TY - JOUR
T1 - Impact of Human Papillomavirus Vaccination, Rwanda and Bhutan
AU - Baussano, Iacopo
AU - Sayinzoga, Felix
AU - Tshomo, Ugyen
AU - Tenet, Vanessa
AU - Vorsters, Alex
AU - Heideman, Daniëlle A M
AU - Gheit, Tarik
AU - Tommasino, Massimo
AU - Umulisa, Marie Chantal
AU - Franceschi, Silvia
AU - Clifford, Gary M
N1 - Funding Information: This work was supported by the Bill and Melinda Gates Foundation (http://www.gatesfoundation.org) (grant no. OPP1053353). Publisher Copyright: © 2021 Centers for Disease Control and Prevention (CDC). All rights reserved. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/1
Y1 - 2021/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85098487462&partnerID=8YFLogxK
U2 - https://doi.org/10.3201/eid2701.191364
DO - https://doi.org/10.3201/eid2701.191364
M3 - Article
C2 - 33350922
SN - 1080-6040
VL - 27
SP - 1
EP - 9
JO - Emerging infectious diseases
JF - Emerging infectious diseases
IS - 1
ER -