision about its administration. Available vaccines are reviewed, as well as use recommendations and controversy regarding effectiveness, security, required doses, prevention efficiency and people’s participation. HPV vaccines offer a promising approach to prevent cervical cancer and conditions associated with these viruses, but they do not replace other prevention strategies since they do not protect against all HPV types.

A vacina contra o vírus do papiloma humano (HPV) é apresentada como uma medida de prevenção primária do câncer do colo do útero (CCU), a segunda principal causa de morte entre as mulheres em todo o mundo. Esta vacina gera tal dicotomia ao nível social que obriga a pensar se é realmente necessário administrá-la. Neste artigo discutem-se as possíveis causas desta controvérsia, a fim de ajudar na tomada de decisões informadas sobre a sua administração. Consideram-se as vacinas disponíveis, as recomendações para seu uso e a polêmica sobre a sua eficácia, segurança, número de doses necessárias, a eficiência na prevenção e a participação cidadã. As vacinas contra o HPV oferecem uma abordagem promissória para a prevenção do CCU e das doenças associadas a estes vírus, mas não substituem outras estratégias de prevenção, por não protegerem contra todos os tipos de vírus do HPV.

Investigation of knowledge and acceptability of human papillomavirus vaccine and assessment of health education among employed urban women in China / 肿瘤研究与临床

Objective To investigate knowledge of cervical cancer,human papillomavirus (HPV) and HPV vaccine and attitude to HPV vaccine among employed urban women in China,and to assess willingness to vaccinate their children.Methods This study was conducted in women from 16 factories or companies in Beijing,Hangzhou,Changsha,Chcngdu and Guangzhou.A questionnaire on cervical cancer,HPV knowledge and HPV vaccine acceptability was administered to participants before and after educational intervention.Results A total of 1 146 women were surveyed from August to November,2011.The awareness rates of cervical cancer,HPV and HPV vaccine were 95.06 ％,27.98 ％ and 12.82 ％,respectively.Only 20.68 ％ knew that HPV was related to cervical cancer.After educatioual instruction,89.26 ％ understood the relationship between HPV and cervical cancer (x2 =93.414,P ＜ 0.001).Only 19.25 ％ women were unwilling to allow their children to be vaccinated.The main reasons were as follows:worried about vaccine safety (23.52 ％),belief that their child was not at risk (21.92 ％),lack of scientific evidence for the vaccine (13.01％),and worricd about vaccine efficacy (12.79 ％).Conclusions In general,there is a high acceptability of HPV vaccine to prevent cervical cancer among employed urban Chinese women after educational intervention.However,some women remain reluctant to vaccinate their children due to concern about vaccine safety and efficacy.

Human Papillomavirus Vaccine / 한양의대학술지

Human papilloma virus (HPV) vaccine is designed to prevent cervical cancer by preventing HPV infection of the uterine cervix. HPV vaccines are made of virus-like particles which are composed of L1 protein of viral coats. Two HPV vaccines have been developed. "Cervarix" is a bivalent vaccine which contains L1 protein of HPV 16 and HPV 18, and "Gardasil" is a quadrivalent vaccine which contained L1 protein of HPV 6 and HPV 11 in addition to HPV16 and HPV18. Clinical studies showed that both vaccines are highly effective to prevent cervical, vaginal and vulvar precancerous lesion in the population who are naive to HPV infection. Furthermore quadrivalent vaccine showed high efficacy to prevent genital warts. Efficacy of the vaccine decreased in total population who included both HPV-naive and HPV-infected people. Both vaccines demonstrated immune responses and immune memory up to 5 years. Safety studies showed no demonstrable major adverse reaction. From the public health standpoint, HPV vaccine is an important vaccine for young adolescent girls who have not begun sexual activities. Efficacy for mid-aged women needs more evidence based on pathology-based efficacy studies.

Prophylactic Vaccine for Cervical Carcinoma

Cervical cancer is the second most common malignant neoplasm affecting women worldwide, with a high rate of mortality throughout the world. Since epidemiologic, biologic, and genetic data have identified a consistent association of human papillomavirus (HPV) infection with cervical cancer development, many researchers have worked on the development of HPV vaccine to establish an efficient program to manage cervical carcinoma in developed countries. Therefore, the aims of this study are to overview the current status of vaccine and to systematically analyze the development process of HPV vaccine through a review of the literature. The basic and clinical data on HPV vaccine inside and outside the country were collected by Medline searching. Recent lines of research on the safety and efficacy of candidate prophylactic vaccines against HPV have shown very promising results with nearly 100% efficacy in preventing persistent infections and the development of cervical precancerous lesions. The variable routes of vaccine administration have been tried-nasal and oral vaccination, as well as parental injection. Recently, clinical trials involving a large population and multi-institutions are ongoing, and also clinical trials are expected in Korea. Although the results of previous HPV vaccine studies are invariably encouraging, several drawbacks need to be addressed. Because the genotype of HPV is regionally different, Korean-specific vaccine needs to be developed, and there are many unsolved problems regarding, for example, the booster injection, optimal timing of vaccination, and vaccination in men.