Prevalence of high-risk human papillomavirus among women with different HPV-vaccination status in Sichuan, China.

While HPV vaccination has significantly reduced HPV 16/18 prevalence in other countries, HPV vaccination was not approved in China until 2016, most of those vaccinated are over the age of 20, the efficacy remains unknown. In this cross-sectional study, we analyzed cervical specimens from 6971 women (20-40 years) undergoing routine gynecological check-ups (2022-2024). The Overall HR-HPV prevalence was 11.12% (775/6971). Vaccination reduced HPV 16/18 prevalence by 60.5% (RR = 0.395, 95% CI: 0.280-0.558) with the 2/4-valent vaccine and 59.8% (RR = 0.402, 95% CI: 0.277-0.583) with the 9-valent vaccine. However, non-vaccine-targeted HR-HPV types (35/39/51/56/59/66/68) were more frequent in 9-valent recipients (6.88% vs. 4.49% in unvaccinated women, p < 0.05), offsetting the decline in overall HR-HPV prevalence. CIN2+ incidence was significantly lower in vaccinated (2/4-valent: 1.97%; 9-valent: 1.16%) than unvaccinated women (3.60%, p < 0.05). These results demonstrate that HPV vaccines effectively reduced vaccine-type infections and the incidence of CIN2+ lesions. It is worth to mention that the prevalence of non-vaccine-targeted HPV types has demonstrated a significant increase. These findings provide compelling evidence to inform cervical cancer screening strategies and vaccination programs in China.