Human papillomavirus vaccination is central to cervical cancer elimination, yet population-level evidence from middle-income countries remains limited. We evaluated the impact of quadrivalent HPV vaccination in Brazil using data from two repeated population-based cross-sectional surveys conducted in 2016–2017 and 2020–2023 among sexually active individuals aged 16–25 years. Genital samples were tested for HPV genotyping and survey-weighted Poisson-regression models adjusted for sociodemographic and behavioral factors were used to compare prevalences between periods. Among 11,794 women and 4932 men, the prevalence of vaccine-type HPV declined from 15.64% (14.23–17.17) to 5.92% (5.23–6.70) among women and 13.81% (11.15–16.99) to 10.39% (8.35–12.85) among men. Adjusted analyses showed an 81% reduction among vaccinated women (PR0.19; 0.14–0.27) and a 33% reduction among unvaccinated women (PR0.67; 0.55–0.81), suggesting both direct and indirect effects. Reductions were significant only among women aged 16–23, the group with higher coverage. Among men, lower prevalence of vaccine-type HPV was observed only among vaccinated individuals (PR0.39; 0.18–0.86). The overall HPV prevalence increased modestly between the two surveys. No differences in prevalence reduction were observed according to the number of vaccine doses. These findings demonstrated the impact of HPV vaccination in Brazil and highlight the importance of maintaining high vaccination coverage and continued surveillance.
Wendland et al. (Thu,) studied this question.
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