Is vaccine type seropositivity a marker for human papillomavirus vaccination? National Health and Nutrition Examination Survey, 2003–2010. (April 2015)

• Record Type: Journal Article
• Authors: Petrosky, Emiko Y.; Hariri, Susan; Markowitz, Lauri E.; Panicker, Gitika; Unger, Elizabeth R.; Dunne, Eileen F.
• Is Part Of: International journal of infectious diseases. Volume 33(2015:Apr.)
• Page Start: 137
• Page End: 141
• Publication Date: 2015-04
• Subjects: Human papillomavirus vaccine -- National Health and Nutrition Examination Survey -- Seropositivity; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2015.01.010
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: We analyzed 2003–2010 National Health and Nutrition Examination Survey (NHANES) data of females aged 14–59 years. We evaluated seropositivity to vaccine types as a marker for HPV vaccine coverage. Vaccine type seropositivity was significantly higher post vaccine introduction. There was high agreement between seropositivity and report of HPV vaccination. Summary: Objective: Since 2006, human papillomavirus (HPV) vaccination has been routinely recommended for adolescent females in the USA. The quadrivalent vaccine induces long-term seropositivity to HPV 6/11/16, which may be useful as a marker for HPV vaccine coverage. Methods: We evaluated vaccine type seropositivity (i.e., seropositivity to HPV 6/11/16 with or without HPV18) among females aged 14–59 years participating in the 2003–2010 National Health and Nutrition Examination Survey (cross-sectional, nationally representative surveys). We compared pre-vaccine era (2003–2006) to vaccine era (2007–2010) seropositivity and assessed agreement between vaccine era seropositivity and reported vaccination by kappa statistic. Results: Seropositivity was 1.0% among 2151 females in the pre-vaccine era and 22.1% among 1420 females in the vaccine era ( p < 0.001); 23.1% of vaccine era females reported receipt of one or more HPV vaccine dose. Seropositivity and reported vaccination had high agreement (kappa = 0.79; 95% confidence interval 0.74–0.84). Among seropositive females, 14.5% reported no vaccination. Conclusion: The increase in vaccine era seropositivity likely reflects vaccination uptake. Our study suggests seropositivity to HPV 6/11/16 may be a useful marker for vaccination coverage in adolescent and young adult females. Discordance between seropositivity and reported vaccination may be explained by inaccurate reporting and/or natural exposure to HPV.