HPV Vaccines


The discovery in the early 1970s that cervical cancer was caused by infection with human papillomavirus (HPV) stimulated a highly successful vaccine development programme based on the use of recombinant deoxyribonucleic acid (DNA) technology to produce virus proteins in a form that can stimulate powerful and long‐lasting antibody responses. The vaccines have been designed as combinations to target the HPV virus types that are responsible for most human disease. Clinical trials have shown that it is possible to prevent both genital warts and the early stages of cervical cancer through vaccination and this has led to licensure and use of HPV vaccines in many countries throughout the world. Progression from initial virus infection to development of invasive cancer is often very slow, however, and so it will be many years before the impact of the vaccine on the overall disease burden is fully understood.

Key Concepts

  • Vaccine development for HPV has been complex but highly successful. Successful vaccines were made by recombinant protein expression to produce virus‐like particles (VLPs).
  • Prevention of papillomavirus‐induced disease requires neutralising antibodies at the mucosal site of infection.
  • The main public health priority was to achieve high coverage in vaccinating women with the aim to prevent cervical cancer.
  • Prophylactic HPV vaccine efficacy has been remarkably high.
  • Some cross‐protection is observed between different vaccine types.
  • HPV vaccines have been implemented in populations of young women widely around the world.
  • Access to affordable HPV vaccines in poor countries is a key goal but remains a challenge.
  • The scope of HPV vaccination extends to the prevention of non‐cervical HPV infections and related diseases in both females and males.

Keywords: HPV; vaccine; cervical cancer; genital warts; vaccine trials; multivalent vaccines; immunisation

Figure 1. Principal disease targets for HPV vaccination. (a) Courtesy of Professor Margaret Stanley and (b) Courtesy of Professor Charles Lacey.
Figure 2. Histological changes associated with progression to cervical cancer. Courtesy of Professor Margaret Stanley.
Figure 3. Electron micrographs of naturally occurring virus and virus‐like particles produced by recombinant DNA expression.


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Further Reading

ECDC (2012) European Centre for Disease Prevention and Control. Introduction of HPV vaccines in EU countries – an update. Stockholm. Available at http://www.ecdc.europa.eu/en/publications/_layouts/forms/Publication_DispForm.aspx?List=4f55ad51‐4aed‐4d32‐b960‐af70113dbb90&ID=677. This is a guidance document for policymakers in Europe.

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ICO Information Centre on Human Papilloma Virus (HPV) and Cervical Cancer. http://www.who.int/hpvcentre/en/

Stern PL and Kitchener HC (eds) (2008) Vaccines for the Prevention of Cervical Cancer (Oxford Oncology Library), Paperback, pp. 1–170. Oxford: Oxford University Press.

Vaccine (2013) Dec 31 Suppl 7. Several review articles on HPV vaccines and their implementation.

WHO HPV Vaccine Introduction Clearing House; http://www.who.int/immunization/hpv/en/

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Wilkinson, Dianna E, and Inglis, Stephen(Jan 2015) HPV Vaccines. In: eLS. John Wiley & Sons Ltd, Chichester. http://www.els.net [doi: 10.1002/9780470015902.a0021551.pub2]