Continued reduction in HPV prevalence and early evidence of herd immunity following the human papillomavirus vaccination programme in Scotland

Ross L Cameron, Kimberley Kavanagh, Jiafeng Pan, John Love, Kate Cuschieri, Chris Robertson, Syed Ahmed, Timothy Palmer, Kevin G.J. Pollock

Research output: Contribution to journalArticlepeer-review

78 Citations (Scopus)
54 Downloads (Pure)


In 2008, a national human papillomavirus (HPV) immunization program using a bivalent vaccine against HPV types 16 and 18 was implemented in Scotland along with a national surveillance program designed to determine the longitudinal effects of vaccination on HPV infection at the population level. Each year during 2009–2013, the surveillance program conducted HPV testing on a proportion of liquid-based cytology samples from women undergoing their first cervical screening test for precancerous cervical disease. By linking vaccination, cervical screening, and HPV testing data, over the study period we found a decline in HPV types 16 and 18, significant decreases in HPV types 31, 33, and 45 (suggesting cross-protection), and a nonsignificant increase in HPV 51. In addition, among nonvaccinated women, HPV types 16 and 18 infections were significantly lower in 2013 than in 2009. Our results preliminarily indicate herd immunity and sustained effectiveness of the bivalent vaccine on virologic outcomes at the population level.
Original languageEnglish
Pages (from-to)56-64
Number of pages9
JournalEmerging Infectious Diseases
Issue number1
Publication statusPublished - 1 Jan 2016


  • human papillomavirus vaccine
  • cancer screening
  • prevalence
  • cervical cancer
  • herd immunity

Cite this