Expanding HPV Vaccination Strategies to Combat Cervical Cancer in South Korea

Cervical cancer ranks as the fourth most prevalent cancer among women globally, with over 660,000 new cases and approximately 350,000 deaths annually. Nearly all cervical cancer cases are attributed to human papillomavirus (HPV), the most common sexually transmitted infection. While HPV is vaccine-preventable and often resolves naturally, persistent infections can lead to cancer.

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In South Korea, the National Immunization Program (NIP) initiated in 2016 has successfully vaccinated around 80% of girls aged 12-17, with an additional 30,000 women aged 18-26 receiving catch-up vaccinations each year. The National Cancer Screening Program provides regular Pap tests to about 61% of women over 20. Despite these efforts, a recent study indicates that current policies are insufficient to eliminate HPV and related cancers.

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Researchers from the University of Maryland (UMD) developed a mathematical model to evaluate the effectiveness of various vaccination strategies. The model, calibrated using South Korean cancer data from 1999 to 2020, predicts HPV transmission dynamics across different demographics. Simulations suggest that while existing vaccination efforts will reduce the burden of HPV-associated cancers, they will not eradicate the virus.

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The study proposes two enhanced vaccination scenarios. The first involves expanding vaccine access to cover 99% of females, while the second maintains the current 80% female vaccination rate and adds vaccination for 65% of boys aged 12-17. These strategies could potentially eliminate HPV-related cancers in South Korea within 60 to 70 years.

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The findings underscore the importance of expanding vaccination coverage to achieve herd immunity, which would protect those unable to be vaccinated. The researchers noted that public support for vaccination campaigns in South Korea is high, and the country has a strong track record of infant immunization, with coverage rates nearing 98%.

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Despite the promising model, some experts caution that simply expanding vaccination may not be sufficient. Gumel, a collaborator on the study, emphasized that while current efforts are reducing cervical cancer cases, they do not aim for complete elimination. He advocates for a comprehensive approach that includes promoting safer sex practices, such as condom use, alongside vaccination.

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The researchers believe their model can inform vaccination strategies worldwide, including in the United States. They suggest that with the 95% effective Gardasil-9 vaccine, achieving around 70% coverage could be sufficient for herd immunity in the U.S.

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The study highlights the potential for improved vaccination strategies to significantly reduce the incidence of cervical cancer in South Korea and beyond. As researchers call for enhanced public health initiatives, the goal remains clear: to eliminate HPV and its associated cancers globally.

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“Cervical cancer is one of the few cancers effectively prevented by vaccines,” — Soyoung Park, Ph.D. Candidate, UMD

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“It’s achieving the objective of reducing cases of cervical cancer, but it’s not going to eliminate it,” — Gumel, Collaborator with Merck Inc.

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“We do not have to be losing 350,000 people globally to cervical cancer each year,” — Gumel, on the need for improved vaccination coverage.

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