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IARC 60th Anniversary - 19-21 May 2026

Session : Translating Evidence into Action for Cervical Cancer Elimination: HPV Vaccination and HPV-Based Screening

Fifteen-year immune responses of a single, two and three doses of the HPV vaccine compared to those obtained through natural immunity

JADHAV R. ³, SIDDIQI M. ¹⁴, SANKARAN S. ⁴, KANNAN T. ⁴, WATERBOER T. ⁶, MÜLLER M. ⁶, SEHR P. ¹⁶, UNGER E. ⁵, SANKARANARAYANAN R. ¹, BASU P. ¹, MUWONGE R. ¹, BHATLA N. ², JOSHI S. ³, ANANTHARAMAN D. ⁴, PANICKER G. ⁵, BUTT J. ⁶, POLI U. ⁷, MALVI S. ⁸, ESMY P. ⁹, LUCAS E. ¹, VERMA Y. ¹⁰, SHAH A. ¹¹, ZOMAWIA E. ¹², PIMPLE S. ¹³, JAYANT K. ⁸, HINGMIRE S. ⁸, CHIWATE A. ⁸, DIVATE U. ³, VASHIST S. ², MISHRA G. ¹³

¹ Early Detection, Prevention & Infections Branch, International Agency for Research on Cancer, Lyon, France; ² Department of Obstetrics & Gynaecology, All India Institute of Medical Sciences, New Delhi 110 029, India; ³ Jehangir Clinical Development Centre, Jehangir Hospital Premises, Pune, India; ⁴ Rajiv Gandhi Centre for Biotechnology, Poojappura, , Thiruvananthapuram 695 014, Kerala, India; ⁵ National Center for Emerging and Zoonotic Infectious Diseases, CDC, United States; ⁶ Infection, Inflammation and Cancer Program, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 242, D-69120 , Heidelberg, Germany; ⁷ Public Health Foundation of India, IIPH-H, Hyderabad, Telangana 500 033, India; ⁸ Tata Memorial Centre Rural Cancer Project, Nargis Dutt Memorial Cancer Hospital, Barshi District Solapur, Maharashtra 413 401, India; ⁹ Christian Fellowship Community Health Centre, Ambillikai (near Oddanchathram), Dindigul District, Tamil Nadu 624 612, India; ¹⁰ Sikkim Manipal Institute of Medical Sciences, Sikkim Manipal University, Gangtok, Sikkim 737102, India; ¹¹ Gujarat Cancer & Research Institute (GCRI), M.P. Shah Cancer Hospital, Civil Hospital Campus, Asarwa, Ahmedabad 380 016, India; ¹² Civil Hospital, Aizawl 796 001, Mizoram, India; ¹³ Department of Preventive Oncology, Centre for Cancer Epidemiology (CCE), Homi Bhabha National Institute, Tata Memorial Centre, Mumbai, India; ¹⁴ Cancer Foundation of India, Kolkata, West Bengal 700 039, India; ¹⁵ Department of Health Disparities Research, Division of Cancer Prevention and Population Sciences, University of Texas M.D. Anderson Cancer Centre, 1400 Pressler St, Houston, TX 77030-3906, United States; ¹⁶ EMBL-DKFZ Chemical Biology Core Facility, European Molecular Biology Laboratory, D-69117, Heidelberg, Germany

Background
In its human papilloma virus (HPV) vaccine off-label single-dose 2022 recommendation, the World Health Organization highlighted the need for long-term follow-up studies to monitor waning protection over time.. The first indication for reduced protection would be reflected in vaccine-induced immune responses falling to the levels on those in unvaccinated women.
Objective
To compare the 15-year immune responses of 1, 2, and 3 doses of the quadrivalent HPV vaccine compared to those obtained through natural immunity.
Methods
Serology samples were obtained at months 0, 7, 12, 18, 24, 36, 48, 60, 120 and 180 after first dose from a sample of vaccinated participants and from age-matched unvaccinated women at two timepoints, 5 years apart. The evolution of the binding and neutralizing antibody responses was assessed by dose received. 10-year durability of immune responses induced by a single-dose was compared to that after three doses of the vaccine and that in unvaccinated married women. We will soon receive the 15-year immune responses data that we will additionally present.
Results
The evolution of antibody response among the single-dose recipients observed over 120 months show stabilized levels 18 months after vaccination for the four vaccine-targeted HPV types. Although the HPV type-specific (binding or neutralizing) antibody titres after a single-dose were significantly inferior to those after three doses of the vaccine (lower bounds of GMT ratios < 0.5), they were all significantly higher than those observed in unvaccinated women following natural infections (GMT ratios: 2.05 to 4.04-fold higher).
The results correlate well with the high vaccine efficacy of single-dose against persistent HPV 16/18 infections reported by us for the 16-years post-vaccination. We expect a similar trend from the 15-year timepoint data.
Conclusions
Our study demonstrates the high and durable immune response in single-dose recipients of
HPV vaccine at 10-years post vaccination.

Evolution of immune responses for HPV 16 and 18 over time in the recipients of a single-dose or three doses of the HPV vaccine