Surrogate outcomes do not translate into actual outcomes. I would like to see how incidence and prevalence of actual CIS and cervical cancer drop as a result of the vaccine. There are many HPV variants, and humans evolved over time to the mix that exists as a function of survival advantage. I would not want to find out that induced immunity to four serotypes promotes natural infection with another that causes neoplasia more efficiently.
Vaccination Has Led to Marked Decline in HPV Prevalence in Young Women — Physician’s First Watch
Vaccination Has Led to Marked Decline in HPV Prevalence in Young Women
By Cara Adler
Edited by André Sofair, MD, MPH
Six years after introduction of the quadrivalent human papillomavirus vaccine (4vHPV), prevalence of the 4vHPV types (6, 11, 16, and 18) dropped 64% in girls aged 14 to 19, according to a Pediatrics study.
Using National Health and Nutrition Examination Survey data, researchers compared HPV prevalence in females aged 14 to 34 in the years before (2003–2006) and after (2009–2012) 4vHPV vaccine was introduced.
Some 51% of participants aged 14 to 19 reported receiving at least one vaccine dose, and 35% received three doses. Between the periods, prevalence of 4vHPV types (based on self-collected cervicovaginal swabs) decreased from 12% to 4% among participants aged 14 to 19 and from 19% to 12% among those aged 20 to 24. Prevalence of nonvaccine HPV types did not change.
Dr. Alain Joffe of NEJM Journal Watch Pediatrics and Adolescent Medicine comments, "these results clearly demonstrate that HPV vaccination reduces the prevalence of HPV types related to development of cervical cancer. Studies have shown that a strong recommendation from providers to vaccinate is a key variable in parental acceptance of the vaccine. Based on the substantial body of evidence, there is no reason for providers to shy away from making such a recommendation."