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Human Papillomavirus Vaccine Against Cervical Cancer: New Usage Strategies and...
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Human Papillomavirus Vaccine Against Cervical Cancer: New Usage Strategies and Coverage Issues

A special issue of Vaccines (ISSN 2076-393X). This special issue belongs to the section "Human Papillomavirus Vaccines".

Deadline for manuscript submissions: 30 June 2025 | Viewed by 10854

Special Issue Editors

Dr. Luca Giannella

E-Mail Website
Guest Editor
Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, 60213 Ancona, Italy
Interests: pathology of the lower genital tract disease; HPV related disaese; HPV vaccination; HPV genotype distribution
Special Issues, Collections and Topics in MDPI journals
Dr. Andrea Ciavattini

E-Mail Website
Guest Editor
Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, 60213 Ancona, Italy
Interests: pathology of the lower genital tract disease; HPV related disease; HPV vaccination; HPV genotype distribution
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Cervical cancer (CC) represents one of the most common female cancers worldwide, with 80% of cases originating from developing countries. These data are surprising given that CC is the only tumor that has primary and secondary prevention. The WHO has set goals for its elimination by 2030, proposing a vaccination coverage of 90%. In many countries worldwide, the vaccination coverage is well below this set goal. Hence, there is a need to implement vaccination coverage.

This Special Issue aims to provide evidence regarding the use of the HPV vaccine in different settings. Adolescent girls represent the primary target, but its use after excisional or definitive treatments is a trending topic of interest. Furthermore, the tools necessary for its implementation aimed at women of screening age or parents with daughters of vaccination age are topics of crucial interest.

In this Special Issue, original research articles and reviews are welcome. Research areas may include (but are not limited to) the following: HPV vaccination coverage in developed and developing countries, HPV vaccination after conization, HPV vaccination after hysterectomy for cervical pathology, the role of HPV vaccination after fertility-sparing treatment, HPV vaccination in male, HPV vaccination in vaginal and vulvar pathology, and HPV genotype distribution in cervical pathology according to age.

We look forward to receiving your contributions.

Dr. Luca Giannella
Dr. Andrea Ciavattini
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Vaccines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • HPV vaccination coverage
  • HPV vaccination after conization
  • HPV vaccination in fertility-sparing treatment
  • male HPV vaccination HPV
  • vaccination after hysterectomy
  • tools for HPV vaccination implementation
  • HPV genotype in pre-invasive and invasive cervical pathology
  • HPV vaccination in vaginal pathology
  • HPV vaccination in vulvar pathology

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Published Papers (4 papers)

