Effectiveness of human papillomavirus vaccine against incident and persistent infections among young girls: Results from a longitudinal Dutch cohort study. Issue 23 (28th May 2015)

• Record Type: Journal Article
• Authors: Mollers, Madelief; King, Audrey J.; Knol, Mirjam J.; Scherpenisse, Mirte; Meijer, Chris J.L.M.; van der Klis, Fiona R.M.; de Melker, Hester E.
• Is Part Of: Vaccine. Volume 33:Issue 23(2015)
• Page Start: 2678
• Page End: 2683
• Publication Date: 2015-05-28
• Subjects: Monitoring -- Vaccination -- HPV -- Impact -- Cervical cancer; Vaccines -- Periodicals; 615.372
• DOI: 10.1016/j.vaccine.2015.04.016
• Languages: English
• ISSNs: 0264-410X

Abstract

Highlights: Routine HPV16/18-vaccination for girls in the Netherlands shows high vaccine effectiveness. We show protection against HPV16/18 infections and cross-protection against HPV31/45. Vaccine-effectiveness remained high during the first 3 years of follow-up. This ongoing study using early surrogate markers informs on long term vaccine impact. Abstract: Introduction: Because of the long interval between infection with high-risk human papillomavirus (hrHPV) and development of cervical cancer surrogate markers for cancer incidence are necessary to monitor vaccine effectiveness (VE). The aim of this study was to calculate VE of HPV16/18 vaccination by annually assessing incident and persistent infections among (un)vaccinated girls from the general Dutch population up to 3 years after vaccination. Methods: In 2009, 1668 girls (54% vaccinated) aged 14–16 years were enrolled in a prospective cohort study. Annually, questionnaire data were obtained, and a vaginal swab was tested for type-specific HPV DNA with SPF10 -LiPA. VE was estimated by a Poisson model comparing type-specific infection rates in (un)vaccinated girls. Results: The adjusted VE (95% CI) was 73% (49–86%) against incident infections with HPV16/18 and 72% (52–84%) against HPV16/18/31/45. VE against persistent HPV16/18 was 100% and 76% (−17 to 95%) against HPV16/18/31/45. This number was lower (36%) when girls who were positive for HPV16 and 18 at baseline were included in the analysis. The overall VE for hrHPV types combined was small. Although 96% of girls were HPV-naïve at baseline, the cumulative 36-month incidence for any HPV was 20%, indicating high sexual activity. Discussion: Vaccination is effective against incident and persistent infections with HPV16/18 and HPV16/18/31/45. Low VE against persistent HPV16/18 infection in girls positive at baseline indicates importance of vaccination before sexual debut.