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Home Genital Warts Genital Warts Fewer Warts Down Under

Fewer Warts Down Under

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HPV vaccine has impact in Australia

Rates of genital warts sharply decreased in young women in the years after the launch of Australia’s national HPV vaccine program, and young men from Down Under seem to have benefited, too.

In 2007, Australia began a program of free school-based HPV vaccination for all girls aged 12 and older, and also offered a free “catch-up” vaccine program for all female Australian residents up to age 26, administered through primary and community-based health care providers.

To determine how effective all these “needles in arms” have been in actually preventing genital warts, Australian researchers looked at rates of genital warts, HPV vaccine status and sexual behavior (to determine gender of sex partners) among clients of eight urban sexual health services around the country from 2004-2009.

The investigators note that vaccine uptake has been good: in the school-based program, 70% of vaccine-eligible females have received all three doses in the immunization series (compared to about 32% in the U.S.).

Of 112,083 new patients at sexual health services clinics, 9% (9,867) were diagnosed with warts. The rate of genital warts in young women residents using the sexual health services declined from 11.7% in 2007 to 4.8% in 2009, a 59% reduction.

The impact wasn’t limited to women, as external genital warts in heterosexual males decreased 28% in the same period. The reduction was especially pronounced among younger men (ages 12-26), whose rate of genital warts dropped 39%.

No significant reduction in warts was seen among men who have sex with men, women older than 26, or non-Australian residents in the country, leading the researchers to conclude the HPV vaccination program for girls and young women has indeed reduced the burden of genital warts, making this the first study to show a population-effect decrease in warts following implementation of an HPV vaccine program.

The quadrivalent vaccine used in Australia’s national program protects against the HPV type found in most cervical cancers (HPV 16 and HPV 18) and also covers the types associated with about 90% of genital warts (HPV 6 and HPV 11). Another study, looking at the vaccine’s potential impact on cervical precancers, found the incidence of high-grade cervical diseases decreased by nearly half among girls under age 18 in the first three years of the HPV vaccination program. “High-grade” diseases in this study were defined as cervical intraepithelial neoplasia (CIN) and adenocarcinoma in situ (AIS), both of which are considered precursors to invasive cervical cancer.

References
Donovan B, Franklin N, Guy R, Grulich A, Regan D, Ali H, Wand H, Fairley C. Quadrivalent human papillomavirus vaccination and trends in genital warts in Australia: analysis of national sentinel surveillance data. The Lancet Infectious Diseases, 2011. 11:39-44.
Brotherton J, Fridman M, May C, Chappell G, Saville A, Gertig D. Early effects of the HPV vaccination programme on cervical abnormalities in Victoria, Australia: an ecological study. The Lancet, 2011. 377(9783):2085-2092.