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TOPLINE
Human papillomavirus (HPV) vaccination rates remain low in solid organ transplant recipients (SOTRs), despite their elevated risk for cutaneous squamous cell carcinoma (cSCC), and the association of HPV with post-transplant cSCC, a review shows.
METHODOLOGY
- Researchers conducted a systematic review of 16 studies involving pediatric and adult SOTRs published from January 2006 through August 2025.
- Two reviewers independently screened articles, extracted data, and assessed quality using Grading of Recommendations, Assessment, Development, and Evaluations and Joanna Briggs Institute tools, with discrepancies adjudicated by a third reviewer.
- Studies were categorized according to vaccination uptake, immunogenicity, or HPV-associated lesion outcomes.
TAKEAWAY
- HPV vaccination rates were consistently low in SOTR cohorts (six studies), particularly among adults; pharmacist-led counseling and structured infectious disease consultations increased uptake.
- Seroconversion rates for HPV 6, 11, 16, and 18 ranged from 52% to 90% (six studies), compared with more than 99% observed in immunocompetent individuals; HPV16 seroconversion was among the highest across cohorts.
- Greater immunosuppression, including higher tacrolimus levels, mycophenolate use, lung transplant status, and earlier post-transplant vaccination, predicted lower immune response to HPV vaccination.
- Efficacy data from four studies suggested reductions in HPV-associated lesion burden with vaccination, including fewer cervical complications, reduction in keratinocyte carcinoma incidence, resolution of squamous cell carcinoma in situ, and decreased wart recurrence.
IN PRACTICE
"HPV vaccination is underutilized in SOTRs, though targeted interventions may improve uptake," the authors wrote. "Post-transplant vaccination elicits attenuated but measurable immune responses, influenced by immunosuppression intensity and timing," they added.
SOURCE
The study was led by Elizabeth Fan, BA, Duke University School of Medicine, Durham, North Carolina, and was published online on August 7 in JAAD Reviews.
LIMITATIONS
The efficacy evidence was limited by small, heterogeneous studies that could not establish causality.
DISCLOSURES
The study received no funding. The authors disclosed having no relevant conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
