HPV vaccination impact in South Africa: evidence and next steps
Menée en Afrique du Sud auprès de 2 470 filles, cette étude analyse l'effet du programme de vaccination contre le papillomavirus humain (HPV) en milieu scolaire sur la prévalence du HPV chez les adolescentes
Scaling up human papillomavirus (HPV) vaccination is fundamental to South Africa's cervical cancer elimination agenda, particularly in the context of the world's largest HIV epidemic. School-based HPV vaccination represented a major policy achievement; however, sustained programme confidence requires real-world evidence that vaccination reduces oncogenic HPV prevalence across heterogeneous immune profiles and health-system contexts. Updated data on HPV prevalence among young women, stratified by HIV status, are therefore essential for tracking progress towards elimination. In The Lancet Global Health, Dorothy A Machalek and colleagues’ repeat cross-sectional study provides timely population-level evidence that South Africa's bivalent HPV vaccination programme has substantially reduced vaccine-type HPV prevalence, including among adolescent girls and young women (aged 17–18 years) living with HIV.
This study shows the real-world impact of a two-dose HPV vaccination schedule in a high HIV-burden setting.1 Reductions in HPV-16 and HPV-18 and cross-protected types HPV-31 and HPV-45 were similar to those reported from three-dose programmes in high-income countries and selected low-income and middle-income countries, supporting the principle that early, school-based vaccination can achieve population effects.2,3 The observed impact specifically shows marked declines in vaccine and cross-protected types with no consistent reductions in unrelated oncogenic HPVs, which supports a causal interpretation and aligns with biological evidence from clinical trials and post-introduction studies.3,4 These population-level impacts are further underscored by findings among young women living with HIV.
The Lancet Global Health , commentaire en libre accès, 2026