HPV vaccines: a decade of progress
The history of vaccination against the human papilloma virus (HPV) is not a long one, with the US Food and Drug Administration approving the first preventive HPV vaccine just over a decade ago. Since then, significant progress has been made to roll out vaccination programmes worldwide. With the UK recently announcing that it will extend HPV vaccination to boys from 2019, Charlotte Edwards examines major developments in the vaccine’s history.
According to the World Health Organization (WHO), cervical cancer is the leading cause of cancer deaths in women in developing countries and is responsible for 91% of global estimated HPV-related cancer deaths.
The human papilloma virus (HPV) vaccine is a treatment that was created to prevent patients becoming infected with certain types of HPV, a group of viruses than can affect the skin and moist membranes lining the body. The most common areas it affects include the cervix, anus, mouth and throat. There are more than 100 types of HPV and genital HPV infections are the most contagious. They are spread through sexual intercourse and skin-to-skin contact.
Patients who contract HPV are at risk of developing abnormal tissue growth, which can lead to cervical cancer. It is for this reason that many countries offer young girls the HPV vaccine.
Earlier this year, the UK Government announced that its national HPV vaccine programme will be extended to include adolescent boys aged 12 to 13 years old. The current UK programme only covers girls aged 12 to 18 years old and men who have sex with men.
Abbas Kanani is a pharmacist at the online pharmacy Chemist Click and has already given the vaccine to some young men. He thinks it is fantastic that the UK Government has recognised the importance of vaccinating males against HPV and believes the positive long-term complications out-weigh any argument about the cost-effectiveness.
“Although males are not directly affected by cervical cancer, they are still capable of contracting the strains that are responsible for causing cervical cancer and passing it on to females,” Kanani says. “The HPV vaccination is also effective in protecting against other cancers as well as genital warts and I’m almost certain that we’ll see a drop in the cases of these complications in the near future as a result of this initiative.”
Considering its success, the HPV vaccine is actually quite young in the grand scheme of vaccinations. Here is a timeline highlighting some of the most notable moments in the short history of the cancer-preventing treatment, from its invention to future plans to extend its accessibility.
Invention and approval
The HPV vaccine was developed by Ian Frazer and Jian Zhou at the University of Queensland in Australia during the 1990s and early 2000s. The Queensland researchers then collaborated with teams at Georgetown University Medical Center, the University of Rochester, and the US National Cancer Institute to create the final form of the vaccination.
The vaccine finally received approval from the US Food and Drug Administration in 2006. It was first marketed by US pharmaceutical company Merck & Co under the trade name Gardasil.
Fast track reviews result in rapid expansion
In 2007, British pharmaceutical company GlaxoSmithKline filed for US approval of a similar HPV preventative vaccine called Cervarix. By the second quarter of 2007, the Gardasil HPV vaccine had been approved in 80 countries, thanks to many fast track reviews.
In 2008, German researcher Harald zur Hausen was awarded half of the $1.4m Nobel Prize in Medicine for helping to prove that genital HPV infections can lead to cervical cancer and subsequently inspiring the invention of the HPV vaccine.
Cervarix was approved for use in the US in October 2009.
Gardasil 9 approved
HPV Action is just one of the organisations campaigning for the HPV vaccine to be extended to boys. The charity was set up in 2013 with the main goal of getting the UK HPV vaccination programme to cover all genders.
In December 2014, the FDA approved a vaccine called Gardasil 9, aimed at protecting females between the ages of nine and 26 and males between the ages of nine and 15 against nine strains of HPV. Gardasil 9 protects against the HPV strains covered by the first generation of Gardasil, as well as five other strains that are known to be responsible for 20% of cervical cancers.
In 2015, the work of Frazer and Zhou was recognised once more when they were awarded the European Inventor Award for developing the world’s first vaccine against cervical cancer.
China approves vaccine
In July 2016, the Cervarix HPV vaccine was approved by China’s Food and Drug Administration (CFDA) and became the first approved HPV vaccine in China. It was made more easily accessible for women in China in 2018.
These events marked an important milestone in China’s healthcare history, as delays in approval of the vaccine on the Chinese mainland due to scepticisms over its low risk resulted in thousands of women travelling to Hong Kong and abroad for the medication. Hundreds of millions of women now have the chance to be vaccinated.
China is also developing its own HPV vaccine, which is expected to enter the market in 2022.
Negative rumours surrounding the vaccine still plague its uptake in certain countries, such as Japan, Denmark and India.
WHO announced earlier this month that ten lower-income countries will have introduced the vaccine by the end of 2018, following on from its recent introduction to Tanzania and Zimbabwe.
UK approves vaccine for boys
After years of passionate campaigning, in July 2018, the UK Government announced that the national HPV vaccination programme will be extended to adolescent boys aged 12 to 13 years old in 2019.
It is estimated that approximately 400,000 boys in the UK will be protected from the HPV virus once this programme is rolled out. The UK will join a number of countries that have already vaccinated or plan to vaccinate boys, including Australia, Austria, Brazil, Canada, Israel, Italy, New Zealand, Norway, Switzerland and the US.
However, it may take a number of years before results regarding how successful this early vaccination programme has been at preventing cancer can be assessed, as the HPV virus can take a long time to manifest.
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