Kavita Panwar

Background: In England, a national school-based human papillomavirus (HPV) vaccination programme was introduced in September 2008. Routine vaccination against HPV16/18 is offered to girls aged 12-13 and a ‘catch-up’ offer ran for girls aged 14-18 during the programme’s first two years. Methods: Data from 19,407 women aged 25-29yrs attending cervical screening across England 2016-2025 were collected and residual samples from 4,837 high-risk (HR) HPV-screening-positive women were genotyped to monitor type-specific HR-HPV prevalence and evaluate vaccination impact. Results: Type-specific HR-HPV results were available for 3,683 HR-HPV-screen-positive samples. Estimated age-adjusted prevalence of HPV16 and HPV18 was 91% (95% confidence interval [CI]: 87-94%) and 84% (95%CI: 65-93%) lower respectively among routine-eligible women than vaccination-ineligible women. Large declines were also observed for HPV31 (85% [95%CI: 72-92%]) and HPV45 (84% [95%CI: 73-90%]) but not for other HR-HPV types. Among 618 women with cytological abnormalities, HPV16/18 was present in samples from 53.9% (95%CI: 34.8-73.1%) of vaccination-ineligible, 18.1% (95%CI: 13.5-22.7%) of catch-up-eligible, and 6.5% (95%CI: 3.6-9.3%) of routine-eligible women. Conclusions: The early years of the HPV vaccination programme in England conferred strong protection against HPV16, 18, 31 and 45, and dramatically changed the target remaining for screening strategies to detect and reduce cervical disease.

Background: A national human papillomavirus (HPV) vaccination programme for gay, bisexual, and other men who have sex with men (GBMSM) in England began in 2016. We evaluated the impact of this programme by monitoring the prevalence of type-specific HPV infections over time. Methods: Residual rectal swab specimens were collected from GBMSM aged ≤45 years undergoing chlamydia and/or gonorrhoea screening at 10 SHS between 2017-19 (Phase 1) and 2021-24 (Phase 2). Specimens were linked to data on sociodemographic characteristics, previous STI diagnoses, and HPV vaccination reported to UKHSA’s national STI surveillance system. Anonymised specimens were tested for type-specific HPV DNA using an in-house multiplex PCR and Luminex-based genotyping test. We compared the prevalence of vaccine-type HPV in each phase, and in those with and without any reported HPV vaccinations. Results: Data from 5,787 rectal swab specimens with HPV testing results were analysed: 3,291 in Phase 1 and 2,496 in Phase 2. There was a 36% decline in the prevalence of anal HPV16/18 infection between Phase 1 and Phase 2. Overall, the prevalence of HPV16/18 was similar in GBMSM with (16.6%; 95% CI 15.2-18.1) and without reported HPV vaccination (15.8%; 95% CI 14.5-17.1). Conclusion: Eight years after HPV vaccination of GBMSM began, the prevalence of vaccine-type HPV in GBMSM has declined. Vaccine effectiveness estimates were uncertain, likely due to the combined effects of underreporting of vaccinations, herd protection, and bias in vaccination uptake. These findings, albeit ecological, bode well for this targeted programme meeting its aim of reducing HPV-related diseases amongst GBMSM and reducing health inequalities.