EFICÁCIA DA VACINA ANTI-HPV EM MULHERES DE DIFERENTES REGIÕES GEOGRÁFICAS

Abstract

INTRODUCTION: Cervical cancer (CCU), associated with persistent Human Papillomavirus (HPV) infection, remains a leading cause of female mortality, especially in low and middle-income countries. Prophylactic HPV vaccination represents an essential preventive measure. Various vaccines have been introduced since 2006, including bivalent, quadrivalent, and nonavalent versions. This study aimed to evaluate the efficacy of these vaccines in vaccinated women, based on a systematic review and meta-analysis, considering the impact of vaccination on preventing precancerous lesions and CCU. METHODOLOGY: This was a systematic review with meta-analysis, registered in PROSPERO under number 1057257, conducted between February 2024 and May 2025, based on studies published between 2016 and 2025. The databases used were PubMed/Medline and SciELO. Filters applied included "free full text," "human," and "female." Study selection followed PRISMA 2020 guidelines. Methodological quality was assessed according to Joanna Briggs Institute (JBI) criteria. The meta-analysis was performed using a random-effects model, applying the inverse variance (IV) method and double arcsine transformation. Heterogeneity was measured by Cochran's Q and Higgins' I² statistics. Subgroup analysis by vaccine type and leave-one-out sensitivity analysis were also conducted. RESULTS: Eleven studies were included, totaling 571,283 women. The overall efficacy estimate was 99.9% (95% CI: 99.7–100), although with high heterogeneity (I² = 97.3%). DISCUSSION: HPV vaccines demonstrated high efficacy in preventing CCU-associated lesions. Early vaccination, before sexual debut, proved essential for maximizing efficacy. The observed heterogeneity stems from differences in methodological designs, population contexts, and vaccine types used. Adopting a single dose and increasing vaccination coverage are promising strategies, especially in resource-limited countries. CONCLUSION: The analysis highlights the high efficacy of HPV vaccines in preventing cervical cancer. Vaccination represents an essential tool for controlling CCU morbidity and mortality, reinforcing the need for public policies that expand access, adherence, and vaccination coverage, especially among adolescents and at-risk groups.