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Vaccination and the evolutionary ecology of human papillomavirus.

Abstract

New and upcoming vaccines provide protection against types 16 and 18 of human papillomavirus (HPV), which are responsible for an estimated 70% of all cervical cancers. One vaccine also protects against HPV types 6 and 11, which cause more than 90% of genital warts. We use a mathematical model of HPV transmission and immunity to explore the effect of vaccination on the evolution of HPV types. If vaccination provides cross-immunity at least equal to that of natural infection, it may contract the niche space available to other HPV types a million-fold. If natural infection provides greater cross-immunity than vaccination, vaccination may expand available niche space up to 470-fold. The balance of epidemiologic data suggests vaccination will reduce the available niche space.

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