# Maximizing impact: the power of early HPV vaccination for long-term protection―lessons from a systematic review and meta-regression analysis

## TL;DR

This study shows that getting the HPV vaccine at a younger age provides stronger long-term protection against cervical cancer and severe pre-cancerous lesions.

## Contribution

The study demonstrates that early HPV vaccination (ages 12–25) significantly increases vaccine effectiveness against advanced cervical lesions and cancer.

## Key findings

- HPV16/18-AS04 vaccine effectiveness against CIN3+ ranged from 76.78% in HPV16/18-specific cases.
- Vaccine effectiveness was highest when administered at younger ages.
- Combined trial and observational data showed 56.19% effectiveness irrespective of HPV type.

## Abstract

This systematic review and meta-regression analysis assessed the impact of human papillomavirus 16/18 (HPV16/18)-AS04 vaccine (Cervarix®) on advanced cervical lesions, including grade 3 cervical intraepithelial neoplasia or worse (CIN3, CIN3+), or cervical cancer, highlighting age-at-vaccination–dependent vaccine efficacy and effectiveness.

Studies reporting HPV16/18-AS04 vaccine efficacy or effectiveness were included with an intervention group receiving HPV16/18-AS04 vaccine and comparator group receiving placebo, another vaccine or being unvaccinated. Of 53 articles identified, nine were selected. Meta-analysis and meta-regression models with random effects and data-driven model selection determined vaccine effects (VEs) and impactful covariates.

HPV16/18-AS04 vaccine effectively prevented advanced cervical premalignant lesions and cancer in adolescent girls and women vaccinated at 12–25 years. Combined randomized controlled trials and observational studies VEs on CIN3+ ranged between 76.78% (95% CI 28.15–92.49) for HPV16/18 and 56.19% (95% CI 24.76–74.49) irrespective of HPV type. Vaccine effectiveness was greatest in those vaccinated at the youngest ages.

HPV16/18-AS04 vaccine provides long-term protection against cervical premalignant lesions and cervical cancer in both controlled and real-world settings, particularly when administered at younger ages. The evidence urges policymakers and the community to ensure HPV vaccination begins at the youngest recommended ages.