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Global Health
July 21, 2020

Diverse HPV Strains Require Strategic Vaccine Use

JAMA. 2020;324(3):223. doi:10.1001/jama.2020.12058

As the burden of cervical cancer increases in low- and middle-income countries, a recent study suggested that human papillomavirus (HPV) vaccines that protect a majority of women from the disease would provide only limited protection for women in Honduras.

Researchers who screened 2645 women with HPV DNA testing found that HPV strains 16 and 18—which account for 70% of all cervical cancers worldwide—are far less prevalent in the areas of northern Honduras where the women lived. In fact, only 14% to 26% of the Honduran women screened would have been protected by the bivalent vaccine, which protects against strains 16 and 18, or the quadrivalent vaccine, which protects against strains 16, 18, 6, and 11. A much higher proportion, 40% to 70%, would be protected by the 9-valent vaccine, which protects against the 4 strains in the quadrivalent vaccine plus strains 31, 33, 45, 52, and 58. However, the 9-valent vaccine is also the most expensive. To further verify their results, the researchers analyzed 100 cervical cancer samples from a cancer center in Honduras and found that more than 80% of tumors could have been prevented by the 9-valent vaccine.