The uptake of the HPV vaccine has been high in Australia with a 3 dose coverage rate of 71% amongst young women turning 15 years of age in 2013.  The delivery of the vaccine has also been much more equitable than our National Cervical Cancer Screening Program (NCSP).  This high and equitable coverage has led to profound reductions in the prevalence of vaccine preventable types in the Australian community and this has occurred not only in vaccinated young women but also unvaccinated women suggesting a herd immunity affect .  Further there have been reductions in genoprevalance of types not targeted by the vaccine but related to vaccine targeted types (31,33 and 45), suggesting partial cross protection.

In turn, the reduced prevalence of these HPV genotypes has already had profound impact on the prevalence of histologically confirmed high grade abnormalities in Victoria, Australia’s second most populous state.  These reductions were first noted at an ecological level and more recently have been demonstrated in studies linking the HPV Vaccine Register with the Cervical Screening Register  

Declines in the prevalence of biopsy confirmed high grade abnormalities started in the youngest cohorts of screened women but are progressively being seen in old age groups as the vaccinated cohorts age into the screening programme.