Multidisciplinary, evidence-based consensus guidelines for human papillomavirus (HPV) vaccination in high-risk populations, Spain, 2016

Euro Surveill. 2019 Feb;24(7):1700857. doi: 10.2807/1560-7917.ES.2019.24.7.1700857.


Introduction: Although human papillomavirus (HPV) routine vaccination programmes have been implemented around the world and recommendations have been expanded to include other high-risk individuals, current recommendations often differ between countries in Europe, as well as worldwide.

Aim: To find and summarise the best available evidence of HPV vaccination in high-risk patients aiding clinicians and public health workers in the day-to-day vaccine decisions relating to HPV in Spain.

Methods: We conducted a systematic review of the immunogenicity, safety and efficacy/effectiveness of HPV vaccination in high-risk populations between January 2006 and June 2016. HPV vaccination recommendations were established with levels of evidence according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system.

Results: A strong recommendation about HPV vaccination was made in the following groups: HIV infected patients aged 9-26 years; men who have sex with men aged 9-26 years; women with precancerous cervical lesions; patients with congenital bone marrow failure syndrome; women who have received a solid organ transplant or hematopoietic stem cell transplantation aged 9-26 years; and patients diagnosed with recurrent respiratory papillomatosis.

Conclusions: Data concerning non-routine HPV vaccination in populations with a high risk of HPV infection and associated lesions were scarce. We have developed a document to evaluate and establish evidence-based guidelines on HPV vaccination in high-risk populations in Spain, based on best available scientific evidence.

Keywords: HIV; HIV infection; HPV; MSM; evidence-based medicine; high-risk populations; human papillomavirus infection; immunisation; men who have sex with men; vaccines.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Consensus
  • Female
  • Homosexuality, Male
  • Humans
  • Male
  • Papillomaviridae
  • Papillomavirus Infections / prevention & control*
  • Papillomavirus Vaccines / administration & dosage*
  • Papillomavirus Vaccines / therapeutic use
  • Practice Guidelines as Topic*
  • Precancerous Conditions / prevention & control*
  • Precancerous Conditions / virology
  • Spain
  • Uterine Cervical Neoplasms / prevention & control*
  • Uterine Cervical Neoplasms / virology
  • Vaccination*
  • Young Adult


  • Papillomavirus Vaccines