Efficacy, immunogenicity, and safety of a 9-valent human papillomavirus vaccine in Latin American girls, boys, and young women

Abstract

Background: A 9-valent human papillomavirus (HPV6/11/16/18/31/33/45/52/58; 9vHPV) vaccine was developed to expand coverage of the previously developed quadrivalent (HPV6/11/16/18; qHPV) vaccine.

Methods: Efficacy, immunogenicity, and safety outcomes were assessed in Latin American participants enrolled in 2 international studies of the 9vHPV vaccine, including a randomized, double-blinded, controlled with qHPV vaccine, efficacy, immunogenicity, and safety study in young women aged 16-26 years, and an immunogenicity and safety study in girls and boys aged 9-15 years. Participants (N=5312) received vaccination at Day 1, Month 2, and Month 6. Gynecological swabs were collected regularly in young women for cytological and HPV DNA testing. Serum was analyzed for HPV antibodies in all participants. Adverse events (AEs) were also monitored in all participants.

Results: The 9vHPV vaccine prevented HPV 31-, 33-, 45-, 52-, and 58-related high-grade cervical, vulvar, and vaginal dysplasia with 92.3% efficacy (95% confidence interval 54.4, 99.6). Anti-HPV6, 11, 16, and 18 geometric mean titers at Month 7 were similar in the 9vHPV and qHPV vaccination groups. Anti-HPV antibody responses following vaccination were higher among girls and boys than in young women. Most (>99%) 9vHPV vaccine recipients seroconverted for all 9 HPV types at Month 7. Antibody responses to the 9 HPV types persisted over 5 years. The most common AEs were injection-site related, mostly of mild to moderate intensity.

Conclusions: The 9vHPV vaccine is efficacious, immunogenic, and well tolerated in Latin American young women, girls, and boys. These data support 9vHPV vaccination programs in Latin America, a region with substantial cervical cancer burden.

Trial registration: ClinicalTrials.gov NCT00543543 NCT00943722.

Keywords: 9vHPV; Cervical cancer; Human papillomavirus; Persistent infection; Vaccine.

Fig. 1

Longitudinal anti-HPV cLIA GMTs in the per-protocol immunogenicity population by vaccination group. Vaccination visits (Day 1 and Months 2, 6, and 60) are represented by asterisks above the horizontal axis of each graph. White squares represent girls 9–15 years of age who received the 9vHPV vaccine in Study 002; black diamonds represent boys 9–15 years of age who received the 9vHPV vaccine in Study 002; black circles represent young women 16–26 years of age who received the 9vHPV vaccine in Study 001; white triangles represent young women 16–26 years of age who received the qHPV vaccine in Study 001. 9vHPV, 9-valent human papillomavirus; cLIA, competitive Luminex immunoassay; GMT, geometric mean titer; HPV, human papillomavirus; qHPV, quadrivalent human papillomavirus.