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Vaccine. 2019 Sep 3;37(37):5630-5636. doi: 10.1016/j.vaccine.2019.07.072. Epub 2019 Aug 8.

Long term follow up of persistence of immunity following quadrivalent Human Papillomavirus (HPV) vaccine in immunocompromised children.

Author information

1
Biosecurity Program, Kirby Institute, Faculty of Medicine, University of New South Wales, Kensington, NSW 2052, Australia.
2
BMT Services, Children's Hospital at Westmead, Hawkesbury Rd, Westmead, NSW 2145, Australia.
3
Nephrology, Sydney Children's Hospital, Randwick, High St, Randwick, NSW 2031, Australia; School of Women's & Children's Health, Faculty of Medicine, University of New South Wales, Kensington, NSW 2052, Australia.
4
The Women's and Children's Hospital and Robinson Research Institute and Adelaide Medical School, The University of Adelaide, 55 King William Road, North Adelaide 5006, Australia.
5
School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Kensington, NSW 2052, Australia.
6
Biosecurity Program, Kirby Institute, Faculty of Medicine, University of New South Wales, Kensington, NSW 2052, Australia. Electronic address: mallory.trent@unsw.edu.au.
7
Department of Gastroenterology, Children's Hospital at Westmead, Hawkesbury Rd, Westmead, NSW 2145, Australia.

Abstract

BACKGROUND:

Human Papillomavirus (HPV) causes significant burden of HPV-related diseases, which are more prevalent in immunosuppressed compared to immunocompetent people. We conducted a multi-centre clinical trial to determine the immunogenicity and reactogenicity of HPV vaccine in immunocompromised children. Here we present the immunogenicity results 5 years post vaccination.

METHODS:

We followed up immunocompromised children (5-18 years) with a range of specified underlying conditions who were previously recruited from three Australian paediatric hospitals. Participants received three doses of quadrivalent HPV vaccine (Gardasil Quadrivalent HPV Types 6, 11, 16, 18) and were followed up between 2007 and 2016 (60 months post-vaccination). The immunogenicity primary outcome was seroconversion and geometric mean titres (GMT) of the quadrivalent HPV vaccine serotypes in the study.

RESULTS:

Of the 59 original participants, 37 were followed up at 60 months. The proportion of participants who seroconverted were: 86.5%, 89.2%, 89.2%, 91.9% by competitive Luminex immunoassay (cLIA) and 83.8%, 83.8%, 94.6%, 78.4% by total immunoglobulin G assays (IgG) for serotypes 6, 11, 16 and 18 respectively. GMT values ranged from 118 (95%CI: 79-177) for serotype 11, to 373 (95%CI: 215-649) for serotype 16 by cLIA. For IgG, serotype 16 had the highest GMT of 261 (95%CI: 143-477) and serotype 18 had the lowest value of 37 (95%CI: 21-68). All antibody titres were lower in females compared to males but the difference was not statistically significant except for serotype 16. No serious adverse event was reported during this follow-up period.

CONCLUSION:

Our evidence, although limited by small numbers, is reassuring that a three dose schedule of HPV vaccine remains immunogenic in immunocompromised children to five years post vaccination. Large scale studies are required to determine long term protection in immunocompromised children.

CLINICAL TRIAL REGISTRATION:

NCT02263703 (ClinicalTrials.gov).

KEYWORDS:

Adolescents; Cancer; Human papillomavirus; Immunisation; Immunodeficiency; Vaccine; Warts

PMID:
31402238
DOI:
10.1016/j.vaccine.2019.07.072
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