Developments in human papillomavirus vaccines, schedules, and implementation strategies.
Our aspiration is a future with universal administration prior to exposure using simply delivered and affordable vaccines covering all high-risk human papillomavirus (HPV) types and other HPVs associated with significant morbidity. However, this scenario remains unrealized: no vaccine today covers the full range of high-risk HPV types, nor have we reached every population that needs HPV vaccination, so infection remains prevalent. The reasons are multifaceted, involving scientific, economic, sociocultural, and logistical hurdles, yet efforts are ongoing worldwide to overcome these challenges. Broad implementation of primary HPV-based screening, including self-sampling, will improve cervical cancer prevention and inform many more women of their high-risk HPV-positive status. Development of high-risk HPV-targeted therapeutics could further accelerate declines in cervical cancer by clearing prevalent infections. Progress on HPV vaccination and improvements in screening technology continue at a remarkable pace. Reduction in cervical cancer incidence is evident where vaccination and/or screening have been adopted early and widely implemented.