TY - JOUR
T1 - Bivalent vaccine effectiveness against type-specific HPV positivity: evidence for cross-protection against oncogenic types among Dutch STI clinic visitors
AU - Med Microbiological Labs Public
AU - Woestenberg, Petra J.
AU - King, Audrey J.
AU - van Benthem, Birgit H. B.
AU - Donken, Robine
AU - Leussink, Suzan
AU - van der Klis, Fiona R. M.
AU - de Melker, Hester E.
AU - van der Sande, Marianne A. B.
AU - Hoebe, Christian J. P. A.
AU - Bogaards, Johannes A.
N1 - FTX; (CC BY-NC-ND 4.0)
PY - 2018
Y1 - 2018
N2 - 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-LiPA(25)) 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 vaccinationConclusion: We demonstrated high VE of the bivalent vaccine against HPV-16/18 and cross-protection against HPV45/ 35/31/52. Protection against HPV-16/18 was sustained up to 6 years postvaccination.
AB - 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-LiPA(25)) 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 vaccinationConclusion: We demonstrated high VE of the bivalent vaccine against HPV-16/18 and cross-protection against HPV45/ 35/31/52. Protection against HPV-16/18 was sustained up to 6 years postvaccination.
KW - human papillomavirus
KW - human papillomavirus vaccine
KW - vaccine effectiveness
KW - public health
KW - Cervarix
KW - HUMAN-PAPILLOMAVIRUS VACCINATION
KW - HPV-16/18 AS04-ADJUVANTED VACCINE
KW - INVASIVE CERVICAL-CANCER
KW - BLIND PATRICIA TRIAL
KW - OF-STUDY ANALYSIS
KW - INTRAEPITHELIAL NEOPLASIA
KW - BROAD-SPECTRUM
KW - PCR ASSAY
KW - INFECTION
KW - EFFICACY
U2 - 10.1093/infdis/jix582
DO - 10.1093/infdis/jix582
M3 - A1: Web of Science-article
SN - 0022-1899
VL - 217
SP - 213
EP - 222
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 2
ER -