Petrosky Emiko Y, Hariri Susan, Markowitz Lauri E, Panicker Gitika, Unger Elizabeth R, Dunne Eileen F
Division of Sexually Transmitted Disease Prevention, National Center for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Disease, and Tuberculosis Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, USA.
Division of Sexually Transmitted Disease Prevention, National Center for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Disease, and Tuberculosis Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, USA.
Int J Infect Dis. 2015 Apr;33:137-41. doi: 10.1016/j.ijid.2015.01.010. Epub 2015 Jan 14.
Since 2006, human papillomavirus (HPV) vaccination has been routinely recommended for adolescent females in the USA. The quadrivalent vaccine induces long-term seropositivity to HPV 6/11/16, which may be useful as a marker for HPV vaccine coverage.
We evaluated vaccine type seropositivity (i.e., seropositivity to HPV 6/11/16 with or without HPV18) among females aged 14-59 years participating in the 2003-2010 National Health and Nutrition Examination Survey (cross-sectional, nationally representative surveys). We compared pre-vaccine era (2003-2006) to vaccine era (2007-2010) seropositivity and assessed agreement between vaccine era seropositivity and reported vaccination by kappa statistic.
Seropositivity was 1.0% among 2151 females in the pre-vaccine era and 22.1% among 1420 females in the vaccine era (p < 0.001); 23.1% of vaccine era females reported receipt of one or more HPV vaccine dose. Seropositivity and reported vaccination had high agreement (kappa = 0.79; 95% confidence interval 0.74-0.84). Among seropositive females, 14.5% reported no vaccination.
The increase in vaccine era seropositivity likely reflects vaccination uptake. Our study suggests seropositivity to HPV 6/11/16 may be a useful marker for vaccination coverage in adolescent and young adult females. Discordance between seropositivity and reported vaccination may be explained by inaccurate reporting and/or natural exposure to HPV.
自2006年起，美国常规建议青春期女性接种人乳头瘤病毒（HPV）疫苗。四价疫苗可诱导对HPV 6/11/16产生长期血清阳性反应，这可作为HPV疫苗接种覆盖率的一个有用指标。
我们评估了参与2003 - 2010年国家健康与营养检查调查（横断面、具有全国代表性的调查）的14 - 59岁女性中疫苗型血清阳性反应（即对HPV 6/11/16有或无HPV18的血清阳性反应）。我们比较了疫苗接种前时代（2003 - 2006年）和疫苗接种时代（2007 - 2010年）的血清阳性反应，并通过kappa统计量评估疫苗接种时代血清阳性反应与报告的疫苗接种之间的一致性。
在疫苗接种前时代的2151名女性中，血清阳性反应率为1.0%，在疫苗接种时代的1420名女性中为22.1%（p < 0.001）；疫苗接种时代23.1%的女性报告接种了一剂或多剂HPV疫苗。血清阳性反应与报告的疫苗接种具有高度一致性（kappa = 0.79；95%置信区间0.74 - 0.84）。在血清阳性的女性中，14.5%报告未接种疫苗。
疫苗接种时代血清阳性反应的增加可能反映了疫苗接种情况。我们的研究表明，对HPV 6/11/16的血清阳性反应可能是青少年和年轻成年女性疫苗接种覆盖率的一个有用指标。血清阳性反应与报告的疫苗接种之间的不一致可能是由于报告不准确和/或自然感染HPV所致。
