A single dose of HPV vaccine may be enough
November 4th, 2013
10:27 AM ET

A single dose of HPV vaccine may be enough

Just one dose of the HPV vaccine Cervarix appears to provide enough of an immune response to protect women from two strains of human papillomavirus (HPV) and ultimately cervical cancer, according to a new study published Monday.

HPV is the most common sexually transmitted infection (STI), according to the U.S. Centers for Disease Control and Prevention (CDC). The infection, transmitted through genital contact, is the primary cause of cervical cancer, which affects about 10,300 women in the United States each year.  It causes about 275,000 deaths annually worldwide and is a leading cause of cancer deaths among women in low-income countries, according to the World Health Organization.

“Cervical cancer is a major cause of public health concern, especially in less developed countries where about 85% of cervical cancer occurs,” says study author Mahboobeh Safaeian. “The reason for that is mainly because of lack of screening infrastructure offered.”

Safaeian and her team followed a group of women in Costa Rica who were participating in the National Cancer Institute-funded phase III clinical trial testing the efficacy of Cervarix.  About 20% of these women did not complete the three-dose vaccine regimen. Safaeian compared the groups of women who had received one, two and three doses of the vaccine, as well as women who had antibodies from having been naturally infected.

The researchers found that women vaccinated with a single dose of Cervarix, as opposed to the current CDC recommendation of three, had antibodies against HPV that remained stable in their blood after four years. The findings suggest that the common recommendation for three doses may not be necessary to ensure long-lasting antibodies that prevent HPV.  Safaeian, a researcher for the National Cancer Institute's Division of Cancer Epidemiology & Genetics, Infections and Immunoepidemiology, says this could have significant implications for women across the world by simplifying the logistics and costs of vaccinations.

“This vaccine is about $130 a dose ... It’s just not feasible in a lot of undeveloped countries,” Safaeian explains.

Even in the United States, where vaccinations are easily accessible and covered under health insurance and federal programs for children, many women are not getting all three doses.  In 2012, only about half of girls between ages 13 and 17 started the HPV vaccination regimen and only about a third had received all three doses, according to the CDC.

Dr. Kevin Ault, a physician and professor at the Emory University Department of Gynecology and Obstetrics, emphasizes that it is always easier to get people into the office for a one-time vaccination. In countries outside the United States, one stop may be the only option.

“Certainly if you’re in South Asia or Africa, where you have a high burden of cancer and screening is expensive, a single dose vaccine would really be a game changer,” says Ault, who worked on the clinical trials that led to the approval of the first HPV vaccine Gardasil, which protects against four strains of HPV.

However, while this new study reveals promising results for one and two doses of Cervarix, Ault does not see this changing the standards in the United States anytime soon.  He said he believes further research will be conducted in the following years, for Cervarix and also for Gardasil, the more common of the two HPV vaccines in America. Gardasil has not yet been tested for the efficacy of less than three doses.  Until then, Ault plans to stick to the CDC recommendation of the three-dose vaccine for his patients.

Safaeian also stresses that this research is still at the beginning stages.  She notes that long-term protection is one of the outstanding questions.
“The data we have thus far only goes up to four years,” Safaeian emphasized.  “Ideally, you would want protection to last 10 to 15 years.  So, we still are not there yet – the studies have not gone that far.”

Some countries, such as Chile, have already implemented a two-dose vaccination plan, but Safaeian said that it’s still too early to tell whether it is sufficient for long-term protection.

Safaeian continues to move forward with her research, following the same participants to see whether the antibody stability extends beyond the four years.  She said that while it’s not over yet, her team has “provided some intriguing research that could help discussions of what should be the next step for evaluating number of doses.”

The new study was published Monday in Cancer Prevention Research, a journal of the American Association for Cancer Research.

Post by: ,
Filed under: Cancer • HPV • Living Well • Sex

soundoff (61 Responses)
  1. cali girl

    The price needs to come down.

