Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 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

Petra J Woestenberg  1   2 , Audrey J King  1 , Birgit H B van Benthem  1 , Robine Donken  1   3 , Suzan Leussink  1 , Fiona R M van der Klis  1 , Hester E de Melker  1 , Marianne A B van der Sande  1   4   5 , Christian J P A Hoebe  2   6 , Johannes A Bogaards  1   7 ; Medical Microbiological Laboratories and the Public Health Services
Collaborators, Affiliations

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

Petra J Woestenberg et al. J Infect Dis. .

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.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Human papillomavirus (HPV) vaccination in the Netherlands, the PASSYON study design, and the study population selection.
Figure 2.
Figure 2.
High-risk human papillomavirus (HPV) prevalence by vaccination status.
Figure 3.
Figure 3.
Vaccine effectiveness (VE) for at least one dose against, (A) type-specific high-risk (hr) human papillomavirus (HPV) positivity and (B) pooled estimates. The hr nonavalent HPV types included: HPV-16/18/31/33/45/52/58. All hrHPV types included: HPV-16/18/31/33/35/39/45/51/52/56/58/59. VE was corrected for: ethnicity, education level, recent sex partners, age at sexual debut, history of sexually transmitted infections, and hormonal contraceptives use.
See this image and copyright information in PMC

References

    1. Walboomers JM, Jacobs MV, Manos MM et al. Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol 1999; 189:12–9. - PubMed
    1. Bouvard V, Baan R, Straif K et al. ; WHO International Agency for Research on Cancer Monograph Working Group A review of human carcinogens–Part B: biological agents. Lancet Oncol 2009; 10:321–2. - PubMed
    1. de Sanjose S, Quint WG, Alemany L et al. ; Retrospective International Survey and HPV Time Trends Study Group Human papillomavirus genotype attribution in invasive cervical cancer: a retrospective cross-sectional worldwide study. Lancet Oncol 2010; 11:1048–56. - PubMed
    1. Plummer M, de Martel C, Vignat J, Ferlay J, Bray F, Franceschi S. Global burden of cancers attributable to infections in 2012: a synthetic analysis. Lancet Glob Health 2016; 4:e609–16. - PubMed
    1. Paavonen J, Naud P, Salmerón J et al. ; HPV PATRICIA Study Group Efficacy of human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine against cervical infection and precancer caused by oncogenic HPV types (PATRICIA): final analysis of a double-blind, randomised study in young women. Lancet 2009; 374:301–14. - PubMed

Publication types

MeSH terms

Substances