In the recent issue of Pediatrics, scientists published the results of an ten year follow-up study on a population of kids who received an HPV-9 vaccine during the original clinical trials. The primary outcome of interest was HPV related cancer diagnosis. The secondary outcome was the incidence of persistent HPV related outcomes.
So what did they find?
Among females, the incidence in PPE analyses of the composite endpoint of HPV6/11/16/18/31/33/45/52/58-related 6-month persistent infection and disease was 52.4 per 10 000 person-years (persistent infection: 52.4 per 10 000 person-years; disease: 2.2 per 10 000 person-years; Table 2). There were no cases of high-grade CIN and no cases of VIN and VaIN related to vaccine-targeted HPV types. One case of cervical intraepithelial neoplasia grade 1 (CIN1) tested positive for HPV16, HPV39, and HPV59 by PCR at month 84 (Supplemental Appendix 1); cervical cytology results were negative at subsequent visits….
Among males, the incidence in PPE analyses of the composite endpoint of HPV6/11/16/18/31/33/45/52/58-related 6-month persistent infection and disease was 54.6 per 10 000 person-years (persistent infection: 54.6 per 10 000 person-years; disease: 0 per 10 000 person-years; Table 2). There were no cases of disease related to vaccine-targeted HPV types.
Results were similar when effectiveness was analyzed in the HN-TS population (Supplemental Table 14). There were no additional cases of disease endpoints in females or males in the HN-TS population.
10 years of follow-up from initial vaccination shows one, low grade, cancer in the entire population. The expected rate of cervical cancer is about 8 per 100,000 person years. This study shows over a 75% decline in incidence of cervical cancer.
So what does it mean!
First WOW. Vaccines are weirdly incredible. This is an awesome result. Teens should be vaccinated for the biggest impact on both personal protection and population health. Secondly, we are in an era where basic public health policies and programs are highly politicized. We’re seeing lower vaccination rates for the recommended kindergarten disease menu. COVID is the clearest examine where partisanized identity has led to massive vaccine preventable excess deaths.
HPV has always been a politicized vaccine because it acknowledges that most teens at some point will be sexually active either today or sometime in the next few decades. We as a society don’t do a good job thinking about teen sexual autonomy and health and we do a piss poor job as a society respecting teen woman and gender minority sexual health and autonomy in particular.
The only question I’ve had with my 14 year old on the HPV vaccine is whether they preferred ice cream or a Frappuccino afterwards. The last two choices have been fancy coffee-like drinks as a reward. My 11 year old prefers ice cream as their post vaccine incentive. And I assume that the kids of most of my friends and peers either are, in the process of, or will be vaccinated against HPV. However if we move thirty miles down the road, that assumption weakens substantially.
We’re building future health disparities by our choices today.