October 15, 2009
To the Editor: In her review of human papillomavirus (HPV) vaccination (July 16 issue),1 Kahn neglects to discuss one key “area of uncertainty,” namely, the extent to which other high-risk oncogenic HPV types may rapidly occupy the epidemiologic niche vacated by vaccine-targeted HPV types 16 and 18. If this rapid occupation occurs, the large expenditure of health care dollars for widespread HPV vaccination would be rendered futile.
Steven Leiner, N.P.
Mission Neighborhood Health Center
San Francisco, CA
Kahn JA. HPV vaccination for the prevention of cervical intraepithelial neoplasia. N Engl J Med 2009;361:271-278.
Comment from Leslie
Aaah, virus – mutating little buggers….Finally people are waking up and smelling the coffee.