    November 4, 2013 at 12:57 | Report abuse | Reply
  2. Dryden robinson

    Homework #⃣5

    November 4, 2013 at 13:42 | Report abuse | Reply
  3. Dryden robinson

    Homework number 5

    November 4, 2013 at 13:43 | Report abuse | Reply
  4. Dryden robinson

    Work 5

    November 4, 2013 at 13:44 | Report abuse | Reply
  5. scars

    I'm not anti-vaccine, but I will not allow my daughter to have this vaccine. There have been too many reports of adverse effects and there is absolutely no real benefit from this vaccine. It only protects against a few of the strains of HPV. HPV usually clears up on its own without treatment. Cervical cancer, if detected early, is highly treatable. The best thing you can do for your daughters is teach them about safe sex practices and make sure they have access to condoms. Yearly pap exams to screen for cervical cancer should be stressed as well. That will keep you safer from cervical cancer (and unwanted pregnancy and other STDs) than this vaccine. I'm all for vaccines when the benefits outweigh the risks and in this case the risks clearly outweigh the benefits.

    November 4, 2013 at 15:47 | Report abuse | Reply
    • sc341

      Condoms don't fully protect against this infection. The only way to be sure not to get it is to be abstinent and have a potential partner tested for it (or only date virgins!) Maybe that's not such a bad idea.

      November 4, 2013 at 16:03 | Report abuse |
    • SixDegrees

      "There have been too many reports of adverse effects and there is absolutely no real benefit from this vaccine."

      There have been no such reports, and the benefit is obvious – an enormously reduced risk of a deadly type of cancer.

      November 4, 2013 at 17:20 | Report abuse |
    • talluluah




      Of course NOW they say one dose is "enough." They couldn't get enough sales when it was three. So its "discount" time.

      November 4, 2013 at 20:49 | Report abuse |
    • mumpta

      Most of the "adverse" were from girls getting a shot and then getting up too quickly and getting light headed. Nothing really bad.
      A vaccine that prevents cancer–opposed? Really? Move into modern society. We all know everyone uses condoms all the time.
      You can also get it after you're married too when you think you're "safe".

      November 5, 2013 at 01:13 | Report abuse |
    • anonCNN

      Please do not listen to talluluah. His/her statements are factually wrong. Simple research easily proves the statements wrong.

      November 5, 2013 at 05:26 | Report abuse |
    • gladr

      The vaccine protects against the types of HPV that cause the MAJORITY of cases of cervical cancer.

      November 5, 2013 at 12:37 | Report abuse |
    • MD

      Cervical cancer is DEADLY. And often treatment of pre-cancerous lesions on the cervix can leave a female with a lot of difficulty carrying a pregnancy to term. I have seen the pain and anxiety women have faced from this disease. Your daughters will have sex. Spare you daughters from cervical cancer.

      November 5, 2013 at 18:47 | Report abuse |
    • Kmom

      You are absolutely right. A simple search online will give you a ton of information about the adverse effects of this unnecessary vaccine. I refused to let my daughter be vaccinated because of the risks. Knowing that so many people had/are having issues and they are purposely covering up the issues is unacceptable.
      You see people leave dumb comments about things they have not obviously done any research about. Yes, if you go to the manufacturers website they will tell you it is harmless. People need to use their brains to think for themselves.

      November 6, 2013 at 11:33 | Report abuse |
  6. sc341

    Gynecologists should be testing for this infection when females have a pap smear. I have no idea how they would test males since they don't get a pap smear... Doctors could potentially do a modified smear of the urethral opening of the penis for sexually transmissible diseases or do a blood test for antibodies. You would have to ask a doctor.
    Dr. Gupta, could you address how males could be tested for HPV????

    November 4, 2013 at 16:05 | Report abuse | Reply
    • SixDegrees

      It's a whole lot cheaper, easier and safer to administer the vaccine, which greatly reduces the incidence of the associated cancer. Your body will eventually work off an infection anyway, but by that point you're left with the elevated cancer risk that a vaccine would have avoided.

      November 4, 2013 at 17:21 | Report abuse |
    • talluluah

      SixDegrees, please post the link to the many studies that prove this vaccine PREVENTS CANCER. Let me save you the time. It doesn't. There are no studies. Not one study.

