Trends in the incidence and prevalence of juvenile-onset recurrent respiratory papillomatosis following implementation of national HPV vaccination initiatives: a systematic review.

Background: Infection with human papillomavirus (HPV) low-risk type 6 and 11 in the respiratory tract can cause recurrent benign squamous papillomas in the larynx, in children, juvenile-onset recurrent respiratory papillomatosis (JoRRP).

Objectives: This systematic review investigated the impact of national HPV vaccination programs on JoRRP incidence and prevalence.

Methods: PubMED was systematically searched for publications between 2010 and March 2024 that assessed the incidence and prevalence of JoRRP post-implementation of HPV vaccination programs.

Results: Four studies met the inclusion criteria, comprising 622 patients with JoRRP (range 15-576) from Australia, New Zealand and the Unites States. The majority were girls (F:M ratio 2:1), with a median debut age between three to four years. Two studies (n = 591) showed a significant decline in JoRRP incidence after vaccination from 2,0 per 100,000 < 18 years (2004-2005) to 0,5 per 100,000 < 18 years (2012-2013) in the United States, and 0,16 per 100,000 < 15 years (2012) to 0,02 per 100,000 < 15 years (2016) in Australia. Higher vaccination coverage correlated with a reduced JoRRP burden.

Conclusion: Our findings indicate implementation of HPV-vaccination programs reduced the JoRRP incidence and prevalence emphasizing the importance of large-scale HPV vaccination. Total impact of HPV vaccination will become fully evident when the vaccinated population reach childbearing ages.