Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Are we ready for a single-dose HPV vaccine?

Jennifer Gunter, MD
Meds
June 29, 2015
Share
Tweet
Share

shutterstock_206493670

A new paper in the journal Lancet Oncology evaluates outcomes after vaccination with Cervarix, which is the HPV vaccine that is effective against the 2 most oncogenic (cancer-causing) strains: HPV 16 and 18. The paper is actually a compilation of results from two studies of Cervarix among women ages 15-25 and now has four years of follow-up data on more than 26,000 women.

While the intent of both studies was to give all women three doses, not everyone received all three. (It was often a pregnancy that lead to the dropout.) The outcomes of women who received one and two doses were compared with the women who received all three. When the data was analyzed, one dose of Cervarix was equally effective at protecting against infection with HPV 16 and 18 as two and three doses. Antibody levels were lower with one dose versus two or three but still much higher at four years than would occur after a “natural” HPV infection. When two doses were given six months apart, there was some cross-protection against infection with HPV 31/33/45 (other cancer-causing strains not in the vaccine).

Both HPV vaccines (Cervarix and Gardasil) were developed with a prime-prime-boost schedule, which means doses at 1,2, and 6 months. These vaccines are highly effective at producing antibodies, and there is some data to suggest two doses (the 2nd dose at six months) are as good as the three. The U.K. has already moved to a 2 dose regimen for both vaccines.

These results cannot be translated to Gardasil, the other HPV vaccine. This is because there are one of two things giving the immune system such a good kick from a single dose of Cervarix — the virus-like particles (VPL, which are recognized by the immune system and stimulate an antibody response) or the adjuvant (the ingredient that helps trigger the immune response).  VLP vaccines are very good at stimulating the immune system and typically produce high levels of antibodies that last. If the favorable response to a single dose of Cervarix is due to the VPL, then a single dose could potentially be enough for Gardasil. However, if the response is due to the adjuvant, then this will be unique to Cervarix as it has a completely different adjuvant than Cervarix.

This isn’t enough data to move to a single-dose of Cervarix just yet. In a press release from Lancet Oncology Dr. Cosette Wheeler, co-lead author, indicated that a randomized study will be needed to confirm the findings. Also, according to Dr. Wheeler duration of protection from the single dose for more than four years will need to be confirmed.

The public health implications of going to a single dose would be huge. This vaccine protects against the two viruses that cause about 70 percent of cervical cancers, and a single dose would reduce costs dramatically as well as simplify administration.  If a single dose proves as effective in a prospective trial, this could be a real game changer, especially for women in third world countries where cervical cancer screening programs are virtually non-existent. However, even in industrialized countries the cost savings would be huge, and it is reasonable the think that vaccination rates might rise if only a single dose was needed.

hpvredo1

 

hovredp2

Jennifer Gunter is an obstetrician-gynecologist and author of The Preemie Primer. She blogs at her self-titled site, Dr. Jen Gunter.

Image credit: Shutterstock.com

Prev

Should radiologists disclose results to patients? The answer isn't what you think.

June 29, 2015 Kevin 13
…
Next

Doctor saves patient from harm after her insurer tries save money

June 29, 2015 Kevin 32
…

Tagged as: OB/GYN

Post navigation

< Previous Post
Should radiologists disclose results to patients? The answer isn't what you think.
Next Post >
Doctor saves patient from harm after her insurer tries save money

ADVERTISEMENT

More by Jennifer Gunter, MD

  • The Ellen Show broadcasts potentially harmful information about ovarian cancer screening

    Jennifer Gunter, MD
  • Dear science: an appreciation

    Jennifer Gunter, MD
  • Are there too many female OB/GYNs?

    Jennifer Gunter, MD

More in Meds

  • From stigma to science: Rethinking the U.S. drug scheduling system

    Artin Asadipooya
  • How drugmakers manipulate your health from diagnosis to prescription

    Martha Rosenberg
  • The food-drug interaction risks your doctor may be missing

    Frank Jumbe
  • Why retail pharmacies are the future of diverse clinical trials

    Shelli Pavone
  • Why does rifaximin cost 95 percent more in the U.S. than in Asia?

    Jai Kumar, MD, Brian Nohomovich, DO, PhD and Leonid Shamban, DO
  • A world without antidepressants: What could possibly go wrong?

    Tomi Mitchell, MD
  • Most Popular

  • Past Week

    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
  • Past 6 Months

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • Why Medicaid cuts should alarm every doctor

      Ilan Shapiro, MD | Policy
  • Recent Posts

    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Decoding your medical bill: What those charges really mean

      Cheryl Spang | Finance
    • The emotional first responders of aesthetic medicine

      Sarah White, APRN | Conditions
    • Why testosterone matters more than you think in women’s health

      Andrea Caamano, MD | Conditions
    • A mind to guide the machine: Why physicians must help shape artificial intelligence in medicine

      Shanice Spence-Miller, MD | Tech
    • How subjective likability practices undermine Canada’s health workforce recruitment and retention

      Olumuyiwa Bamgbade, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
  • Past 6 Months

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • Why Medicaid cuts should alarm every doctor

      Ilan Shapiro, MD | Policy
  • Recent Posts

    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Decoding your medical bill: What those charges really mean

      Cheryl Spang | Finance
    • The emotional first responders of aesthetic medicine

      Sarah White, APRN | Conditions
    • Why testosterone matters more than you think in women’s health

      Andrea Caamano, MD | Conditions
    • A mind to guide the machine: Why physicians must help shape artificial intelligence in medicine

      Shanice Spence-Miller, MD | Tech
    • How subjective likability practices undermine Canada’s health workforce recruitment and retention

      Olumuyiwa Bamgbade, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...