a single dose of HPV vaccine is enough, says WHO

Geneva, Switzerland – A single dose of human papillomavirus (HPV) vaccine provides strong protection against cervical cancer, comparable to 2- or 3-dose regimens, the Strategic Advisory Group of Experts on Immunization (SAGE) has concluded. of the’World Health Organization (WHO) after analysis of the literature[1].

SAGE recommends updating dosing regimens as follows:

  • one- or two-dose schedule for primary target, 9-14 year old girls;

  • one- or two-dose schedule for young women 15-20 years;

  • Two doses 6 months apart for women over 21.

Immunocompromised people, including those living with HIV, should receive three doses if possible, or at least two doses because the evidence on the effectiveness of a single dose in this group is limited.

At this stage, boys and young men “may follow the same dosing regimen as women, pending further data on the efficacy and immunogenicity of a single-dose dosing regimen in this male population.”

Soon new recommendations

As a reminder, current HPV vaccination recommendations for both sexes provide for a 2-dose schedule between 9 and 14 years old, 3 doses for 15 and over, and 3 doses for immunocompromised populations of all ages (9 and over). , including people living with HIV. For men who have sex with men up to age 26: three doses given on a 0, 2 and 6 month schedule. “WHO recommendations will be updated after further consultation among stakeholders” , indicates the institution.

Improve global immunization coverage

More than 95% of cervical cancers are caused by sexually transmitted HPV, which is the fourth most common type of cancer in women worldwide, with 90% of these women living in low-income countries or intermediary, recalls the WHO. However, “the HPV vaccine is very effective in preventing papillomavirus serotypes 16 and 18, which cause 70% of cervical cancers”, recalled the Dr Alexandre CraviotoPresident of SAGE. The WHO hopes, thanks to these new recommendations, to facilitate access to this vaccination in logistical but also economic terms; HPV vaccines having a relatively high cost, especially for middle-income countries.

“This single-dose recommendation could accelerate our goal of immunizing 90% of girls before the age of 15 by 2030,” said WHO Assistant Director-General Dr Princess Nothemba Simelela.

The single-dose vaccine option is less expensive, requires fewer resources and is easier to administer. It facilitates the implementation of catch-up campaigns, avoids running after those lost to follow-up for the second dose and makes it possible to redirect financial and human resources towards other health priorities, concludes the WHO.

Gardasil quadrivalent: 1 dose equivalent to 2 or 3 against HPV 16-18

Recently the results of a longitudinal prospective study conducted in India and published in Lancet Oncology showed that a single dose of the quadrivalent vaccine Gardasil ® prevents infections against HPV 16 and 18 as well as two or three doses after a follow-up of 10 years [2].

17,729 unmarried Indian participants aged 10-18 were included between September 2009 and April 2010. The participants were followed for a median of 9 years: 4348 had received three doses, 4980 two doses and 4949 only one. From annual samples, it was shown that the rate of preventive efficacy for infections by HPV 16 and 18 was similar in the three groups. It was 95.4% after one dose, 93.1% after two doses and 93.3% after three doses. Note that this study did not investigate the effectiveness of a single dose on other HPV-related cancers, both in women and in men: genital cancers (vulva, vagina, penis), anal, ENT, etc.

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