Letters HPV quadrivalent vaccine

Reduction in subsequent HPV related disease was unrelated to vaccination

BMJ 2012; 344 doi: http://dx.doi.org/10.1136/bmj.e3195 (Published 08 May 2012) Cite this as: BMJ 2012;344:e3195
  1. Christian Fiala, specialist in obstetrics and gynaecology1
  1. 1Gynmed Clinic Vienna, A-1150 Vienna, Austria
  1. christian.fiala{at}aon.at

Joura and colleagues found that the incidence of subsequent human papillomavirus (HPV) related disease was 6.6 and 12.2 in vaccine and placebo recipients (46.2% reduction (95% CI 22.5% to 63.2%) with vaccination).1

Table 3 also detailed an unexpected finding: that the quadrivalent HPV vaccine resulted in a 42.5% reduction in the incidence of subsequent cervical intraepithelial neoplasia grade I or worse associated with 10 tested non-vaccine HPV types in women who had undergone cervical surgery.

In summary, the authors found a similar reduction in subsequent diseases of all HPV types (46.2%) and non-vaccine HPV types (42.5%). This leads to the conclusion that the reduction in subsequent disease was unrelated to vaccination. The other possibility would be that the vaccine was active against virus types not contained in the vaccine.


Cite this as: BMJ 2012;344:e3195


  • Competing interests: None declared.