Clinical and Public Health Considerations for HPV Vaccination in Midadulthood: A Narrative Review

Author:

King Laura M1ORCID,Lewnard Joseph A1,Niccolai Linda M2

Affiliation:

1. Division of Epidemiology, School of Public Health, University of California Berkeley , Berkeley, California , USA

2. Department of Epidemiology of Microbial Diseases, Yale School of Public Health , New Haven, Connecticut , USA

Abstract

Abstract Human papillomavirus (HPV) is an important cause of anogenital and oropharyngeal cancers, anogenital warts, and recurrent respiratory papillomatosis. Beginning in 2019, US guidelines recommended shared clinical decision-making (SCDM) for HPV vaccination among midadults (27–45 years). We conducted a narrative review of existing literature on HPV vaccination in midadults. The available evidence demonstrates that HPV vaccination in midadults is safe, efficacious, and likely to benefit both HPV-naïve midadults and those with previous infections. However, gaps in knowledge related to HPV vaccination have been identified among clinicians and midadult patients. Universal midadult HPV vaccination in the United States could avert 20 934–37 856 cancer cases over 100 years, costing $141 000–$1 471 000 per quality-adjusted life-year gained. Wide variation in these estimates reflects uncertainties in sexual behavior, HPV natural history, and naturally acquired immunity. Greater awareness among clinicians and midadult patients and broad implementation of SCDM may accelerate progress toward eliminating HPV-associated cancers and other diseases.

Funder

Merck Sharp & Dohme

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Oncology

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