Madelief Mollers1, Audrey J King2, Mirjam J Knol3, Mirte Scherpenisse4, Chris J L M Meijer5, Fiona R M van der Klis2, Hester E de Melker6. 1. Department of Epidemiology and Surveillance, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands; Department of Pathology, VU University Medical Centre (VUmc), Amsterdam, The Netherlands. 2. Laboratory For Infectious Diseases and Screening, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. 3. Department of Epidemiology and Surveillance, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. 4. Department of Pathology, VU University Medical Centre (VUmc), Amsterdam, The Netherlands; Laboratory For Infectious Diseases and Screening, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. 5. Department of Pathology, VU University Medical Centre (VUmc), Amsterdam, The Netherlands. 6. Department of Epidemiology and Surveillance, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. Electronic address: Hester.de.Melker@rivm.nl.
Abstract
INTRODUCTION: Because of the long interval between infection with high-risk human papillomavirus (hrHPV) and development of cervical cancer surrogate markers for cancer incidence are necessary to monitor vaccine effectiveness (VE). The aim of this study was to calculate VE of HPV16/18 vaccination by annually assessing incident and persistent infections among (un)vaccinated girls from the general Dutch population up to 3 years after vaccination. METHODS: In 2009, 1668 girls (54% vaccinated) aged 14-16 years were enrolled in a prospective cohort study. Annually, questionnaire data were obtained, and a vaginal swab was tested for type-specific HPV DNA with SPF10-LiPA. VE was estimated by a Poisson model comparing type-specific infection rates in (un)vaccinated girls. RESULTS: The adjusted VE (95% CI) was 73% (49-86%) against incident infections with HPV16/18 and 72% (52-84%) against HPV16/18/31/45. VE against persistent HPV16/18 was 100% and 76% (-17 to 95%) against HPV16/18/31/45. This number was lower (36%) when girls who were positive for HPV16 and 18 at baseline were included in the analysis. The overall VE for hrHPV types combined was small. Although 96% of girls were HPV-naïve at baseline, the cumulative 36-month incidence for any HPV was 20%, indicating high sexual activity. DISCUSSION: Vaccination is effective against incident and persistent infections with HPV16/18 and HPV16/18/31/45. Low VE against persistent HPV16/18 infection in girls positive at baseline indicates importance of vaccination before sexual debut.
INTRODUCTION: Because of the long interval between infection with high-risk human papillomavirus (hrHPV) and development of cervical cancer surrogate markers for cancer incidence are necessary to monitor vaccine effectiveness (VE). The aim of this study was to calculate VE of HPV16/18 vaccination by annually assessing incident and persistent infections among (un)vaccinated girls from the general Dutch population up to 3 years after vaccination. METHODS: In 2009, 1668 girls (54% vaccinated) aged 14-16 years were enrolled in a prospective cohort study. Annually, questionnaire data were obtained, and a vaginal swab was tested for type-specific HPV DNA with SPF10-LiPA. VE was estimated by a Poisson model comparing type-specific infection rates in (un)vaccinated girls. RESULTS: The adjusted VE (95% CI) was 73% (49-86%) against incident infections with HPV16/18 and 72% (52-84%) against HPV16/18/31/45. VE against persistent HPV16/18 was 100% and 76% (-17 to 95%) against HPV16/18/31/45. This number was lower (36%) when girls who were positive for HPV16 and 18 at baseline were included in the analysis. The overall VE for hrHPV types combined was small. Although 96% of girls were HPV-naïve at baseline, the cumulative 36-month incidence for any HPV was 20%, indicating high sexual activity. DISCUSSION: Vaccination is effective against incident and persistent infections with HPV16/18 and HPV16/18/31/45. Low VE against persistent HPV16/18 infection in girls positive at baseline indicates importance of vaccination before sexual debut.
Authors: Michael J Silverberg; Wendy A Leyden; Jennifer O Lam; Steven E Gregorich; Megan J Huchko; Shalini Kulasingam; Miriam Kuppermann; Karen K Smith-McCune; George F Sawaya Journal: Lancet Child Adolesc Health Date: 2018-08-08
Authors: Li Dong; Rui Mei Feng; Li Zhang; Xiao Qian Xu; Xue Lian Zhao; Margaret Zhuoer Wang; You Lin Qiao; Fang Hui Zhao Journal: J Gynecol Oncol Date: 2017-06-05 Impact factor: 4.401
Authors: Petra J Woestenberg; Audrey J King; Birgit H B van Benthem; Robine Donken; Suzan Leussink; Fiona R M van der Klis; Hester E de Melker; Marianne A B van der Sande; Christian J P A Hoebe; Johannes A Bogaards Journal: J Infect Dis Date: 2018-01-04 Impact factor: 5.226
Authors: Pascal van der Weele; Martijn Breeuwsma; Robine Donken; Elske van Logchem; Naomi van Marm-Wattimena; Hester de Melker; Chris J L M Meijer; Audrey J King Journal: PLoS One Date: 2019-03-04 Impact factor: 3.240