Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven.
Department of Pathology, VU University Medical Center, Amsterdam.
J Infect Dis. 2018 Apr 23;217(10):1579-1589. doi: 10.1093/infdis/jiy067.
Monitoring vaccine effectiveness (VE) in vaccination programs is of importance for assessing the impact of immunization. This study aimed to estimate the VE of the bivalent human papillomavirus (HPV) vaccine against incident and 12-month persistent infections up to 6 years after vaccination.
In 2009-2010, girls eligible for the vaccination catch-up campaign (ie, those aged 14-16 years) were enrolled into a prospective cohort. Annually, participants completed a questionnaire and submitted a self-collected vaginal swab sample for HPV testing by the SPF10-LiPA25 assay. We compared sociodemographic characteristics and infection rates between vaccinated and unvaccinated girls. The VE was adjusted for characteristics related to HPV vaccination status. We used combined end points for VE estimation.
In total, 1635 women, of whom 54% were fully vaccinated, were included for VE estimation. The adjusted VE against HPV16 and 18 persistent infections amounted to 97.7% (95% confidence interval [CI], 83.5%-99.7%). We found a VE against HPV31, 33, and 45 persistent infections of 61.8% (95% CI, 16.7%-82.5%). We found no indications that the protection against vaccine or cross-protective types changes over time.
Our findings of nearly full protection against vaccine-type persistent infections and significant cross-protection to nonvaccine types in a population-based cohort study confirm the effectiveness of the bivalent HPV vaccine as estimated in trials. We found no indications for waning protection up to 6 years after vaccination.
监测疫苗效力(VE)在接种计划中对于评估免疫接种的影响非常重要。本研究旨在估计双价人乳头瘤病毒(HPV)疫苗对14-16 岁接种人群在接种后 6 年内新发病例和 12 个月持续性感染的效力。
2009-2010 年,符合接种追赶计划(即 14-16 岁)的女孩被纳入前瞻性队列。每年,参与者完成一份问卷,并提交一份自我采集的阴道拭子样本,采用 SPF10-LiPA25 法进行 HPV 检测。我们比较了接种和未接种女孩的社会人口统计学特征和感染率。将 VE 调整为与 HPV 接种状态相关的特征。我们使用联合终点来估计 VE。
共纳入 1635 名女性,其中 54%完全接种疫苗,用于 VE 估计。HPV16 和 18 持续性感染的调整 VE 为 97.7%(95%可信区间[CI],83.5%-99.7%)。我们发现 HPV31、33 和 45 持续性感染的 VE 为 61.8%(95% CI,16.7%-82.5%)。我们没有发现保护作用针对疫苗或交叉保护型别随时间变化的迹象。
在基于人群的队列研究中,我们发现针对疫苗型持续性感染几乎完全保护,对非疫苗型有显著交叉保护作用,这与试验中估计的双价 HPV 疫苗的有效性一致。我们没有发现接种后 6 年内保护作用减弱的迹象。