      November 4, 2013 at 20:52 | Report abuse |
  7. sc341

    Is it true that men can’t be tested for HPV? That there’s no HPV test for men?

    Yes and no. Although HPV testing for men is used in some research studies, HPV testing is not commonly done by doctors or in clinics. The test is unpleasant for many men – it involves using something akin to a metal nail file to scrape skin cells from a man’s penis – and is not quite as sensitive or specific of a test as the HPV test is for women, as I understand it. As a result, HPV testing for men is not widely offered. Men cannot really know, then, if they carry and HPV strain or not. However, if you think you have genital warts – they can be as small as little pimples or larger and resembling cauliflower – please see your healthcare provider. They can do a biopsy or, if you’d prefer, try one of the standard treatments (such as a topical cream) to see if that works. Also, warts often go away on their own even without treatment. And now, men can get the Gardasil vaccine to help prevent cases of warts.

    Read more at Men's Health magazine. From 2010

    November 4, 2013 at 16:07 | Report abuse | Reply
    • sc341

      I can't believe that there isn't widespread testing for men. Do doctors even suggest testing to men?

      November 4, 2013 at 17:11 | Report abuse |
  8. sc341

    Why do they need to use a nail file to open the urethral opening....why not just squeeze the opening of the penis and smear the contents onto a slide and send to a lab????

    November 4, 2013 at 16:08 | Report abuse | Reply
    • gladr

      Because you need cells, not just fluid.

      November 5, 2013 at 12:27 | Report abuse |
  9. sc341


    Sex Hygiene – US Navy Training Film (1942) (part 1 of 2)

    We need to educate teens and young adults with a modern film.

    November 4, 2013 at 16:11 | Report abuse | Reply
  10. sc341


    November 4, 2013 at 16:19 | Report abuse | Reply
  11. sc341

    Videos posted for informative purposes only. Modern medicine has advanced, however political correctness is now rife so that people are not being given the information to protect themselves from these STDs.

    November 4, 2013 at 16:21 | Report abuse | Reply
  12. sc341

    Dr. Gupta, why is there not widespread testing of males for HPV and other STD's? I brought my 20 year old son to a new GP and they didn't ask him whether he was sexually active.

    I was in the room because my son has a slight handicap (Asperger's) and I wanted to make sure the doctor had all his medical info for his first visit. My son is not sexually active yet due to his social awkwardness. However, I want him to have the information he needs just in case he eventually does have a relationship.

    November 4, 2013 at 16:24 | Report abuse | Reply
  13. buongiorno

    give it a break you morons

    November 4, 2013 at 21:27 | Report abuse | Reply
  14. candros

    This vaccine is a scam. If you get the chicken pox vaccine, you know it didn't work if you catch the chicken pox. This vaccine MIGHT prevent SOME types of cancer that MIGHT be caused by SOME types of STD. So IF you get an STD at age 20, and 10 years later it turns into cervical cancer, and it is the right type of cancer, then you will know that it did not work. There are a bunch a affluent American teenagers out there right now whose parents can afford the vaccine – who are live lab rats. Let's see the side effects when they are in their 20's and starting to have children.

    November 5, 2013 at 06:02 | Report abuse | Reply
    • Kmom

      My daughter had to get another chicken pox vaccine because they told her that the first dose wasn't effective for long term. They only reason I agreed was because she had to have it for school and at 17 we didn't think that having the chicken pox would be that much fun. I do agree with you that the kids are like live lab rats. They know the issues and are not saying anything, that is why I don't trust them about the side effects. Just do the research.

      November 6, 2013 at 11:38 | Report abuse |
  15. That girl

    Cervical cancer kills around 4000 women a year. People have a higher risk of dying in a car accident than dying from this disease. It is highly curable as long as you see your gynocologist as recommended.

    November 5, 2013 at 08:13 | Report abuse | Reply
    • gladr

      But about 12000 people get the disease. Prevention of death is not the only reason to get vaccinations. The treatment for cervical cancer is not a walk in the park...surgery, radiation, chemotherapy...loss of ability to have children, pain, costs, etc.

      November 5, 2013 at 12:34 | Report abuse |
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