The evolution of the human papillomavirus vaccine in the United States; an update on performance and remaining challenges
Abstract
Three prophylactic human papillomavirus (HPV) vaccines have been approved for use in the United States: a bivalent, quadrivalent, and nine-valent vaccine. Large-scale phase III clinical trials demonstrated that, when administered appropriately, the three vaccines are highly efficacious against neoplastic lesions of the cervix, vagina, vulva, and anus, while maintaining an excellent safety profile. Despite this, vaccination rates remain below national goals. In this article, we review the epidemiology of the human papillomavirus and its associated diseases; describe the various licensed HPV vaccines, with a focus on the more recent Gardasil9; and assess recent data on the effectiveness of the vaccines. Finally, we evaluate the current state of implementation and uptake in the United States and the various interventions and policy changes implemented to improve HPV vaccination rates in the United States at the patient, health care provider, state, local and national level.
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DOI: http://dx.doi.org/10.18103/imr.v3i1.319
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