Impact of HPV vaccination in Spain: Reductions in vaccine-type genotypes, cytological abnormalities, and the influence of epidemiological factors
- 1National Center for Microbiology. Instituto de Salud Carlos III (ISCIII). Madrid, Spain. Biomedical Research Networking Center in Public Health (CIBERESP). Madr
Abstract
Data evaluating human papillomavirus (HPV) vaccine impact in Spain remain limited. We aimed to assess HPV and cytology findings among vaccinated and unvaccinated women as an early indicator of its effectiveness. During April 2024-January 2026, a total of 908 women participating in a population-based cervical cancer screening in three regions of Spain were recruited (58% vaccinated). Cervical samples and epidemiological and vaccination data were obtained. HPV was detected in 37% (337/908) and high-risk HPV in 24% (221/908). High-grade cytological lesions (1.2%, 11/907) were more frequent in unvaccinated women (2.4% vs 0.38%, p=0.011) and showed higher prevalence of HPV 16/18 (5.5% vs 0.76%; aOR: 4.9; 95% CI: 1.4-17) and HPV31 (3.4% vs 1.3%; aOR: 2.7; 95% CI: 1.0-6.9) compared with vaccinated women. HPV51 and HPV70 were more frequent among vaccinated women; however, both were associated with factors unrelated to vaccination. HPV51 was linked to a higher number of sexual partners (aOR: 2.6; 95% CI: 1.2-5.6), while HPV70 to smoking (aOR: 0.36; 95% CI: 0.13-0.99). Lower detection of HPV 16/18, HPV31 and high-grade lesions among vaccinated women supports vaccine effectiveness and cross-protection, highlighting the importance of continuous comprehensive surveillance of HPV genotype, including epidemiological and sexual behavioral factors.
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BibTeX
@misc{senan2026impact,
title = {{Impact of HPV vaccination in Spain: Reductions in vaccine-type genotypes, cytological abnormalities, and the influence of epidemiological factors}},
author = {A. I. Garcia Senan and E. Arenaza Lamo and A. Davila Exposito and M. Arruti Martin and J. W. Comba Miranda and D. del Valle Pena and M. R. Ramos Trivino and S. Palomo Cousido and B. Dominguez Eguizabal and M. Cortes Antolin and M. J. Puente Martinez and T. Zudaire Fuertes and J. J. Sola Gallego and C. Ruiz Sanchez and H. Gil and Spanish HPV Vaccine Impact Study Group},
howpublished = {medRxiv},
year = {2026},
month = sep,
doi = {10.64898/2026.09.10.26362440},
url = {https://www.medrxiv.org/content/10.64898/2026.09.10.26362440v1},
note = {CC BY-NC-ND},
}
RIS
TY - UNPB
TI - Impact of HPV vaccination in Spain: Reductions in vaccine-type genotypes, cytological abnormalities, and the influence of epidemiological factors
AU - A. I. Garcia Senan
AU - E. Arenaza Lamo
AU - A. Davila Exposito
AU - M. Arruti Martin
AU - J. W. Comba Miranda
AU - D. del Valle Pena
AU - M. R. Ramos Trivino
AU - S. Palomo Cousido
AU - B. Dominguez Eguizabal
AU - M. Cortes Antolin
AU - M. J. Puente Martinez
AU - T. Zudaire Fuertes
AU - J. J. Sola Gallego
AU - C. Ruiz Sanchez
AU - H. Gil
AU - Spanish HPV Vaccine Impact Study Group
PY - 2026
DA - 2026/09/10
PB - medRxiv
DO - 10.64898/2026.09.10.26362440
UR - https://www.medrxiv.org/content/10.64898/2026.09.10.26362440v1
AB - Data evaluating human papillomavirus (HPV) vaccine impact in Spain remain limited. We aimed to assess HPV and cytology findings among vaccinated and unvaccinated women as an early indicator of its effectiveness. During April 2024-January 2026, a total of 908 women participating in a population-based cervical cancer screening in three regions of Spain were recruited (58% vaccinated). Cervical samples and epidemiological and vaccination data were obtained. HPV was detected in 37% (337/908) and high-risk HPV in 24% (221/908). High-grade cytological lesions (1.2%, 11/907) were more frequent in unvaccinated women (2.4% vs 0.38%, p=0.011) and showed higher prevalence of HPV 16/18 (5.5% vs 0.76%; aOR: 4.9; 95% CI: 1.4-17) and HPV31 (3.4% vs 1.3%; aOR: 2.7; 95% CI: 1.0-6.9) compared with vaccinated women. HPV51 and HPV70 were more frequent among vaccinated women; however, both were associated with factors unrelated to vaccination. HPV51 was linked to a higher number of sexual partners (aOR: 2.6; 95% CI: 1.2-5.6), while HPV70 to smoking (aOR: 0.36; 95% CI: 0.13-0.99). Lower detection of HPV 16/18, HPV31 and high-grade lesions among vaccinated women supports vaccine effectiveness and cross-protection, highlighting the importance of continuous comprehensive surveillance of HPV genotype, including epidemiological and sexual behavioral factors.
ER -