title: Public health paradoxes and the epidemiological impact of an HPV vaccine.
abstract: BACKGROUND
  our understanding of human papilloma virus (HPV) and cervical cancer has improved dramatically, with a vaccine against the viral infection being a real possibility in the near future.
  
  
  OBJECTIVE
  the goal of an HPV vaccine would be to reduce the prevalence of infection and hence the risk of cervical abnormalities. However, questions arise as to how this would interact with an existing intervention, screening, which reduces the progress of cervical abnormalities to serious disease. Furthermore, will a vaccine against one genotype influence the other types within a population and will the patterns of infection and disease remain the same if the vaccine alters the timing and type of HPVs experienced within a population? What would a vaccine that only worked in one sex achieve and how widespread would the use of such a vaccine have to be?
  
  
  CONCLUSIONS
  the above-given questions can be addressed within a theoretical framework that describes the transmission dynamics of human papilloma virus.
authors.affiliation: Wellcome Trust Centre for the Epidemiology of Infectious Disease, University of Oxford, South Parks Road, OX1 2JD, Oxford, UK.
authors.forename: G P
authors.initials: GP
authors.lastname: Garnett
authors.forename: H C
authors.initials: HC
authors.lastname: Waddell
mesh_terms: D003140:Communicable Disease Control; D019049:Developed Countries; D003906:Developing Countries; D005260:Female; D005838:Genotype; D006801:Humans; D007114:Immunization; D008297:Male; D027383:Papillomaviridae / Q000235:genetics / Q000276:immunology*; D030361:Papillomavirus Infections / Q000453:epidemiology / Q000517:prevention & control*; D053918:Papillomavirus Vaccines; D015995:Prevalence; D014412:Tumor Virus Infections / Q000453:epidemiology / Q000517:prevention & control*; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control* / Q000821:virology; D014765:Viral Vaccines
chemical_list: D053918:Papillomavirus Vaccines; D014765:Viral Vaccines