Impact of Human Papillomavirus Vaccination, Rwanda and Bhutan

Iacopo Baussano, Felix Sayinzoga, Ugyen Tshomo, Vanessa Tenet, Alex Vorsters, Daniëlle A M Heideman, Tarik Gheit, Massimo Tommasino, Marie Chantal Umulisa, Silvia Franceschi, Gary M Clifford

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Rwanda and Bhutan, 2 low- and middle-income countries, implemented primarily school-based national human papillomavirus (HPV) vaccination in 2011 (Rwanda) and 2010 (Bhutan). We estimated vaccination effectiveness through urine-based HPV prevalence surveys in schools in 2013-2014 and 2017. In Rwanda, 912 participants from baseline surveys and 1,087 from repeat surveys were included, and in Bhutan, 973 participants from baseline surveys and 909 from repeat surveys were included. The overall effectiveness against vaccine-targeted HPV types (i.e., HPV-6/11/16/18) was 78% (95% CI 51%-90%) in Rwanda, and 88% (6%-99%) in Bhutan and against other α-9 types was 58% (21-78) in Rwanda and 63% (27-82) in Bhutan. No effect against other HPV types was detectable. Prevalence of vaccine-targeted HPV types decreased significantly, as well as that of other α-9 types, suggesting cross-protection. These findings provide direct evidence from low- and middle-income countries of the marked effectiveness of high-coverage school-based, national HPV vaccination programs.

Original languageEnglish
Pages (from-to)1-9
Number of pages9
JournalEmerging infectious diseases
Issue number1
Publication statusPublished - Jan 2021

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