The national vaccination program against the human papillomavirus, which was introduced to schools in Israel more than a decade ago, continues to prove itself in the field. A new and large–scale Israeli study by the KSM Research Institute of Maccabi Healthcare Services found a dramatic decline in the prevalence of genital warts among adolescents and young adults vaccinated within the education system. At the same time, a troubling trend was also revealed: An increase in the rates of the phenomenon specifically among young adults and older individuals who were not included in the original vaccination program.
The study, which was recently published in the scientific journal Vaccine, is considered the first in Israel to examine over time the impact of the national HPV vaccination program on the prevalence of genital warts in the general population. The researchers analyzed data of Maccabi Healthcare Services members aged 10 to 65 between the years 2006 and 2022, and examined how diagnosis rates changed over the years.
The results were unequivocal, particularly among the younger age groups.
A consistent and significant decline in the occurrence rate of genital warts
According to the study's findings, among girls and women up to the age of 45, a consistent and significant decline in the occurrence rate of genital warts was recorded throughout the follow–up period. The sharpest decline was observed among girls aged 10 to 17, where a plunge of approximately 65 percent was documented after the introduction of the vaccine to the education system.
A substantial decline was also found among boys and young men, but the picture was slightly more complex. Among the younger age groups who were eligible for the vaccine through schools, a decline of between 45 and 60 percent was recorded in the prevalence of warts. In contrast, among men over the age of 21, who were not included in the national vaccination program at the outset, an increase in incidence rates was actually recorded.
The significance for the researchers is clear: The earlier and more widely the vaccine is given in the population, the more pronounced its impact.
Can lead to malignant diseases
The human papillomavirus, HPV, is one of the most common viruses in the world. In most cases, the infection passes without symptoms, but some strains can cause genital warts and various malignant diseases, including cervical cancer, anal cancer, oropharyngeal cancer, and other types of cancer.
The papillomavirus vaccine entered the national vaccination program in Israel for female students in the school year 2013 to 2014. Approximately two years later, the program was expanded to male students as well. Today, an advanced vaccine is administered in Israel that covers nine different strains of the virus, including the strains with the highest risk for developing cancer.
In the medical world, substantial evidence has already accumulated in recent years that HPV vaccines succeed in significantly reducing infection rates and the prevalence of precancerous lesions. However, the current Israeli study provides a large–scale local situational assessment and illustrates how public vaccination policy actually affects population health over time.
One of the prominent data points in the study is the gap created between the age groups that received orderly access to the vaccine and those that were not included in the original program. The increase observed among men over the age of 21 highlights the importance of expanding access to the vaccine to older populations as well.
The healthcare system has already taken action on the matter. Since last September, the papillomavirus vaccine has been included in the healthcare basket for young men and women aged 18 to 26 who were not vaccinated in schools. The vaccine is provided at no cost, with the aim of closing the gaps that have developed over the years and allowing adults to also enjoy the protection provided by the vaccine.
The researchers emphasize that beyond preventing genital warts, the truly major significance of the vaccine is the prevention of severe diseases in the future. According to them, the decline in the prevalence of warts is actually an early indication that the vaccine is succeeding in reducing infection with certain HPV strains, which may in the future also lead to a decline in the rates of cancerous diseases associated with the virus.
Dr. Michal Tzuchman, Vice President of Research and Innovation at Maccabi Healthcare Services, stated that the study illustrates the importance of using real–world data for decision–making in the healthcare system.
"This is another study that illustrates the central role that Maccabi's research institute plays in the Israeli healthcare system," she said. "The ability to analyze data on a large scale allows for a better understanding of the impact of preventive treatments and the translation of medical knowledge into a tangible impact on public health."
According to her, the study demonstrates how investment in vaccines and medical prevention can generate a long–term impact on society as a whole. "For us at Maccabi, research is an inseparable part of the responsibility for public health. We will continue to invest in research and innovation in order to promote data–driven medicine and lead to a real improvement in the health of Israelis."