In April 2007 Australia became the first country to launch a national human papillomavirus (HPV) vaccination program for all girls and women ages 12 to 26 years. And that approach seems to work, according to the authors of a recent report that found a reduction of 38% in high-grade (precancerous) cervical abnormalities (HGAs) in female residents younger than 18 years.

Australian girls were offered the quadrivalent HPV vaccine (Gardasil) at school, and 79% of girls who were 14 to 15 years old received the required three doses in 2007. The incidence rate of HGAs detected three years after the launch of the vaccine program was compared with the incidence rate before the introduction of the vaccine: prior to the vaccine's introduction, 80% of girls 17 years and younger had HGAs; after its introduction, that rate fell to 42%. This decrease occurred soon after the vaccination program started.

The HPV vaccine is aimed at girls nine to 12 years of age because it's most effective before the onset of sexual activity. Finding that the incidence of HGA is lowest in the youngest girls reinforces the appropriateness of targeting preadolescent girls; indeed, older age groups didn't experience this decline in HGAs. Determining the success of the vaccine in terms of the main goal of HPV vaccines-reducing the incidence of cervical cancer-will take several decades.

"Nurses in Australia and in other countries play a critical role in vaccination," lead author Julia Brotherton told AJN. That involves making information available to parents and young girls in health care settings and inquiring whether they've been vaccinated. "We should be moving to a time when HPV vaccination is seen as an obvious, safe, and effective health choice for girls," she said.-Carol Potera

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