Since 2007 two prophylactic HPV vaccines (a bivalent incorporating VLPs 16 and 18, plus a quadrivalent vaccine with VLPs 16, 18, 6, 11) have been licensed for use. This was based on excellent efficacy, immunogenicity and safety data from phase 3 clinical trials. In addition there is also some cross protection for disease for phylogenetically related genotypes. Where these vaccines have been incorporated into public health programs with high coverage, (particularly targeted school based programs), already reductions in those disease those with the shortest incubation periods, are being seen that is, genital warts for the quadrivalent vaccine.
The greatest challenge today is to obtain wide vaccine coverage to those countries with the highest incidence of disease.
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