Several issues about the vaccine remain to be addressed. It will be important to confirm that the strong safety profile remains intact as more individuals receive the vaccine. It remains to be determined how long the high level of type-specific protection is maintained, as this issue will have implications for whether and when booster injections might be advisable and will also contribute to the cost-effectiveness of the vaccine.
A substantial degree of cross-protection could increase the potential impact of the vaccine by further reducing the incidence of serious genital HPV infections and by reducing the number of abnormal Pap tests and the cost of their follow-up. On the other hand, protection against heterologous HPV types is likely to wane more quickly than that against the HPV types specifically targeted by the vaccine, which could also have implications for boosting.
Another unanswered question is whether vaccination might alter the natural history of prevalent HPV infection by reducing the incidence of persistent infection or cytological abnormalities. The large vaccine trials may have a sufficient number of prevalent infections attributable to the HPV types in the vaccine to address this question.
If such a “therapeutic effect” were seen, it could provide an added rationale to vaccinate sexually active women who might have prevalent infection with one of the types in the vaccine. The most likely explanation for such an effect would be that the vaccine had reduced the efficiency of transmission of an early infection from one genital site to other genital sites, presumably via specific antibodies in the genital tract.
It is also possible that the vaccine could have direct therapeutic effects against established lesions. However, this possibility seems less likely, as persistent infection is usually attributed to the presence of the viral genome in long-lived basal epithelial cells, which do not express L1. The experimental evidence also does not support this possibility.
A key question will be whom to vaccinate. In the United States, the main national advisory committee will be the Advisory Committee on Immunization Practices at the Centers for Disease Control and Prevention. Until there are data that show the vaccine is protective in men, it would seem most logical to focus public health efforts primarily on vaccinating women.
If the principal activity of the vaccine is the prevention of incident HPV infection, the greatest reduction in the number of infections would likely result from immunizing girls or women before they become sexually active. In the United States, this consideration would imply that pre- or young adolescent girls would be prime candidates for the vaccine.
Of course, older girls and women with no prior sexual exposure should also achieve maximum benefit from the vaccine, which implies that “catch-up” vaccination for these groups should be seriously considered. Giving the vaccine to women who have had some prior sexual activity could also reduce their number of infections, although their degree of benefit from the vaccine would probably be inversely related to their degree of prior sexual activity.
Most pharmacology efforts now focus on developing a vaccine to inoculate the population in order to stop the HPV virus from infecting the system. This is ideal for the pharmaceutical companies as it would of course reap a monetary windfall of epic proportions for the drug companies, but not useful at all for those already affected with warts. Most doctors use cauterization or freezing as a first option to cure genital warts.
Unfortunately, success achieved with this method is often temporary and the warts soon reappear. HPVCurative is a new, highly effective and potent way to cure genital warts. It is valued for its role in the realm of genital warts cures, and has provided total clearance of the infection time after time.
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It eliminates genital warts and restores skin tissue to the state it was in prior to the infection. Since the treatment can effectively remove genital warts and wart-like substances on the genitals, acid or surgical HPV cures may soon become a thing of the past. To learn more, please
