Post-vaccination HPV seroprevalence among female sexual health clinic attenders in England. Issue 30 (5th July 2021)

• Record Type: Journal Article
• Authors: Mesher, David; Thomas, Sara L.; Linley, Ezra; Edmundson, Claire; Checchi, Marta; Waterboer, Tim; Bender, Noemi; Müller, Martin; Beddows, Simon; Borrow, Ray; Soldan, Kate
• Is Part Of: Vaccine. Volume 39:Issue 30(2021)
• Page Start: 4210
• Page End: 4218
• Publication Date: 2021-07-05
• Subjects: HPV -- Serology -- Seroprevalence -- Genital warts -- Vaccination; BPV Bovine papillomavirus -- CI Confidence interval -- DKFZ Deutsches Krebsforschungszentrum (German Cancer Research Center) -- HPV Human papillomavirus -- IMD Index of multiple deprivation -- LSOA Lower layer super output area -- MFI Median fluorescent intensity -- OR Odds ratio -- PHE Public Health England -- SSHS Specialist sexual health services -- STI Sexually transmitted infection -- UK United Kingdom -- USA United States of America -- VEU Vaccine Evaluation Unit -- VLP Virus-like particle; Vaccines -- Periodicals; 615.372
• DOI: 10.1016/j.vaccine.2021.05.018
• Languages: English
• ISSNs: 0264-410X

Abstract

Highlights: This study explores vaccination coverage in women attending sexual health clinics in England. HPV vaccine-induced seropositivity was in line with vaccination coverage in the population. Vaccine-induced seropositivity was lower in some at-risk sub-groups. There was little evidence of a protective effect of the bivalent HPV vaccine against genital warts. Abstract: Background: The National HPV Immunisation Programme was introduced in England in September 2008 using the HPV16/18 bivalent vaccine. We conducted serological surveillance to explore vaccination coverage levels. We also conducted a case-control study to investigate a hypothesised cross-protective effect of the HPV16/18 vaccine against genital warts. Methods: Residual serum specimens from 16 to 20 year-old women attending six specialist sexual health services (SSHS) between 2011 and 2015 in England were tested for antibodies against HPV16 and HPV18 using a virus-like particle (VLP)-based multiplex serology assay. Patients were classified as having vaccine-induced seropositivity if they were seropositive for both HPV types and either had high antibody levels for at least one HPV type, or moderately high levels for both HPV types. Differences in vaccine-induced seropositivity by patient characteristics were investigated using logistic regression. Vaccine-induced seropositivity was then compared for patients with genital warts (cases) and matched patients without (controls). Results: Of 3, 973 serum specimens collected, 3, 870 (97.4%) had a valid result. The proportion of women with vaccine-induced seropositivity decreased with age (from 78.1% in 16-year-olds to 52.6% in 20-year-olds). Vaccine-induced seropositivity was lower among women born outside the UK, from more deprived areas and with a history of chlamydia diagnosis. A difference in uptake by ethnic group was also seen but this was largely confounded by differences in deprivation and country of birth. Among 537 cases and 1, 515 controls, there was little evidence of a protective effect of the bivalent HPV vaccine against genital warts (adjusted odds ratio 0.93; 95% CI: 0.74–1.18). Discussion: Vaccine-induced seropositivity in this high-risk population was in line with vaccination coverage in the general population although was lower in some at-risk sub-groups. This study does not provide evidence to support a cross-protective effect of the HPV16/18 vaccine against genital warts.