Background and Aims: In Australia, the National HPV Vaccination Program began in April 2007 in an effort to reduce the incidence of cervical cancer. Australia was the first country to implement a government-funded program, and hence is ideally placed to measure vaccine effectiveness in a real-world setting.
Methods and results: A review of HPV prevalence of vaccine-targeted genotypes (HPV6, 11, 16, 18) among vaccine-eligible young women presenting for routine cervical (Pap) cytology has already shown a significant reduction (77%)1 . Amongst diseases caused by HPV there has been a significant reduction in genital warts of >90% in young women and also in young males, a marker of herd immunity2 . In addition, a significant reduction in high grade cervical dysplasias has been reported3 . The “VACCINE” (Vaccine Against Cervical Cancer Impact and Effectiveness) study is a novel study in which we are measuring i) HPV prevalence in CIN3/AIS lesions occurring in vaccine age-eligible Victorian women (born after 30 June 1981), using laser capture microdissection to dissect lesions prior to HPV genotyping to define the causal HPV genotype for each lesion4 , and ii) prevalence of vaccine-targeted HPV genotypes among vaccine-eligible Victorian women aged 18-25 being recruited from the general population through the social networking website Facebook5 .
Conclusion:
In Australia, with high coverage of vaccination to the targeted population we are already seeing that the prevalence of vaccine-related HPV genotypes is remarkably low. This reduction in vaccine-targeted HPV genotypes has also translated into a reduction in the shortest incubation period diseases: genital warts and high grade cervical dysplasias. Ultimately, reductions in cervical cancer and other HPV-related anogenital neoplasias is predicted.