人群水平的人乳头瘤病毒 (HPV) 疫苗接种对非靶向 HPV 病毒生态学的长期影响知之甚少。我们对 33 个社区进行了为期 8 年的随访，这些社区随机接受不分性别的 HPV16/18 疫苗接种、仅女孩接种 HPV16/18 疫苗接种以及未接种 HPV 疫苗的对照社区。 1992/93和1994年出生的学生在2007/8和2008/9学年被邀请。分别有 11,396 名参与者和 5,602 名参与者在 18 岁和 22 岁、疫苗接种后 4 年和 8 年进行了后续宫颈阴道取样。对 HPV 6/11/16/18/31/33/35/39/45/51/52/56/58/59/66/68 型进行基因分型并用于群落水平生态多样性估计。尽管针对疫苗的目标已被清除，但与仅女孩接种疫苗的社区相比，性别中立的疫苗接种社区的群体免疫力更强，在疫苗接种后 4 至 8 年中，HPV α 多样性显着增加 (p = 1.1 × 10-8)这些社区中的 HPV。非疫苗靶向 HPV 占据利基的这一可能迹象可能会影响未来的宫颈癌筛查计划，但不应干扰世界卫生组织消除宫颈癌的使命。版权所有 © 2023 作者。由爱思唯尔公司出版。保留所有权利。

The long-term effect of population-level human papillomavirus (HPV) vaccination on the viral ecology of the untargeted HPVs is poorly understood. We performed an 8-year follow-up of 33 communities randomized to gender-neutral HPV16/18 vaccination, girls-only HPV16/18 vaccination, and control communities without HPV vaccination. The 1992/93 and 1994 birth cohorts were invited in school years 2007/8 and 2008/9. Follow-up cervico-vaginal sampling at 18 and 22 years of age, 4 and 8 years post-vaccination, respectively, were attended by 11,396 and 5,602 participants. HPV types 6/11/16/18/31/33/35/39/45/51/52/56/58/59/66/68 were genotyped and used for the community-level ecological diversity estimations. Gender-neutral vaccination communities with a stronger herd immunity than girls-only vaccination communities show a significantly increased HPV α-diversity (p = 1.1 × 10-8) from 4 to 8 years post-vaccination, despite the clearance of the vaccine-targeted HPVs in these communities. This likely sign of niche occupation by the non-vaccine-targeted HPVs will potentially affect the future cervical cancer screening programs but should not interfere with the WHO mission to eliminate cervical cancer.Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.