AUTHOR=Freire-Salinas Javier , Benito Rafael , Azueta Ainara , Gil Joaquina , Mendoza Claudia , Nicolás Montserrat , García-Berbel Pilar , Algarate Sonia , Gómez-Román Javier 

TITLE=Genotype Distribution Change After Human Papillomavirus Vaccination in Two Autonomous Communities in Spain

JOURNAL=Frontiers in Cellular and Infection Microbiology

VOLUME=Volume 11 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/cellular-and-infection-microbiology/articles/10.3389/fcimb.2021.633162

DOI=10.3389/fcimb.2021.633162

ISSN=2235-2988

ABSTRACT=Context: It has been more thanten years since the Human Papillomavirus vaccination program was initiated in most advanced countries. It seems necessary to change the uterine cervical cancer screening strategy and molecular tests are considered essential in this scenario.  
Objective: To review the distribution of HPV genotypes after introducing the vaccination program in two autonomous communities in Spain, looking for a possible change in distribution and a herd effect.
Design: A cross-sectional study was performed in 45362 samples that were processed in Cantabria and Aragon communities during the period 2003–2016. We compare the genotype distribution before and after the vaccination program was initiated.
Results: The genotypes 6 and 11 have decreased significantly after vaccine introduction. HPV16 has had a decrease but not a significant one in statistical analysis. However, HPV31, 52 and 45 have increased in percentage. A replacement phenomenon with other types not included in the vaccine has been observed in our population.  
Conclusions: Continued surveillance is needed to provide further indication of any changes over time in the genotypes in circulation, and will be facilitated by monitoring of genotyping results from the new model of cervical screening using primary HPV DNA testing