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Berlaimont and Welby have queried why our recent publication (Checchi et al)1 reporting the declining trend in genital warts (GW) diagnoses in young people attending specialist sexual health services in England does not consider cross-protection of the bivalent human papillomavirus (HPV) vaccine against GW as a contributing explanation.
In a previous analysis of data to 2014 (Canvin et al), we concluded that the observed trends in young people from 2009 to 2014 were strongly in keeping with a modest cross-protective effect, and associated herd-protection, from the bivalent vaccine.2 Since then, evidence has not amassed to support that hypothesis. Most notably, data from our surveillance of …
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