Vaccination as a prevention strategy for human papillomavirus-related diseases.

Childhood vaccines have had an enormously beneficial impact on human health. Large-scale vaccination programs have controlled diseases associated with high morbidity and mortality such as poliomyelitis, smallpox, diphtheria, tetanus, yellow fever, pertussis, Haemophilus influenzae, Streptococcus pneumoniae, measles, mumps, and rubella. Human papillomavirus (HPV) is a significant source of morbidity and mortality throughout the world. In the United States, HPV is the most common sexually transmitted infection (STI), and sexually active adolescents are at particularly high risk for HPV acquisition. Genetic and epidemiologic studies have clearly demonstrated that HPV infection is a necessary cause of both cervical cancer and genital warts. More than 99% of cervical cancers contain at least one high-risk HPV type, and approximately 70% contain HPV types 16 or 18. Moreover, low-risk HPV types 6 or 11 are responsible for approximately 90% of genital warts and almost all cases of recurrent respiratory papillomatosis. Thus, a vaccine that could prevent HPV acquisition would have the potential to significantly reduce the incidence of both childhood and adult diseases.