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Research

16 pages, 1898 KiB  
Article
Impact of HPV Catch-Up Vaccination on High-Grade Cervical Lesions (CIN2+) Among Women Aged 26–30 in Northern Norway
by Amanda Sørensen Jørgensen, Gunnar Skov Simonsen and Sveinung Wergeland Sørbye
Vaccines 2025, 13(1), 96; https://doi.org/10.3390/vaccines13010096 - 20 Jan 2025
Viewed by 1270
Abstract
Background/Objectives: Human papillomavirus (HPV) is the primary cause of high-grade cervical lesions and cervical cancer worldwide. In Norway, HPV vaccination was introduced in 2009 for seventh-grade girls and extended through a catch-up program from 2016 to 2019 for women born between 1991 and [...] Read more.
Background/Objectives: Human papillomavirus (HPV) is the primary cause of high-grade cervical lesions and cervical cancer worldwide. In Norway, HPV vaccination was introduced in 2009 for seventh-grade girls and extended through a catch-up program from 2016 to 2019 for women born between 1991 and 1996. This study evaluates the impact of the catch-up vaccination program on the incidence of HPV and high-grade cervical lesions in Troms and Finnmark. Methods: We analyzed data from 40,617 women aged 26 to 30 who underwent cervical screening between 2009 and 2023 in Troms and Finnmark, including 1850 women with high-grade cervical lesions (CIN2+) on biopsy. Using linear regression, we assessed trends in high-grade lesion incidence per 1000 screened women and the association between vaccination status and HPV-16/18 incidence. Results: Between 2017 and 2023, the incidence of high-grade cervical lesions significantly decreased: CIN2+ decreased by 33.4%, and CIN3+ decreased by 63.4%. Significant reductions in HPV-16/18-associated high-grade cervical lesions were observed among vaccinated women, with the proportion of CIN2+ cases due to HPV-16 and 18 decreasing from 56.8% in 2017 to 40.7% in 2023, reflecting a 55.8% reduction in the absolute number of cases caused by these high-risk HPV types. Comparing unvaccinated women aged 25–26 in 2016 and vaccinated women in 2023, HPV-16 incidence decreased from 5.1% to 0.1%, and HPV-18 incidence decreased from 3.3% to 0.0%. Conclusions: The catch-up vaccination program significantly reduced the incidence of HPV-16/18 and high-grade cervical lesions in Troms and Finnmark, even with the lower vaccination coverage observed in the catch-up program. These findings demonstrate the effectiveness of HPV vaccination programs in reducing HPV infections and associated cervical lesions. Full article
(This article belongs to the Special Issue Human Papillomavirus Vaccine Against Cervical Cancer: New Usage Strategies and Coverage Issues)
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23 pages, 1959 KiB  
Article
The Potential Impact of a Single-Dose HPV Vaccination Schedule on Cervical Cancer Outcomes in Kenya: A Mathematical Modelling and Health Economic Analysis
by Grace Umutesi, Christine L. Hathaway, Jesse Heitner, Rachel Jackson, Christine W. Miano, Wesley Mugambi, Lydiah Khalayi, Valerian Mwenda, Lynda Oluoch, Mary Nyangasi, Rose Jalang’o, Nelly R. Mugo and Ruanne V. Barnabas
Vaccines 2024, 12(11), 1248; https://doi.org/10.3390/vaccines12111248 - 1 Nov 2024
Viewed by 1792
Abstract
Background: Human Papillomavirus (HPV) is the primary cause of cervical cancer. Single-dose HPV vaccination can effectively prevent high-risk HPV infection that causes cervical cancer and accelerate progress toward achieving cervical cancer elimination goals. We modelled the potential impact of adopting single-dose HPV [...] Read more.
Background: Human Papillomavirus (HPV) is the primary cause of cervical cancer. Single-dose HPV vaccination can effectively prevent high-risk HPV infection that causes cervical cancer and accelerate progress toward achieving cervical cancer elimination goals. We modelled the potential impact of adopting single-dose HPV vaccination strategies on health and economic outcomes in Kenya, where a two-dose schedule is the current standard. Methods: Using a validated compartmental transmission model of HPV and HIV in Kenya, we evaluated the costs from the payer’s perspective to vaccinate girls by age 10 with either one or two doses and increasing coverage levels (0%, 70%, 77%, 90%). Additionally, we modelled single-dose strategies supplemented with either catch-up vaccination of adolescent girls and young women or vaccination for all by age 10, funded with the first five-years of cost savings of switching from a two- to one-dose schedule. Costs and outcomes were discounted at 3% annually, and incremental cost-effectiveness ratios (ICERs) were calculated per disability-adjusted-life-year (DALY) averted. Results: All one-dose and the two-dose 90% coverage strategies were on the efficiency frontier, dominating the remaining two-dose strategies. The two-dose 90% coverage strategy had a substantially higher ICER (US$6508.80/DALY averted) than the one-dose 90% coverage (US$197.44/DALY averted). Transitioning from a two- to one-dose schedule could result in US$21.4 Million saved over the first five years, which could potentially fund 2.75 million supplemental HPV vaccinations. With this re-investment, all two-dose HPV vaccination scenarios would be dominated. The greatest DALYs were averted with the single-dose HPV vaccination schedule at 90% coverage supplemented with catch-up for 11–24-year-old girls, which had an ICER of US$78.73/DALYs averted. Conclusions: Considering the logistical and cost burdens of a two-dose schedule, a one-dose schedule for girls by age 10 would generate savings that could be leveraged for catch-up vaccination for older girls and accelerate cervical cancer elimination in Kenya. Full article
