Optimising Human Papillomavirus Vaccination Strategies for Faster Cervical Cancer Elimination

AIM: Cervical cancer elimination is a global public health goal, with vaccination against Human Papillomavirus (HPV) and HPV screening being two major prevention pillars. This review focuses on how vaccinations can be used in order to reach the timepoint of cervical cancer elimination faster. METHODS: The concepts in previously published reviews on 'faster cervical cancer elimination' are summarised and explained. RESULTS: Major concepts explained are: HPV vaccines prevent not only cancer precursors, but also the HPV infection itself resulting in public health gains that exceed the individual direct vaccine protection because of herd immunity. The effective population coverages of vaccine-induced immunity required to reach the critical extinction level for infection elimination are moderate, in particular when gender-neutral vaccination is used. Major suggested enabling strategies include catch-up vaccinations of adolescents, one-dose HPV vaccination and use of HPV prevalences to monitor and optimise HPV vaccination programs. Finally, cervical screening with HPV testing is predicted to be easier if there are no new HPV infections. CONCLUSION: The major challenge for faster cervical cancer elimination is to design HPV vaccination strategies that achieve an effective population immunity against the HPV infection as fast as possible.