The human papillomavirus (HPV) vaccination programme for girls was introduced in 2008, primarily to prevent cervical cancer. Initially, the bivalent vaccine Cervarix® was used that provides protection against two HPV types, HPV 16 and 18. Since September 2012, the quadrivalent vaccine Gardasil® has been used that provides protection against those two HPV types and also against two additional types, HPV 6 and 11 which cause genital warts.
The number of cases of recurrent respiratory papillomatosis that have occurred in children born to females who were vaccinated with bivalent vaccine as part of the HPV immunisation programme during 2008-2012 is unknown and has not been estimated. An assessment of the implications of this condition on vaccination policy has not been made.
Public Health England (PHE) has previously published estimates on the numbers of cancers and anogenital warts which would be prevented in males and females with a female only HPV vaccination programme. Within this work it was assumed that the use of the quadrivalent vaccine would reduce the incidence of new cases of recurrent respiratory papillomatosis at the same rate as the reduction in anogenital warts due to HPV 6 and 11, i.e. by 95% (over time). These PHE estimates assumed no reduction in genital warts (or recurrent respiratory papillomatosis) with the use of the bivalent vaccine. However, some reduction in genital warts have since been seen associated with use of the bivalent vaccine and it is therefore possible that some (smaller) reductions in recurrent respiratory papillomatosis may result from bivalent vaccine use.