COMMENTARY

One and Done: A Single-Dose HPV Vaccination Strategy May Be Coming

Maurie Markman, MD

Disclosures

July 26, 2022

This transcript has been edited for clarity.

I'm Dr Maurie Markman from Cancer Treatment Centers of America. I would like to briefly discuss what I would characterize as one of the most important papers on cancer prevention published over the past 20-plus years.

The paper was recently published in NEJM Evidence, which is the new journal of The New England Journal of Medicine, and the paper is entitled Efficacy of Single-Dose Human Papilloma Virus Vaccination among Young African Women.

It is very clear that HPV vaccination has an enormously positive impact on the precursors of cervical cancer and increasing evidence is showing an effect on cervical cancer itself. We know that more than 70% of cervical cancers are caused by HPV-16 and HPV-18. If a patient does not already have persistent HPV-16 or HPV-18, vaccination is almost 100% effective in preventing that persistence and subsequent development of the precursors of cervical cancer.

The strategies that have been used to date have required three doses of the HPV vaccine, though some have looked at two doses. The issue is cost, time, and effort. In parts of the world and parts of the United States where it is difficult to have individuals come back for a second or third vaccination, the concern has been that the adequacy of the vaccination would be dramatically reduced.

This paper, however, suggests just the opposite: that in fact, a single dose of the available vaccines is highly effective.

A single dose was 97.5% effective in preventing persistent HPV infection — close to 100% effective in this population.

The issue with this particular trial is that the follow-up was relatively short; it was actually 18 months. So more data are required and certainly longer follow-up with this population.

By the way, the World Health Organization has now supported the recommendation for a single-dose schedule. If single-dose HPV vaccines are shown to be equally effective to two or three doses, then this may be a game changer for encouraging individuals to be vaccinated. It's a single dose. They don't have to come back, thus reducing costs and addressing obstacles in areas where it is difficult to get patients vaccinated once, much less two or three times.

We need to watch the data to confirm that these results are maintained over a period of not a couple of years, but much longer than that.

For those of you who are interested in cervical cancer prevention, or cancer prevention of any kind, this is an extremely important paper. I would encourage you to read and review the paper, and carefully follow additional results that come out not only from this trial but from other trials looking at a single-dose HPV vaccination strategy. I thank you for your attention.

Maurie Markman, MD, is president of medicine and science at Cancer Treatment Centers of America in Philadelphia. He has more than 20 years of experience in cancer treatment and gynecologic oncology research.

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