Should older women be vaccinated against human papillomavirus, too?

A study led by Cosette Wheeler from the University of New Mexico Comprehensive Cancer Center (UNM; NM, USA) has demonstrated that the human papillomavirus (HPV) vaccine is effective in protecting women over the age of 25 years against infection.  This study, published in The Lancet Infectious Disease, highlights the need for these older age groups to be vaccinated, too.

These data are the result of the ongoing VIVIANE study, which aims to evaluate the efficacy, safety and immunogenicity of the HPV 16/18 AS04-adjuvanted vaccine in adult women – an age group that is currently not protected against HPV.

Five types of HPV infection account for approximately 85% of all invasive cervical cancers and can also cause cancer of the anus and middle throat.  Many countries have vaccination programs that vaccinate girls and boys under the age of 26 years while leaving older individuals vulnerable.

The Phase III, multinational, double-blind, controlled study randomly allocated either the HPV 16/18 vaccine or aluminum hydroxide control to 5747 healthy women over the age of 25 years. The women were separated into groups aged 26–35 years, 36–45 years and over 46 years.  Up to 15% of women in each age group had a history of HPV infection.

The women were followed for 4–7 years and results indicated that vaccine efficacy against HPV infection or cervical intraepithelial neoplasia grade 1 or higher was significant across all the age groups.  The women were also found to be protected from other HPV-associated infections.

These findings demonstrate the benefit of vaccinating women of all age groups against HPV infection. Future approaches in cancer prevention could consider these results and lead to older women being included in vaccination programs.

Sources: Wheeler CM, Skinner SR, Del Rosario-Raymundo MR, et al.  Efficacy, safety, and immunogenicity of the human papillomavirus 16/18 AS04-adjuvanted vaccine in women older than 25 years: 7-year follow-up of the phase 3, double-blind, randomised controlled VIVIANE study. Lancet. Infect. Dis. DOI: (2016); UNM press release