TY - JOUR
T1 - Vaccine Effectiveness Following Routine Immunization With Bivalent Human Papillomavirus (HPV) Vaccine
T2 - Protection Against Incident Genital HPV Infections From a Reduced-Dosing Schedule
AU - Hoes, Joske
AU - King, Audrey J.
AU - Klooster, Tessa M. Schurink Van't
AU - Berkhof, Johannes
AU - Bogaards, Johannes A.
AU - de Melker, Hester E.
N1 - Publisher Copyright: © The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America.
PY - 2022/9/4
Y1 - 2022/9/4
N2 - BACKGROUND: In the Netherlands, the bivalent human papillomavirus (HPV) vaccine has been offered to preadolescent girls via the National Immunization Program in a 2-dose schedule since 2014. The current study estimates vaccine effectiveness (VE) against HPV infections up to 4 years postvaccination among girls eligible for routine 2-dose immunization. METHODS: A cohort study (HAVANA2) was used in which participants annually filled out an online questionnaire and provided a vaginal self-sample for determination of HPV by the SPF10-LiPA25 assay, able to detect 25 HPV types. VE against incident type-specific infections and pooled outcomes was estimated by a Cox proportional hazards model with shared frailty between the HPV types. RESULTS: In total, 2027 girls were included in the study, 1098 (54.2%) of whom were vaccinated with 2 doses. Highest incidence rate was 5.0/1000 person-years (HPV-51) among vaccinated participants and 9.1/1000 person-years (HPV-74) among unvaccinated participants. Adjusted pooled VE was 84.0% (95% confidence interval [CI], 27.0%-96.5%) against incident HPV-16/18 infections and 86.5% (95% CI, 39.5%-97.08%) against cross-protective types HPV-31/33/45. CONCLUSIONS: Four years postvaccination, 2 doses of bivalent HPV vaccine were effective in the prevention of incident HPV-16/18 infections and provided cross-protection to HPV-31/33/45. Our VE estimates rival those from 3-dose schedules, indicating comparable protection by 2-dose schedules.
AB - BACKGROUND: In the Netherlands, the bivalent human papillomavirus (HPV) vaccine has been offered to preadolescent girls via the National Immunization Program in a 2-dose schedule since 2014. The current study estimates vaccine effectiveness (VE) against HPV infections up to 4 years postvaccination among girls eligible for routine 2-dose immunization. METHODS: A cohort study (HAVANA2) was used in which participants annually filled out an online questionnaire and provided a vaginal self-sample for determination of HPV by the SPF10-LiPA25 assay, able to detect 25 HPV types. VE against incident type-specific infections and pooled outcomes was estimated by a Cox proportional hazards model with shared frailty between the HPV types. RESULTS: In total, 2027 girls were included in the study, 1098 (54.2%) of whom were vaccinated with 2 doses. Highest incidence rate was 5.0/1000 person-years (HPV-51) among vaccinated participants and 9.1/1000 person-years (HPV-74) among unvaccinated participants. Adjusted pooled VE was 84.0% (95% confidence interval [CI], 27.0%-96.5%) against incident HPV-16/18 infections and 86.5% (95% CI, 39.5%-97.08%) against cross-protective types HPV-31/33/45. CONCLUSIONS: Four years postvaccination, 2 doses of bivalent HPV vaccine were effective in the prevention of incident HPV-16/18 infections and provided cross-protection to HPV-31/33/45. Our VE estimates rival those from 3-dose schedules, indicating comparable protection by 2-dose schedules.
KW - human papillomavirus
KW - immunization schedule
KW - observational study
KW - reduced dosing
KW - vaccination
UR - http://www.scopus.com/inward/record.url?scp=85136745203&partnerID=8YFLogxK
U2 - https://doi.org/10.1093/infdis/jiab250
DO - https://doi.org/10.1093/infdis/jiab250
M3 - Article
C2 - 33964158
SN - 0022-1899
VL - 226
SP - 634
EP - 643
JO - The Journal of Infectious Diseases
JF - The Journal of Infectious Diseases
IS - 4
ER -