HPV Vaccination in immunosuppressed patients with established skin warts and non-melanoma skin cancer: A single-institutional cohort study

BackgroundcSCC (cutaneous squameous cell carcinom) and its precursors are a major cause of morbidity especially in immunosuppressed patients and are frequently associated with human papilloma virus (HPV) infections. ObjectiveThe purpose of this study is to investigate the therapeutically potential of alpha-HPV vaccination for immunosuppressed patients with established cSCC and its precursors. MethodsIn this retrospective study, all patients who received Gardasil-9(R), a nonavalent HPV vaccine, as secondary prophylaxis were examined. Dermatologic interventions in both the pre- and post-vaccination periods were analyzed with zero-inflated poisson regression and a proportional intensity model for repeated events with consideration of the clinically relevant cofactors. ResultsThe hazard ratio for major dermatologic interventions was 0.27 (CI 0.14-0.51, p <0.001) between pre- and post Gardasil-9(R) intervention. Gardasil-9(R) vaccination showed good efficacy in reducing major dermatologic interventions even after correction of relevant cofactors and national COVID-19 case loads during the observational period. LimitationThe retrospective study design and the rather low number of patients may influence study results. Furthermore, analysis of HPV types and data collection on vaccine-specific HPV antibody measurements was not possible. ConclusionAlpha-HPV vaccination may potentially cause a significant decrease in dermatologic interventions in immunosuppressed patients with high skin tumor burden. Capsule summaryO_LILittle is known about a possible immunizing effect of alpha-vaccines in immunosuppressed patients with high skin tumor burden C_LIO_LIAlpha-HPV vaccination such as Gardasil-9(R) may potentially cause a significant decrease in dermatologic interventions in IS patients with high skin tumor burden. C_LI