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Meta-Analysis
. 2014 Sep 1;111(35-36):584-91.
doi: 10.3238/arztebl.2014.0584.

The efficacy and duration of vaccine protection against human papillomavirus: a systematic review and meta-analysis

Yvonne Deleré  1 , Ole Wichmann, Stefanie J Klug, Marianne van der Sande, Martin Terhardt, Fred Zepp, Thomas Harder
Affiliations
Meta-Analysis

The efficacy and duration of vaccine protection against human papillomavirus: a systematic review and meta-analysis

Yvonne Deleré et al. Dtsch Arztebl Int. .

Abstract

Background: The German Standing Committee on Vaccination (STIKO) recommends vaccination against human papillomaviruses (HPV) of the high-risk types 16 and 18. The duration of protection afforded by HPV vaccines has been reported in multiple studies to date but has not been systematically evaluated.

Method: Systematic literature review and meta-analysis on the efficacy of vaccination, with assessment of evidence by the GRADE criteria (Grading of Recommendations Assessment, Development and Evaluation).

Results: 15 studies were identified: 10 randomized controlled trials (RCTs) and 5 observational studies. The RCTs included a total of 46 436 participants. The duration of follow-up was short (median, 3 years) in 8 RCTs and long (median, 6 years) in 2 RCTs. During the period of short-term follow up, the pooled efficacy of vaccination for the study endpoint of incident HPV infection (percentage of infections prevented) was 83% (95% confidence interval [CI]: 70-90% ), while the pooled efficacy against persistent HPV infection was 90% (95% CI: 79-95% ). In this period, CIN 2+ lesions were prevented with 84% efficacy (95% CI: 50-95% ), and CIN 3+ lesions with 94% efficacy (95% CI: 83-98% ). During the period of long-term follow-up, incident infections were prevented with 94% efficacy (95% CI: 80-98% ) and persistent infections with 95% efficacy (95% CI: 84-99% ). The long-term efficacy against CIN 2+ lesions was 86% (95% CI: -166-99% ). No data are available on the long-term efficacy of vaccination against CIN 3+ lesions.

Conclusion: Long-term observation does not indicate any loss of antiviral protection after vaccination against HPV 16 and 18, although the evidence for long-term protection is of lesser quality than that for short-term protection.

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Figures

Figure 1
Figure 1
Flow diagram showing procedure used to search literature
Figure 2
Figure 2
Forest plots for follow-up <5 years (RCTs)
Figure 3
Figure 3
Forest plots for follow-up ≥5 years (RCTs)
See this image and copyright information in PMC

Comment in

  • Unethical approach.
    Fridrich J. Fridrich J. Dtsch Arztebl Int. 2015 Mar 20;112(12):209. doi: 10.3238/arztebl.2015.0209a. Dtsch Arztebl Int. 2015. PMID: 25838023 Free PMC article. No abstract available.
  • Questionable pooling of data.
    Schenk S. Schenk S. Dtsch Arztebl Int. 2015 Mar 20;112(12):209-10. doi: 10.3238/arztebl.2015.0209b. Dtsch Arztebl Int. 2015. PMID: 25838024 Free PMC article. No abstract available.
  • In reply.
    Harder T, Deleré Y. Harder T, et al. Dtsch Arztebl Int. 2015 Mar 20;112(12):210. doi: 10.3238/arztebl.2015.0210. Dtsch Arztebl Int. 2015. PMID: 25838025 Free PMC article. No abstract available.

References

    1. Robert Koch-Institut, Gesellschaft der Epidemiologischen Krebsregister in Deutschland e.V. 2013. Krebs in Deutschland 2009/2010.
    1. Schiffman M, Castle PE, Jeronimo J, Rodriguez AC, Wacholder S. Human papillomavirus and cervical cancer. Lancet. 2007;370:890–907. - PubMed
    1. Delere Y, Remschmidt C, Leuschner J, Schuster M, Fesenfeld M, Schneider A, et al. Human Papillomavirus prevalence and probable first effects of vaccination in 20 to 25 year-old women in Germany: a population-based cross-sectional study via home-based self-sampling. BMC infectious diseases. 2014;14 - PMC - PubMed
    1. McCredie MR, Sharples KJ, Paul C, Baranyai J, Medley G, Jones RW, et al. Natural history of cervical neoplasia and risk of invasive cancer in women with cervical intraepithelial neoplasia 3: a retrospective cohort study. The lancet oncology. 2008;9:425–434. - PubMed
    1. Gerhardus A. Wie wirksam ist die HPV-Impfung? Dtsch Arztebl. 2009;106:A 330–A 334.

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