Vaccine escape variants of HBV and HPV vaccines

Qu, Sui, Li

Vaccine escape challenges virus prevention: The example of two vaccine-preventable oncogenic viruses

Journal of Medical Virology

Wiley Online Library

First published: 09 November 2023

DOI: https://doi.org/10.1002/jmv.29184

HBV - Hepatitis B vaccine (In the UK, it is given to babies as part of the 6-in-1 vaccine (Vaxelis or Infanrix Hexa))

HPV - Human papillomavirus vaccine (Gardasil 9)

In this review researchers at Obstetrics and Gynecology Hospital in China analysed the literature on vaccine escape variants of both HBV and HPV vaccines and discussed the mechanism of the virus escaping from vaccine protection.

"Cases of HPV infection after being vaccinated have been observed in clinical practice. However, few researchers have paid attention to the mechanism of HPV vaccine escape."

After more than 30 years of application several mechanisms have been studied to explain HBV vaccine escape. Researchers found:  

"(..) with the extensive coverage of those vaccines, cases of virus infection after vaccination were reported. Several reasons may explain these cases: (1) vaccine failure: the body does not produce specific immune protection after a complete vaccination because of an abnormal immune stage (especially in immunosuppressed patients); (2) vaccine escape: Despite the strong enough immune response of the body, the virus escapes from immune killing through genome mutation, recombination, and protein conformational changes, and (3) breakthrough infection because of unknown reasons."

A breakthrough infection is a case of illness in which a vaccinated individual becomes infected with the illness, because the vaccine has failed.

Vaccine escape is always discovered in HBV breakthrough infection, leading to fulminant, acute, and chronic hepatitis B.

They analysed the gap between studies of HPV and HBV and made prospects for further research in HPV vaccine escape.