Nancy M McClung1, Rayleen M Lewis2, Julia W Gargano3, Troy Querec4, Elizabeth R Unger4, Lauri E Markowitz3. 1. National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia. Electronic address: mti6@cdc.gov. 2. National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia; Synergy America, Inc., Duluth, Georgia. 3. National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia. 4. National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.
Abstract
PURPOSE: To monitor human papillomavirus (HPV) vaccine impact in the U.S., we evaluated quadrivalent vaccine (4vHPV)-type prevalence among females aged 14-34 years in the prevaccine (2003-2006) and vaccine (2013-2016) eras overall and by race/ethnicity in the National Health and Nutrition Examination Survey. METHODS: We analyzed HPV DNA prevalence in self-collected cervicovaginal specimens, demographic characteristics, sexual behavior, and self-reported/parent-reported vaccination status. We compared prevaccine to vaccine era 4vHPV-type prevalence, using unadjusted and adjusted prevalence ratios (PR and aPR) and 95% confidence intervals (CIs). PRs were calculated by race/ethnicity (non-Hispanic white [NHW], non-Hispanic black [NHB], and Mexican American [MA]). Overall aPRs were adjusted for race/ethnicity, lifetime sex partners, and poverty. RESULTS: Overall, 4,674 females had HPV typing results; 3,915 reported NHW, NHB, or MA race/ethnicity. Vaccination coverage of ≥1 dose was 53.9% among 14- to 19-year-olds (NHW 52.6%, NHB 58.1%, and MA 59.5%) and 51.5% among 20- to 24-year-olds (NHW 58.8%, NHB 45.0%, MA 33.8%). Among 14- to 19-year-olds, 4vHPV-type prevalence decreased overall (11.5% to 1.8%; aPR = .14 [CI: .08-.24]) and in NHW (PR = .14 [CI: .06-.29]), NHB (PR = .26 [CI: .12-.54]), and MA (PR = .13 [CI: .03-.53]). In 20- to 24-year-olds, 4vHPV-type prevalence decreased overall (18.5% to 5.3%; aPR = .29 [CI: .15-.56]) and in NHW (PR = .27 [CI: .11-.67]) and NHB (PR = .38 [CI: .18-.80]). No significant declines were observed in older age groups. CONCLUSIONS: Within 10 years of vaccine introduction, 4vHPV-type prevalence declined 86% among 14- to 19-year-olds, with declines observed in NHW, NHB, and MA females, and 71% among 20- to 24-year-olds, with declines in NHW and NHB females. These extraordinary declines should lead to substantial reductions in HPV-associated cancers. Published by Elsevier Inc.
PURPOSE: To monitor human papillomavirus (HPV) vaccine impact in the U.S., we evaluated quadrivalent vaccine (4vHPV)-type prevalence among females aged 14-34 years in the prevaccine (2003-2006) and vaccine (2013-2016) eras overall and by race/ethnicity in the National Health and Nutrition Examination Survey. METHODS: We analyzed HPV DNA prevalence in self-collected cervicovaginal specimens, demographic characteristics, sexual behavior, and self-reported/parent-reported vaccination status. We compared prevaccine to vaccine era 4vHPV-type prevalence, using unadjusted and adjusted prevalence ratios (PR and aPR) and 95% confidence intervals (CIs). PRs were calculated by race/ethnicity (non-Hispanic white [NHW], non-Hispanic black [NHB], and Mexican American [MA]). Overall aPRs were adjusted for race/ethnicity, lifetime sex partners, and poverty. RESULTS: Overall, 4,674 females had HPV typing results; 3,915 reported NHW, NHB, or MA race/ethnicity. Vaccination coverage of ≥1 dose was 53.9% among 14- to 19-year-olds (NHW 52.6%, NHB 58.1%, and MA 59.5%) and 51.5% among 20- to 24-year-olds (NHW 58.8%, NHB 45.0%, MA 33.8%). Among 14- to 19-year-olds, 4vHPV-type prevalence decreased overall (11.5% to 1.8%; aPR = .14 [CI: .08-.24]) and in NHW (PR = .14 [CI: .06-.29]), NHB (PR = .26 [CI: .12-.54]), and MA (PR = .13 [CI: .03-.53]). In 20- to 24-year-olds, 4vHPV-type prevalence decreased overall (18.5% to 5.3%; aPR = .29 [CI: .15-.56]) and in NHW (PR = .27 [CI: .11-.67]) and NHB (PR = .38 [CI: .18-.80]). No significant declines were observed in older age groups. CONCLUSIONS: Within 10 years of vaccine introduction, 4vHPV-type prevalence declined 86% among 14- to 19-year-olds, with declines observed in NHW, NHB, and MA females, and 71% among 20- to 24-year-olds, with declines in NHW and NHB females. These extraordinary declines should lead to substantial reductions in HPV-associated cancers. Published by Elsevier Inc.
Entities:
Keywords:
HPV vaccine; Human papillomavirus; Public health
Authors: Lital Avni-Singer; Carlos R Oliveira; Ashlynn Torres; Eugene D Shapiro; Linda M Niccolai; Sangini S Sheth Journal: Obstet Gynecol Date: 2020-11 Impact factor: 7.623
Authors: Elissa Meites; Peter G Szilagyi; Harrell W Chesson; Elizabeth R Unger; José R Romero; Lauri E Markowitz Journal: MMWR Morb Mortal Wkly Rep Date: 2019-08-16 Impact factor: 17.586
Authors: Hannah G Rosenblum; Rayleen M Lewis; Julia W Gargano; Troy D Querec; Elizabeth R Unger; Lauri E Markowitz Journal: MMWR Morb Mortal Wkly Rep Date: 2021-03-26 Impact factor: 17.586
Authors: Elissa Meites; Laura Stone; Raiza Amiling; Vidisha Singh; Elizabeth R Unger; Craig S Derkay; Lauri E Markowitz Journal: Clin Infect Dis Date: 2021-09-07 Impact factor: 20.999
Authors: Tanja Y Walker; Laurie D Elam-Evans; David Yankey; Lauri E Markowitz; Charnetta L Williams; Benjamin Fredua; James A Singleton; Shannon Stokley Journal: MMWR Morb Mortal Wkly Rep Date: 2019-08-23 Impact factor: 17.586