Primary prevention of cervical cancer: vaccines against human papillomavirus

Currently two excellent vaccines against HPV are available: the quadrivalent vaccine (VT) 6-11-16-18 types, marketed as Gardasil, and the bivalent one (BV), types 16-18, marketed as Cervarix. Both vaccines have updated their sheets in 2014. There are several aspects to emphasize: the administration's age is from 9 years with no upper limit; sexual activity of the woman or her previous contact with the virus doesn't represent a barrier for HPV vaccination; protection conferred is extended to intraepithelial neoplasia of cervix, vagina and vulva; there is some degree of cross protection, especially for VB; VT protects - males (9-26 years) and women-against anal neoplasia and genital warts. We also note three other important contributions: 1) If used to treat cervical intraepithelial neoplasia (both vaccines) or genital warts (VT), vaccines confer a dramatic reduction (60% on average) of risk of recurrence/second injury; 2) Two doses (months 0 and 6) are enough in children aged 9 to 13 years (VT) and girls up to 14 years (VB); 3) very encouraging evidence of immunogenicity, safety and efficacy are reported about the nine-valent vaccine (V503, Merck), type 6/11/16/18/31/33/45/52/58, comparable to VT data. Finally, safety of both vaccines is beyond doubt. WHO and the Center for Disease Control of the United States (CDC) have recently re-confirmed it.