Recurrent respiratory papillomatosis is a rare disease caused by human papillomavirus (HPV) types 6 and 11, and therefore is preventable through HPV quadrivalent vaccination. Following the extensive quadrivalent HPV vaccination program performed in females aged 12-26 years in 2007-2009 in Australia, the authors established a method to monitor the incidence and demographics of juvenile-onset recurrent respiratory papillomatosis (JORRP) cases. They found that the average annual incidence rate to end of 2016 was 0.07 per 100,000. The largest number of cases was seen in the first year, with decreasing annual frequency in subsequent years. Rates declined significantly from 0.16 per 100,000 in 2012 to 0.02 per 100,000 in 2016. Among the 15 incident cases (60% male), none of the mothers had been vaccinated pre-pregnancy, 20% had a maternal history of genital warts and 60% were first born, with 13/15 born vaginally. Of the genotyped cases, four were HPV-6 and three were HPV-11. Therefore there has been a decline in JORRP incidence in children following the introduction of the quadrivalent HPV vaccine.
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