Prevention of recurrent respiratory papillomatosis: Role of HPV vaccination

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Summary

Recurrent respiratory papillomatosis is a rare, but devastating, cause of airway lesions in children and adults. This disease is caused by human papilloma virus subtypes 6 and 11. At this time there are two vaccines in late stages of development seeking Food and Drug Administration (FDA) approval to prevent cervical cancer, which is also caused by human papilloma virus. One of these vaccines has been developed to stimulate immunity to the most common subtypes that cause cervical cancer but also includes those responsible for recurrent respiratory papillomatosis. With the possibility this could drastically reduce the incidence of RRP, the otolaryngology community should advocate for implementation of a vaccine program that provides effective prevention of HPV infection with subtypes 6 and 11.

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Discussion

Recurrent respiratory papillomatosis (RRP) is a frustrating disease to manage due to its unpredictable nature and potential for producing airway compromise. RRP is usually caused by infection with human papilloma virus (HPV) subtypes 6 and 11 and is generally considered to be a vertically sexually transmitted disease from mother to child in the birth canal. We present information for the clinician regarding the potential for new vaccines that could impact the incidence of this disease.

Conclusions

Discussions leading to the approval and recommended administration of HPV vaccines are likely to be charged as there are both public health and political implications involved in the approval process for these products. The cost of the vaccines, third-party coverage and whether either or both will receive approval are yet to be determined and will have bearing on their universal use. Given the upcoming approval process, it would seem prudent for the otolaryngology community to express their

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