The Efficacy, Effectiveness, and Safety of Human Papillomavirus (HPV) Vaccines

Objective: This review aims to (1) synthesize and evaluate the available scientific evidence on the efficacy, effectiveness, and safety of HPV vaccines in both clinical trials and real-world settings; (2) compare the differences in outcomes between vaccines, age groups, and deployment contexts; and (3) discuss public health implications and applicability in the Vietnamese context.

Methods: This narrative review was conducted through a comprehensive search and analysis of published literature in major medical databases, including PubMed, Scopus, Google Scholar, and official reports from the WHO and CDC. Evidence from clinical trials, long-term follow-up studies, and real-world data was compiled thematically using the SANRA scale.

Results: HPV vaccines have shown high efficacy and effectiveness in preventing HPV infection and precancerous cervical lesions. Bivalent HPV vaccines are 93–98% effective against moderate to severe cervical lesions caused by HPV-16/18. The quadrivalent HPV vaccine showed 100% protection against grade 2 or higher cervical lesions during 24,099 person-years of follow-up, reducing HPV-6, 11, 16, and 18 infections by approximately 90% and maintaining a sustained immune response for at least 12 years. The nine-valent HPV vaccine offered protection against five additional high-risk HPV types, achieving ≥90% efficacy for 10–12 years with seropositivity rates of ≥81–90% for the covered types. Real-world data also confirms high preventive effectiveness among children and adolescents. The safety profile of HPV vaccines has been well established in both clinical trials and post-licensure surveillance, with most post-vaccination reactions being mild and transient (pain, swelling, fatigue, headache), while serious adverse events were rare and comparable to placebo.

 

Conclusion: HPV vaccines are safe and highly effective in preventing HPV infection and precancerous cervical lesions, offering superior preventative benefits compared to minimal risks. Early vaccination, a single-dose regimen, expanded coverage, and increased public awareness are key strategies to optimize the effectiveness and coverage of HPV vaccination programs

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