I think further research needs to be done into which of the strains of HPV are the most prevalent but not covered in the current vaccine. Since this article was written, vaccines have been made to cover more strains than just HPV 16 and HPV 18.
HPV 31 and HPV 45 were included along with HPV 16 and 18 to account for 80% of the cases of cervical cancer. The article states that HPV types 33, 35, 39, 51, 52, 56, 58 and 59 are also associated with cervical cancer. Since then, the Gardasil 9 vaccine has been developed that protects against HPV 16, 18, 6, 11, 31, 33, 45, 52 and 58.
Of those listed in the article, HPV 35, 39, 51, 56 and 59 are not covered in the current Gardasil 9 vaccine, so I would probably recommend covering those strains in upcoming treatment.
Another aspect to consider is the prevalence of different strains worldwide. 75% of HPV is considered to be carcinogenic, but the most prevalent strains vary by region and population and some are not currently covered by available vaccines.
In Japan, HPV 35 is part of the 20% most likely to cause cervical cancer, but it is not included in the Gardasil 9 vaccine. Similarly, in one study in Korea, HPV 56 was identified to be in the top 4 most prevalent strains associated with cervical cancer, along with HPV 16, 58 and 68. HPV 56 also is not included in Gardasil 9 vaccine.
Because those strains are so prevalent in those countries and are included in the strains mentioned above that I would focus on in the United States (HPV 35, 39, 51, 56 and 59) it might be good to consider more in depth research on those strains as well, and the importance of contributing to the development of a vaccine for them as well.
Following current guidelines, vaccines for cervical cancer should be administered in their early pre-teen years, between the ages of 9-12, when the strongest immune responses will occur. If not then, then between the ages of 13-26. It is also important to receive the vaccine before any exposure to the strains of HPV can occur.
My sources for this blog include:
Cancer Lett. 2011 June 28; 305(2): 218–227. doi:10.1016/j.canlet.2010.09.011.
https://www.cancer.org/cancer/cancer-causes/infectious-agents/hpv/hpv-vaccines.html
https://www.ncbi.nlm.nih.gov/books/NBK304966/
https://www.ncbi.nlm.nih.gov/books/NBK304966/
