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WHO Panel Concludes a One-Dose HPV Vaccine Effective in Women

WHO recommends updating the one-or two-dose schedules for HPV vaccines in girls aged 9–14 and young women aged 15–20, and the two-dose schedules with a 6-month interval for women over 21.

The World Health Organization’s (WHOs) Strategic Advisory Group of Experts on Immunization (SAGE) recently concluded that a single-dose human papillomavirus (HPV) vaccine provides comparable efficacy to the two- or three-dose regimens.  

SAGE evaluated evidence gathered throughout the recent years and established that one dose of an HPV vaccine delivers solid protection against HPV, the virus that causes cervical cancer. Specifically, over 95% of cervical cancer is caused by sexually transmitted HPV. 

The organization recommended updating the one- or two-dose schedules for girls aged 9–14 and young women aged 15–20 and the two-dose schedules with a 6-month interval for women older than 21.  

Immunocompromised individuals, including those with HIV, should receive three doses if possible and at least two doses if not possible. Notably, there is limited evidence regarding the efficacy of a single dose in this group. 

“The HPV vaccine is highly effective for the prevention of HPV serotypes 16 & 18, which cause 70% of cervical cancer,” Alejandro Cravioto, MD SAGE Chair, said in the announcement.   

“SAGE urges all countries to introduce HPV vaccines and prioritize multi-age cohort catch up of missed and older cohorts of girls. These recommendations will enable more girls and women to be vaccinated and thus preventing them from having cervical cancer and all its consequences over the course of their lifetimes,” Cravioto continued.  

Experts continue to voice concerns over the slow introduction of the HPV vaccine into immunization programs and overall low population coverage, especially in lower countries. For example, vaccine uptake has been slow and coverage in countries is much lower than the 90% target. Global coverage with two doses was only 13% in 2020.  

Supply challenges, programmatic challenges, costs related to delivering a two-dose regimen to older girls not typically part of childhood vaccination programs, and the overall high cost of HPV vaccines were a few factors influencing the slow uptake.  

The option for a single dose of the vaccine is less costly, less resource-intensive, and easier to administer. SAGE’s recommendation could significantly advance disease prevention and get more vaccine doses to more women. 

The WHO indicated that it will update its HPV vaccine recommendations following further consultation across stakeholders.  

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