Declining genital Warts in young women in england associated with HPV 16/18 vaccination: an ecological study

J Infect Dis. 2013 Nov 1;208(9):1397-403. doi: 10.1093/infdis/jit361.


Background: Diagnoses of genital warts (GW) in genitourinary medicine (GUM) clinics have been increasing in England for many years. In 2008, an HPV immunization program began with a bivalent vaccine (Cervarix). This was expected to markedly reduce infections and disease due to human papillomavirus (HPV) 16/18 but not HPV 6/11 infections or disease. However, from 2009 to 2011 there were decreases in reported diagnoses of GW in young females at GUM clinics.

Methods: Using data from GUM clinics and a sample of general practices (GPs) throughout England, we analyzed rates of GW diagnoses by age, year of diagnosis, and estimated immunization coverage.

Results: The overall reduction in GW diagnoses at GUM clinics between 2008 and 2011 was 13.3% among 16- to 19-year-old females, with the greatest decline of 20.8% in 17-year-olds. Declines were positively associated with estimated immunization coverage. A similar pattern was seen in GP diagnoses, but not among older women, and for other GUM consultations.

Conclusions: Several factors might contribute to declines in GW. However, the size and pattern of the declines strongly suggest that we are observing an unexpected, moderately protective effect of HPV 16/18 vaccination against GW.

Trial registration: NCT00122681.

Keywords: Cervarix; HPV immunization; genital warts; surveillance.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Condylomata Acuminata / epidemiology
  • Condylomata Acuminata / prevention & control*
  • Condylomata Acuminata / virology
  • England / epidemiology
  • Female
  • Human papillomavirus 16 / immunology*
  • Human papillomavirus 18 / immunology*
  • Humans
  • Incidence
  • Male
  • Papillomavirus Vaccines
  • Vaccination*
  • Young Adult


  • Papillomavirus Vaccines

Associated data