Effectiveness of human papillomavirus vaccine against incident and persistent infections among young girls: Results from a longitudinal Dutch cohort study

Madelief Mollers; Audrey J King; Mirjam J Knol; Mirte Scherpenisse; Chris J L M Meijer; Fiona R M van der Klis; Hester E de Melker

doi:10.1016/j.vaccine.2015.04.016

Effectiveness of human papillomavirus vaccine against incident and persistent infections among young girls: Results from a longitudinal Dutch cohort study

Madelief Mollers, Audrey J King, Mirjam J Knol, Mirte Scherpenisse, Chris J L M Meijer, Fiona R M van der Klis, Hester E de Melker^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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.

Original language	English
Pages (from-to)	2678-2683
Number of pages	6
Journal	Vaccine
Volume	33
Issue number	23
DOIs	https://doi.org/10.1016/j.vaccine.2015.04.016
Publication status	Published - 28 May 2015
Externally published	Yes

Keywords

Adolescent
Cohort Studies
Female
Humans
Incidence
Longitudinal Studies
Netherlands/epidemiology
Papillomavirus Infections/epidemiology
Papillomavirus Vaccines/administration & dosage
Prospective Studies
Surveys and Questionnaires
Treatment Outcome
Vagina/virology

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10.1016/j.vaccine.2015.04.016

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@article{e1104f36aa6948afb5c16a05b7527be6,

title = "Effectiveness of human papillomavirus vaccine against incident and persistent infections among young girls: Results from a longitudinal Dutch cohort study",

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-na{\"i}ve 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.",

keywords = "Adolescent, Cohort Studies, Female, Humans, Incidence, Longitudinal Studies, Netherlands/epidemiology, Papillomavirus Infections/epidemiology, Papillomavirus Vaccines/administration & dosage, Prospective Studies, Surveys and Questionnaires, Treatment Outcome, Vagina/virology",

author = "Madelief Mollers and King, {Audrey J} and Knol, {Mirjam J} and Mirte Scherpenisse and Meijer, {Chris J L M} and {van der Klis}, {Fiona R M} and {de Melker}, {Hester E}",

year = "2015",

month = may,

day = "28",

doi = "10.1016/j.vaccine.2015.04.016",

language = "English",

volume = "33",

pages = "2678--2683",

journal = "Vaccine",

issn = "0264-410X",

publisher = "Elsevier",

number = "23",

}

TY - JOUR

T1 - Effectiveness of human papillomavirus vaccine against incident and persistent infections among young girls

T2 - Results from a longitudinal Dutch cohort study

AU - Mollers, Madelief

AU - King, Audrey J

AU - Knol, Mirjam J

AU - Scherpenisse, Mirte

AU - Meijer, Chris J L M

AU - van der Klis, Fiona R M

AU - de Melker, Hester E

PY - 2015/5/28

Y1 - 2015/5/28

N2 - 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.

AB - 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.

KW - Adolescent

KW - Cohort Studies

KW - Female

KW - Humans

KW - Incidence

KW - Longitudinal Studies

KW - Netherlands/epidemiology

KW - Papillomavirus Infections/epidemiology

KW - Papillomavirus Vaccines/administration & dosage

KW - Prospective Studies

KW - Surveys and Questionnaires

KW - Treatment Outcome

KW - Vagina/virology

U2 - 10.1016/j.vaccine.2015.04.016

DO - 10.1016/j.vaccine.2015.04.016

M3 - Article

C2 - 25887090

SN - 0264-410X

VL - 33

SP - 2678

EP - 2683

JO - Vaccine

JF - Vaccine

IS - 23

ER -

Effectiveness of human papillomavirus vaccine against incident and persistent infections among young girls: Results from a longitudinal Dutch cohort study

Abstract

Keywords

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