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Human Papillomavirus Vaccines: Successes and Future Challenges

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Abstract

Over a decade has passed since the first human papillomavirus (HPV) vaccine was introduced. These vaccines have received unequivocal backing from the scientific and medical communities, yet continue to be debated in the media and within the general public. The current review is an updated examination that the authors made five years ago on some of the key sociocultural and behavioral issues associated with HPV vaccine uptake and acceptability, given the changing HPV vaccine policies and beliefs worldwide. We explore current worldwide HPV vaccination rates, outline HPV vaccine policies, and revisit critical issues associated with HPV vaccine uptake including: risk compensation, perceptions of vaccine safety and efficacy, age of vaccination, and healthcare provider (HCP) recommendation and communication. While public scrutiny of the vaccine has not subsided, empirical evidence supporting its safety and efficacy beyond preventing cervical cancer has amassed. There are conclusive findings showing no link that vaccinated individuals engage in riskier sexual behaviors as a result of being immunized (risk compensation) both at the individual and at the policy level. Finally, HCP recommendation continues to be a central factor in HPV vaccine uptake. Studies have illuminated how HCP practices and communication enhance uptake and alleviate misperceptions about HPV vaccination. Strategies such as bundling vaccinations, allowing nurses to vaccinate via “standing orders,” and diversifying vaccination settings (e.g., pharmacies) may be effective steps to increase rates. The successes of HPV vaccination outweigh the controversy, but as the incidence of HPV-related cancers rises, it is imperative that future research on HPV vaccine acceptability continues to identify effective and targeted strategies to inform HPV vaccination programs and improve HPV coverage rates worldwide.

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Fig. 1

(From Cervical Cancer Action. Global maps: global progress in HPV vaccination. 2017. Available at: http://www.cervicalcanceraction.org/comments/comments3.php. Accessed 24 Aug 2017)

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Notes

  1. HPV up-to-date rates were defined as those with three or more doses, and those with two doses when the first HPV vaccine dose was initiated before age 15 years and the time between the first and second dose was at least 5 months minus 4 days.

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Authors and Affiliations

  1. Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, QC, H3A 1A1, Canada

    Samara Perez & Zeev Rosberger

  2. Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Côte Ste-Catherine Road, Montreal, QC, H3T 1E2, Canada

    Samara Perez, Ovidiu Tatar & Zeev Rosberger

  3. Mont Royal Psychology, 4260 Girouard, Suite 101, Montreal, QC, H4A 3C9, Canada

    Samara Perez & Zeev Rosberger

  4. Section of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine, 410W. 10th St., HS1001, Indianapolis, IN, 46202, USA

    Gregory D. Zimet

  5. Health Behavior Consultants International, 7575 E Indian Bend Rd, Scottsdale, AZ, 85250, USA

    Nathan W. Stupiansky

  6. Department of Psychology and Department of Obstetrics and Gynaecology, University of Western Ontario, Social Sciences Centre 7428, London, ON, N6A 5C2, Canada

    William A. Fisher

  7. Departments of Psychology and Oncology, McGill University, Montreal, QC, Canada

    Zeev Rosberger

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  1. Samara Perez
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Correspondence to Samara Perez.

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This article received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Conflict of interest

Authors SP, OT, NS, and ZR have no conflicts of interest to declare. Author WF has served as a speaker concerning HPV vaccination for Merck Canada. GZ has received an honorarium from Sanofi Pasteur for participation in an adolescent immunization initiative meeting.

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Perez, S., Zimet, G.D., Tatar, O. et al. Human Papillomavirus Vaccines: Successes and Future Challenges. Drugs 78, 1385–1396 (2018). https://doi.org/10.1007/s40265-018-0975-6

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