MMWR Morb Mortal Wkly Rep. 2021 Mar 26;70(12):415-420. doi: 10.15585/mmwr.mm7012a2.
Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States (1). Although most infections resolve without clinical sequalae, persistent HPV infection can cause cervical, other anogenital, and oropharyngeal cancers and anogenital warts. HPV vaccination has been recommended in the United States at age 11-12 years since 2006 for females and since 2011 for males. Catch-up vaccination is recommended through age 26 years.* A quadrivalent vaccine (4vHPV) targeting types 6, 11, 16, and 18 was mainly used until 2015, when a 9-valent vaccine (9vHPV), targeting the same four types as 4vHPV and five additional types (31, 33, 45, 52, and 58), was introduced; 9vHPV has been the only vaccine available in the United States since the end of 2016 (2). HPV vaccination coverage has increased but remains lower than that of other vaccinations recommended for adolescents (3). A decrease in prevalence of 4vHPV types detected in cervicovaginal swabs among young females from the prevaccine era (2003-2006) to 2007-2010 in the National Health and Nutrition Examination Survey (NHANES) was an early indicator of vaccine impact (2) and was also observed in later periods (4,5). NHANES data from 2017-2018 were included in this analysis to update HPV prevalence estimates among females aged 14-34 years. From the prevaccine era to 2015-2018, significant decreases in 4vHPV-type prevalence occurred among females aged 14-19 years (88%) and 20-24 years (81%). In sexually experienced females, 4vHPV-type prevalence decreased in those who reported receiving ≥1 HPV vaccine dose (97% among those aged 14-19 years, 86% among those aged 20-24 years) and in those who reported no vaccination (87% among those aged 14-19 years, 65% among those aged 20-24 years). Significant declines among unvaccinated females suggest herd effects. These data show increasing impact of HPV vaccination in the United States. HPV vaccination is a critical prevention tool against HPV infection, anogenital warts, and HPV-attributable precancers and cancers. HPV vaccination is highly effective and is recommended routinely at age 11-12 years and through 26 years for persons not already vaccinated.
人乳头瘤病毒（HPV）是美国最常见的性传播感染（1）。尽管大多数感染没有临床后遗症，但持续性 HPV 感染可导致宫颈癌、其他肛门生殖器和口咽癌以及肛门生殖器疣。自 2006 年以来，美国一直建议在 11-12 岁的女性和 2011 年以来的男性中接种 HPV 疫苗。建议在 26 岁之前补种疫苗*。一种针对 6、11、16 和 18 型的四价疫苗（4vHPV）主要用于 2015 年之前，当时一种九价疫苗（9vHPV）被引入，该疫苗针对与 4vHPV 相同的四种类型以及另外五种类型（31、33、45、52 和 58）；自 2016 年底以来，美国一直只有九价疫苗可用（2）。HPV 疫苗接种覆盖率有所增加，但仍低于青少年推荐接种的其他疫苗（3）。国家健康和营养检查调查（NHANES）中，年轻女性宫颈阴道拭子中 4vHPV 型的流行率从疫苗前时期（2003-2006 年）到 2007-2010 年下降，这是疫苗效果的早期指标（2），此后也观察到这种情况（4,5）。本分析包括 2017-2018 年 NHANES 数据，以更新 14-34 岁女性 HPV 流行率估计值。从疫苗前时期到 2015-2018 年，14-19 岁和 20-24 岁女性的 4vHPV 型流行率显著下降（分别为 88%和 81%）。在有性经验的女性中，报告接受至少 1 剂 HPV 疫苗的女性（14-19 岁女性中 97%，20-24 岁女性中 86%）和未接种疫苗的女性（14-19 岁女性中 87%，20-24 岁女性中 65%）的 4vHPV 型流行率下降。未接种疫苗的女性显著下降表明存在群体效应。这些数据表明 HPV 疫苗在美国的影响不断增加。HPV 疫苗是预防 HPV 感染、肛门生殖器疣以及 HPV 相关癌前病变和癌症的重要预防工具。HPV 疫苗具有高度有效性，建议在 11-12 岁和 26 岁之前常规接种，对于尚未接种疫苗的人也应进行接种。
