The case for conducting a randomized clinical trial to assess the efficacy of a single dose of prophylactic HPV vaccines among adolescents.

Human papillomavirus (HPV) types 16 and 18 collectively cause approximately 70% of cervical cancers worldwide (1) and are linked to an even higher percentage of HPV-associated anogenital and oropharyngeal cancers (2). Three-dose regimens of prophylactic vaccines (the bivalent vaccine Cervarix, GlaxoSmithKline Biologicals; the quadrivalent vaccine Gardasil, Merck and Co, Inc.) provide nearly complete protection against HPV16 and -18 infections and related cervical lesions among individuals uninfected with these types at the time of vaccination (3,4). The structure of the HPV virus-like particles (VLPs), the key component of HPV prophylactic vaccines, present closely spaced, repetitive epitopes to the immune system that induce highly potent, protective antibody responses (14), which may reduce or eliminate the need for booster doses. Further, the immune-stimulatory effects of a toll-like receptor agonist adjuvant in the bivalent vaccine may also contribute to the magnitude and durability of the immune response to this vaccine.

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