Assessment of herd effects among women and heterosexual men after girls-only HPV16/18 vaccination in the Netherlands: A repeated cross-sectional study

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Data on the impact of human papillomavirus (HPV) vaccination on the population HPV prevalence are largely obtained from women. We assessed the impact of the girls-only HPV16/18 vaccination program in the Netherlands that started in 2009, on trends in HPV prevalence among women and heterosexual men, using data from the PASSYON study. In this cross-sectional study, the HPV prevalence among 16- to 24-year-old visitors to sexually transmitted infection clinics was assessed in 2009, 2011, 2013, and 2015. We compared the genital postvaccination HPV prevalence with the prevaccination prevalence (2009) using Poisson GEE models. In total, we included 4,996 women and 1,901 heterosexual men. The percentage of women who reported to be vaccinated increased from 2.3% in 2009 to 37% in 2015. Among all women, the HPV16/18 prevalence decreased from 23% prevaccination to 15% in 2015 (adjusted prevalence ratio [aPR] 0.62, ptrend < 0.01). Among heterosexual men, the HPV16/18 prevalence decreased from 17% prevaccination to 11% in 2015 (aPR 0.52, ptrend < 0.01). Of the heterosexual men with a steady partner, HPV16/18 prevalence was lower among those whose steady partner had been vaccine-eligible in the national immunization program (aPR 0.13). Among unvaccinated women, the HPV16/18 prevalence in 2015 was not different from prevaccination. The decreasing HPV16/18 prevalence among heterosexual men and the reduced HPV16/18 prevalence among heterosexual men with a vaccine-eligible steady partner strongly suggests herd protection from girls-only vaccination. Absence of notable herd effects among unvaccinated women 6 years postvaccination may be due to the moderate vaccine uptake among girls in the Netherlands.

Original languageEnglish
Pages (from-to)2718-2727
Number of pages10
JournalInternational Journal of Cancer
Volume144
Issue number11
Early online date13 Nov 2018
DOIs
Publication statusPublished - 1 Jun 2019

Keywords

  • herd protection
  • human papillomavirus
  • population effects
  • public health
  • vaccination
  • Uterine Cervical Neoplasms/immunology
  • Prevalence
  • Cross-Sectional Studies
  • Humans
  • Male
  • Human papillomavirus 16/immunology
  • Papillomavirus Infections/epidemiology
  • Human papillomavirus 18/immunology
  • Sexually Transmitted Diseases/epidemiology
  • Mass Vaccination/methods
  • Young Adult
  • Adolescent
  • Papillomavirus Vaccines/administration & dosage
  • Adult
  • Female
  • Program Evaluation
  • Netherlands/epidemiology
  • Outcome Assessment (Health Care)/statistics & numerical data

Fingerprint

Dive into the research topics of 'Assessment of herd effects among women and heterosexual men after girls-only HPV16/18 vaccination in the Netherlands: A repeated cross-sectional study'. Together they form a unique fingerprint.

Cite this