Ongoing decline in genital warts among young heterosexuals 7 years after the Australian human papillomavirus (HPV) vaccination programme

Abstract

Genital warts have now become rare in young Australian women and heterosexual men 7 years after the launch of the national HPV vaccination programme but in stark contrast, remain common in men who have sex with men.

Human papillomavirus vaccination in men who have sex with men – what will be required by 2020 for the same dramatic changes seen in heterosexuals

“…For example, genital warts and HPV types 16,18 largely disappeared in Australian-born women within 7 years of the vaccination program commencing in women. 7,8 Genital warts have fallen by more than 90%, and a similar magnitude of fall has been seen for HPV 16,18 in genital samples analysed from women; this change has occurred with~70% of women having been vaccinated. 7,8 Importantly, declines of~80% were also seen in genital warts and HPV 16/18 in young heterosexual men who had largely not received the HPV vaccine.…”

“…7,8 Genital warts have fallen by more than 90%, and a similar magnitude of fall has been seen for HPV 16,18 in genital samples analysed from women; this change has occurred with~70% of women having been vaccinated. 7,8 Importantly, declines of~80% were also seen in genital warts and HPV 16/18 in young heterosexual men who had largely not received the HPV vaccine. 7,9 These dramatic falls are consistent with the vaccination coverage being greater than the critical vaccination threshold for both genital warts (largely HPV 6 or11) and the oncogenic HPV types, 16 and 18.…”

“…7,8 Importantly, declines of~80% were also seen in genital warts and HPV 16/18 in young heterosexual men who had largely not received the HPV vaccine. 7,9 These dramatic falls are consistent with the vaccination coverage being greater than the critical vaccination threshold for both genital warts (largely HPV 6 or11) and the oncogenic HPV types, 16 and 18. Not surprisingly, little change in genital warts has occurred in MSM attending sexual health services in Australia.…”

“…When these two factors are considered,~91% (100% minus (30% by 30%)) of random partnerships involving MSM are protected with a vaccine coverage of 70%. 7 So if the vaccination coverage achieved in boys is the same as seen in girls, it is quite possible that this coverage may be sufficient to overcome the higher reproductive rate of HPV infection in MSM. Australia began vaccinating young boys in 2013 and the current vaccination coverage is at least 60%, so that within 5 years' studies looking at genital warts and HPV DNA, young MSM will be able to answer this question.…”

HPV vaccination to prevent cervical cancer and other HPV-associated disease: from basic science to effective interventions

“…Australia was the earliest country to adopt widespread uptake of the HPV vaccine, predominantly the quadrivalent vaccine. Approximately 75% of the female population under 18 was vaccinated, which has led to a dramatic reduction in the incidence of genital warts in women under 30, including evidence of herd immunity, because the incidence of genital warts in young heterosexual men -who were not vaccinated during this period -has also been reduced (30). There has also been a reduction in high-grade cervical dysplasia among young Australian women, together with a substantial and specific decrease in the prevalence of the vaccine types in young women (31).…”