(This article belongs to the Special Issue Human Papillomavirus Vaccine Against Cervical Cancer: New Usage Strategies and Coverage Issues)
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15 pages, 3228 KiB  
Article
Enhanced Broad-Spectrum Efficacy of an L2-Based mRNA Vaccine Targeting HPV Types 6, 11, 16, 18, with Cross-Protection Against Multiple Additional High-Risk Types
by Kosuke Tsukamoto, Akio Yamashita, Masatoshi Maeki, Manabu Tokeshi, Hirotatsu Imai, Akira Fukao, Toshinobu Fujiwara, Koji Okudera, Nobuhisa Mizuki, Kenji Okuda and Masaru Shimada
Vaccines 2024, 12(11), 1239; https://doi.org/10.3390/vaccines12111239 - 30 Oct 2024
Viewed by 1500
Abstract
Background: Current L1-based human papillomavirus (HPV) vaccines provide type-specific protection but offer limited cross-protection against non-vaccine HPV types. Therefore, developing a broad-spectrum HPV vaccine is highly desirable. Methods: In this study, we optimized mRNA constructs and developed a multivalent L2-based mRNA vaccine encoding [...] Read more.
Background: Current L1-based human papillomavirus (HPV) vaccines provide type-specific protection but offer limited cross-protection against non-vaccine HPV types. Therefore, developing a broad-spectrum HPV vaccine is highly desirable. Methods: In this study, we optimized mRNA constructs and developed a multivalent L2-based mRNA vaccine encoding L2 aa 2-130, which includes all known neutralizing epitopes from four prevalent HPV types (HPV-6, -11, -16, and -18). We evaluated its immunogenicity in a mouse model and compared the efficacy of a commercially available mRNA delivery reagent with a custom-synthesized lipid nanoparticle (LNP) formulation. Results: We identified that a construct containing E01 (a 5′-untranslated region) and SL2.7 (a poly(A) polymerase recruitment sequence) significantly increased protein expression. The L2-based mRNA vaccine induced robust and long-lasting humoral immune responses, with significant titers of cross-reactive serum IgG antibodies against L2 epitopes. Notably, the vaccine elicited cross-neutralizing antibodies and conferred cross-protective immunity not only against vaccine-targeted HPV types but also against non-vaccine HPV types, following intravaginal challenge in mice. We also found that LNP delivered mRNA more effectively in vivo. Conclusions: The L2-based mRNA vaccine developed in this study shows significant potential for broad-spectrum protection against multiple HPV types. This approach offers a promising strategy for reducing the global burden of HPV-associated cancers. Full article
(This article belongs to the Special Issue Human Papillomavirus Vaccine Against Cervical Cancer: New Usage Strategies and Coverage Issues)
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22 pages, 3340 KiB  
Article
Vaccination with a Human Papillomavirus L2 Multimer Provides Broad Protection against 17 Human Papillomavirus Types in the Mouse Cervicovaginal Challenge Model
by Zhenwei Han, Shen Wang, Ting Mu, Ping Zhao, Lingli Song, Ying Zhang, Jin Zhao, Wen Yin, Yue Wu, Huan Wang, Bo Gong, Min Ji, Richard B. S. Roden, Yanping Yang, Michel Klein and Ke Wu
Vaccines 2024, 12(6), 689; https://doi.org/10.3390/vaccines12060689 - 20 Jun 2024
Viewed by 4632
Abstract
Human papillomavirus (HPV) is a prevalent cause of mucosal and cutaneous infections and underlying conditions ranging from benign warts to anogenital and oropharyngeal cancers affecting both males and females, notably cervical cancer. Cervical cancer is the fourth leading cause of cancer deaths among [...] Read more.
Human papillomavirus (HPV) is a prevalent cause of mucosal and cutaneous infections and underlying conditions ranging from benign warts to anogenital and oropharyngeal cancers affecting both males and females, notably cervical cancer. Cervical cancer is the fourth leading cause of cancer deaths among women globally and is the most impactful in low- and middle-income countries (LMICs), where the costs of screening and licensed L1-based HPV vaccines pose significant barriers to comprehensive administration. Additionally, the licensed L1-based HPV vaccines fail to protect against all oncogenic HPV types. This study generated three independent lots of an L2-based target antigen (LBTA), which was engineered from conserved linear L2-protective epitopes (aa11–88) from five human alphapapillomavirus genotypes in E. coli under cGMP conditions and adjuvanted with aluminum phosphate. Vaccination of rabbits with LBTA generated high neutralizing antibody titers against all 17 HPV types tested, surpassing the nine types covered by Gardasil®9. Passive transfer of naïve mice with LBTA antiserum revealed its capacity to confer protection against vaginal challenge with all 17 αHPV types tested. LBTA shows stability at room temperature over >1 month. Standard in vitro and in vivo toxicology studies suggest a promising safety profile. These findings suggest LBTA’s promise as a next-generation vaccine with comprehensive coverage aimed at reducing the economic and healthcare burden of cervical and other HPV+ cancers in LMICs, and it has received regulatory approval for a first-in-human clinical study (NCT05672966). Full article
(This article belongs to the Special Issue Human Papillomavirus Vaccine Against Cervical Cancer: New Usage Strategies and Coverage Issues)
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