Vaccines for prevention of human papillomavirus infection.

(1) High risk types of human papillomavirus (HPV) are the causal agents of cervical cancer. The prevention of HPV infection can reduce the incidence of this cancer. (2) Five phase II clinical trials have been published, and several large phase III trials are underway. (3) Trials have shown marked reductions in HPV infection. Most studies did not evaluate the effect of the vaccines on cancer because of lengthy time spans between HPV infection and the development of cancer. (4) Injection site pain, headache, and fatigue are the most common adverse events reported. (5) Important considerations include vaccine efficacy; acceptability; integration into existing vaccine schedules; cost; role of cervical screening programs; and access, particularly for people in the developing world.