Key takeaways:
- HPV vaccination was associated with a markedly lower risk of high-grade vulvar and vaginal precancerous lesions compared with no vaccination.
- The greatest protective benefit was observed in women vaccinated before age 17, reinforcing the importance of early immunization.
- Vaccinated women had significantly lower incidence rates of high-grade vulvovaginal lesions than unvaccinated women across all age groups.
- Population-level reductions in lesion risk were most evident in younger birth cohorts covered by subsidized or catch-up vaccination programs.
- Findings support expanding early and widespread HPV vaccination to reduce the burden of vulvovaginal precancers and cancers.
Alongside protecting against cervical cancer, human papillomavirus (HPV) vaccination has been linked to reduced odds of developing severe precancerous vulva and vaginal lesions, according to a recent study published in JAMA Oncology.1
The data highlighted a 37-fold reduction in severe lesion risk among vaccinated vs unvaccinated women. Additionally, the most significant benefits were reported in women vaccinated while aged under 17 years, with a risk reduction of 55%.
“Our study is the largest of its kind to investigate the link between HPV vaccination and serious diseases of the vulva and vagina,” said Yunyang Deng, a postdoctoral researcher at Karolinska Institutet. “The results highlight the importance of offering the HPV vaccine to girls at an early stage in life, before they become sexually active.”
Assessing lesion risk
The population-based cohort study was conducted to determine the link between HPV vaccination and high-grade vulvovaginal lesions.2 Data was obtained from Swedish population and health care registers and included vaccination data, precancers and cancers, immigration, emigration, birth year and country, residence country, and death.
Women born between 1985 and 1998 who were Swedish residents from 2006 through 2022 were included in the analysis. Follow-up began January 1, 2006, or when a patient reached 10 years of age. Exclusion criteria included death, emigration, any HPV vaccination, loss to follow-up, or high-grade vulvovaginal lesions before the entry date.
Being vaccinated was determined by having received a least 1 dose of the quadrivalent HPV vaccine. An initial diagnosis of high-grade vulvovaginal lesions during follow-up was reported as the primary outcome of the analysis.
These included high-grade vulvar lesions and invasive vulvar cancer, alongside high-grade vaginal lesions and invasive vaginal cancer. Age, calendar year, mother’s birth country, country of residence, annual household income, highest parental education level, and parental history of HPV-related precancers and cancers were reported as covariates.
Incidence of high-grade vulvovaginal lesions
There were 778,943 women included in the analysis, 32.9% of whom received at least 1 quadrivalent HPV vaccine dose. Incident high-grade vulvovaginal lesions were reported in 98 vaccinated patients during follow-up vs 547 unvaccinated patients.
