HPV is still the most common sexually transmitted infection, leading to the onset of many disorders
while causing an increase in direct and indirect health costs. High Risk (HR) HPV is the primary cause of invasive
cervical cancer and contributes significantly to the development of anogenital and oropharyngeal cancers.
The introduction of universal HPV vaccination has led to a significant reduction in vaccine-targeted HPV infections,
cross-protective genotypes, precancerous lesions and anogenital warts. Despite the several limitations of
HPV vaccination programs, including vaccine type specificity, different schedules, target age-groups and poor
communication, the impact has become increasingly evident, especially in countries with high vaccine uptake.
We carried out a review of the most recent literature to evaluate the effects of HPV vaccination on vaccinetargeted
HPV genotypes and to assess the level of cross-protection provided against non-vaccine HPV types.
Subsequently, to assess the rates of HPV infection in a southeast Italian region, we performed an epidemiological
investigation on the impact of vaccination on genotypes and on the prevalence and distribution of HPV infection
during the twelve-year period 2006-2017 in the Local Health Unit (LHU) of Lecce. The vaccination coverage of
about 70% among girls in the LHU led to an initial reduction in vaccine-targeted HPV types and cross-protective
genotypes. However, the results on this population should be interpreted cautiously because the period since the
start of vaccination is too short and the coverage rate is not yet optimal to evaluate the efficacy of vaccination in
lowering the prevalence of non-vaccine HR HPV types in the vaccinated cohort and in older subjects. Nevertheless,
it is expected that direct effects will increase further and that herd immunity will begin to emerge as vaccination