N Engl J Med

Is one HPV vaccine dose as effective as two?

December 5, 2025

The ESCUDDO randomized trial (NCT03180034) enrolled 20,330 girls aged 12 to 16 years, comparing one vs. two doses of bivalent or nonavalent HPV vaccine. Over 5 years of follow-up, one dose was noninferior to two doses in preventing persistent HPV16 or HPV18 infection. For the bivalent vaccine, the rate difference was −0.13 infections per 100 participants (95% confidence interval [CI], −0.45 to 0.15; P<0.001 for noninferiority); for the nonavalent vaccine, 0.21 infections per 100 participants (95% CI, −0.09 to 0.51; P<0.001 for noninferiority). Vaccine effectiveness exceeded 97% in all groups, with no safety concerns identified.

Clinical takeaway: Consider whether a one-dose HPV schedule could reduce missed opportunities and improve completion rates in your patient population.

Source:

Kreimer AR, et al. (2025, December 3). N Engl J Med. Noninferiority of One HPV Vaccine Dose to Two Doses. https://pubmed.ncbi.nlm.nih.gov/41337735/