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
. 2022 Sep 4;226(4):634-643.
doi: 10.1093/infdis/jiab250.

Vaccine Effectiveness Following Routine Immunization With Bivalent Human Papillomavirus (HPV) Vaccine: Protection Against Incident Genital HPV Infections From a Reduced-Dosing Schedule

Joske Hoes  1   2 , Audrey J King  1 , Tessa M Schurink Van't Klooster  1   2 , Johannes Berkhof  2 , Johannes A Bogaards  2   3 , Hester E de Melker  1
Affiliations

Vaccine Effectiveness Following Routine Immunization With Bivalent Human Papillomavirus (HPV) Vaccine: Protection Against Incident Genital HPV Infections From a Reduced-Dosing Schedule

Joske Hoes et al. J Infect Dis. .

Abstract

Background: In the Netherlands, the bivalent human papillomavirus (HPV) vaccine has been offered to preadolescent girls via the National Immunization Program in a 2-dose schedule since 2014. The current study estimates vaccine effectiveness (VE) against HPV infections up to 4 years postvaccination among girls eligible for routine 2-dose immunization.

Methods: A cohort study (HAVANA2) was used in which participants annually filled out an online questionnaire and provided a vaginal self-sample for determination of HPV by the SPF10-LiPA25 assay, able to detect 25 HPV types. VE against incident type-specific infections and pooled outcomes was estimated by a Cox proportional hazards model with shared frailty between the HPV types.

Results: In total, 2027 girls were included in the study, 1098 (54.2%) of whom were vaccinated with 2 doses. Highest incidence rate was 5.0/1000 person-years (HPV-51) among vaccinated participants and 9.1/1000 person-years (HPV-74) among unvaccinated participants. Adjusted pooled VE was 84.0% (95% confidence interval [CI], 27.0%-96.5%) against incident HPV-16/18 infections and 86.5% (95% CI, 39.5%-97.08%) against cross-protective types HPV-31/33/45.

Conclusions: Four years postvaccination, 2 doses of bivalent HPV vaccine were effective in the prevention of incident HPV-16/18 infections and provided cross-protection to HPV-31/33/45. Our VE estimates rival those from 3-dose schedules, indicating comparable protection by 2-dose schedules.

Keywords: human papillomavirus; immunization schedule; observational study; reduced dosing; vaccination.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Study design and first years of follow-up. Abbreviations: 2vHPV, bivalent human papillomavirus vaccine; NIP, National Immunization Program.
Figure 2.
Figure 2.
Type-specific prevalence with 95% confidence intervals of high-risk and low-risk human papillomavirus (hrHPV and lrHPV, respectively) types among vaccinated and unvaccinated participants per study year.
Figure 3.
Figure 3.
Type-specific vaccine effectiveness (VE) estimates against incident human papillomavirus (HPV) infections with 95% confidence intervals (CIs). Crude (gray dots) and adjusted estimates (black dots) are shown for high-risk (A) and low-risk (B) HPV types. VE was adjusted for age, ethnicity, ever had sexual intercourse, and ever used contraception. *For HPV types with no infections among vaccinated participants, confidence estimates could only be included for the crude estimates (using the Peto estimator for the hazard ratio, based on the log-rank statistic).
Figure 4.
Figure 4.
Vaccine effectiveness (VE) estimates for pooled outcomes against incident human papillomavirus (HPV) infections with 95% confidence intervals (CIs) for crude (gray dots) and adjusted estimates (black dots). VE was adjusted for age, ethnicity, ever had sexual intercourse, and ever used contraception.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Baseman JG, Koutsky LA. The epidemiology of human papillomavirus infections. J Clin Virol 2005; 32:16–24. - PubMed
    1. Burchell AN, Winer RL, de Sanjosé S, Franco EL. Chapter 6: epidemiology and transmission dynamics of genital HPV infection. Vaccine 2006; 24:S52–61. - PubMed
    1. Committee for Medicinal Products for Human Use . Assessment report for Cervarix. London, UK: European Medicines Agency, 2013.
    1. Pedersen C, Petaja T, Strauss G, et al. ; HPV Vaccine Adolescent Study Investigators Network . Immunization of early adolescent females with human papillomavirus type 16 and 18 L1 virus-like particle vaccine containing AS04 adjuvant. J Adolesc Health 2007; 40:564–71. - PubMed
    1. Romanowski B, Schwarz TF, Ferguson LM, et al. . Immunogenicity and safety of the HPV-16/18 AS04-adjuvanted vaccine administered as a 2-dose schedule compared with the licensed 3-dose schedule: results from a randomized study. Hum Vaccin 2011; 7:1374–86. - PMC - PubMed

Publication types

Substances