New research shows that school-based immunisation against human papillomavirus (HPV) lowers the risk of pre-cancerous cervical changes in unvaccinated women.
The study, published in The Lancet Public Health, demonstrates the population-wide benefits of high-coverage vaccination programmes.
HPV remains a common sexually transmitted infection and the leading cause of cervical cancer.
Vaccination protects recipients from serious cervical changes, but evidence of indirect protection for unvaccinated individuals had been unclear until now.
Eva Meglic from the Karolinska Institutet highlighted, “School-based HPV vaccination programmes play an important role as a cost-effective strategy to reduce cervical disease and cancer risk not only in vaccinated individuals, but across entire populations.”
“This finding shows that the herd effect can be achieved through high-coverage HPV vaccination,” she further added.
Researchers analysed national health registry data for more than 800,000 unvaccinated women born between 1985 and 2000.
The study compared rates of pre-cancerous cervical changes across cohorts exposed to different vaccination strategies in Sweden, including opportunistic vaccination (1985–1988), subsidised programmes (1989–1992), catch-up programmes (1993–1998), and school-based vaccination (1999–2000).
Findings revealed that unvaccinated women born in 1999 and 2000, who grew up alongside peers vaccinated via school-based programmes, had roughly half the risk of developing serious pre-cancerous cervical changes compared with unvaccinated women born between 1985 and 1988.
During the earlier period, vaccination coverage was lower and limited to women who actively sought it.
Researchers cautioned that as an observational study, factors like sexual behaviour, cervical screening participation, testing practices, and access to healthcare could influence the results. Nevertheless, the findings strongly support the use of school-based HPV vaccination to generate herd immunity.
Experts urge governments and healthcare authorities to prioritise universal vaccination initiatives targeting school-aged populations.
High coverage can maximise protection for both vaccinated and unvaccinated individuals, ultimately reducing the burden of cervical disease and cancer.
School-based vaccination is thus not only a medical intervention but a strategic public health measure that provides population-wide benefits.
Expanding and maintaining these programmes is essential to achieving long-term reductions in cervical cancer risk globally.
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