Bivalent Vaccine Effectiveness Against Type-Specific HPV Positivity
Evidence for Cross-Protection Against Oncogenic Types among Dutch STI Clinic Visitors
Background: Observational postmarketing studies are important to assess vaccine effectiveness (VE). We estimated VE from the bivalent human papillomavirus (HPV) vaccine against HPV positivity of vaccine and nonvaccine types in a high-risk population.
Methods: We included all vaccine-eligible women from the PASSYON study, a biennial cross-sectional survey in Dutch sexually transmitted infection clinics. Vaginal swabs were analyzed using a polymerase chain reaction-based assay (SPF10-LiPA25) able to detect the 12 high-risk HPV (hrHPV) types 16/18/31/33/35/39/45/51/52/56/58/59. We compared hrHPV positivity between self-reported vaccinated (.1 dose) and unvaccinated women, and estimated VE by a logistic mixed model.
Results: We included 1087 women of which 53% were hrHPV positive and 60% reported to be vaccinated. The adjusted pooled VE against HPV-16/18 was 89.9% (81.7%.94.4%). Moreover, we calculated significant VE against nonvaccine types HPV-45 (91%), HPV-35 (57%), HPV-31 (50%), and HPV-52 (37%). Among women who were offered vaccination 5/6 years ago, we estimated similar VE against HPV-16/18 (92%) and all hrHPV types (35%) compared to women who were offered vaccination <5 years ago (83% and 33%, respectively).
Conclusion: We demonstrated high VE of the bivalent vaccine against HPV-16/18 and cross-protection against HPV-45/35/31/52. Protection against HPV-16/18 was sustained up to 6 years postvaccination.
|Keywords||Cervarix, human papillomavirus, human papillomavirus vaccine, public health, vaccine effectiveness|
|Persistent URL||dx.doi.org/10.1093/infdis/jix582, hdl.handle.net/1765/104139|
|Journal||The Journal of Infectious Diseases|
|Note||on behalf of the Medical Microbiological Laboratories and the Publich Health Services|
Woestenberg, P.J. (Petra J.), King, A.J. (Audrey J.), van Benthem, B.H, Donken, R. (Robine), Leussink, S. (Suzan), van der Klis, F.R.M, … Bogaards, J.A. (2018). Bivalent Vaccine Effectiveness Against Type-Specific HPV Positivity. The Journal of Infectious Diseases, 217(2), 213–222. doi:10.1093/infdis/jix582