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J Infect Dis. 2018 Jan 4;217(2):213-222. doi: 10.1093/infdis/jix582.

Bivalent Vaccine Effectiveness Against Type-Specific HPV Positivity: Evidence for Cross-Protection Against Oncogenic Types Among Dutch STI Clinic Visitors.

Author information

1
Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Maastricht University Medical Center, Amsterdam, The Netherlands.
2
Care and Public Health Research Institute, Maastricht University Medical Center, Amsterdam, The Netherlands.
3
Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands.
4
Julius Center, University Medical Center Utrecht, The Netherlands.
5
Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
6
Department of Sexual Health, Infectious Diseases and Environment, South Limburg Public Health Service, Geleen.
7
Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands.

Abstract

Background:

Observational postmarketing studies are important to assess vaccine effectiveness (VE). We estimated VE from the bivalent human papillomavirus (HPV) vaccine against HPV positivity of vaccine and nonvaccine types in a high-risk population.

Methods:

We included all vaccine-eligible women from the PASSYON study, a biennial cross-sectional survey in Dutch sexually transmitted infection clinics. Vaginal swabs were analyzed using a polymerase chain reaction-based assay (SPF10-LiPA25) able to detect the 12 high-risk HPV (hrHPV) types 16/18/31/33/35/39/45/51/52/56/58/59. We compared hrHPV positivity between self-reported vaccinated (≥1 dose) and unvaccinated women, and estimated VE by a logistic mixed model.

Results:

We included 1087 women of which 53% were hrHPV positive and 60% reported to be vaccinated. The adjusted pooled VE against HPV-16/18 was 89.9% (81.7%-94.4%). Moreover, we calculated significant VE against nonvaccine types HPV-45 (91%), HPV-35 (57%), HPV-31 (50%), and HPV-52 (37%). Among women who were offered vaccination 5/6 years ago, we estimated similar VE against HPV-16/18 (92%) and all hrHPV types (35%) compared to women who were offered vaccination <5 years ago (83% and 33%, respectively).

Conclusion:

We demonstrated high VE of the bivalent vaccine against HPV-16/18 and cross-protection against HPV-45/35/31/52. Protection against HPV-16/18 was sustained up to 6 years postvaccination.

KEYWORDS:

Cervarix; human papillomavirus; human papillomavirus vaccine; public health; vaccine effectiveness

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