HPV Vaccination in Women Above 25 Years: Reasons Why?

Prophyllactic HPV vaccines are efficacious in preventing persistent infections by vaccine-HPV types and related cervical disease. The maximum effect is achieved in women who are not exposed to HPV vaccine types at the time of vaccination (HPV DNA negative women). Today's published data demonstrate equal clinical vaccine efficacy in women between 15 and 26 years and women between 24 and 45 years. The public health effect of vaccinating women older than 25 years is not clear yet, but may be smaller than after vaccination of adolescents. Unresolved issues are duration of protection and long-term preventive effects after treatment of HPV-related disease or natural clearance of HPV infection. Furthermore, it remains difficult to define subgroups of older women who would benefit from the vaccine. It may be that older women exposed to HPV or who are being treated for HPV related disease will benefit most at long term. This needs longer follow-up of vaccinated women and more detailed analysis of data from vaccine trials.