Mehanna Hisham, Bryant Tyler S, Babrah Jaspreet, Louie Karly, Bryant Jennifer L, Spruce Rachel J, Batis Nikolaos, Olaleye Oladejo, Jones June, Struijk Linda, Molijn Anco, Vorsters Alex, Rosillon Dominique, Taylor Sylvia, D'Souza Gypsyamber
Institute of Head and Neck Studies and Education, College of Medical and Dental Sciences, University of Birmingham, United Kingdom.
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Clin Infect Dis. 2019 Sep 27;69(8):1296-1302. doi: 10.1093/cid/ciy1081.
Oropharyngeal cancer incidence is rapidly rising due to human papillomavirus (HPV) type 16 infection. The dearth of data on effectiveness of national female-only vaccination programs in preventing oral HPV infection and potential herd immunity in unvaccinated males has resulted in considerable controversy regarding the need to vaccinate males, especially in countries with high female vaccination coverage.
Subjects aged 0-65 years undergoing tonsillectomy for nonmalignant indications were recruited in 6 hospitals in the United Kingdom. Oral samples were collected as follows: oral rinse, tongue base, and pharyngeal wall brushes, then tonsil tissue (tonsillectomy). Vaccination data were obtained from regional health authorities. All samples were centrally tested for HPV DNA by polymerase chain reaction.
Of 940 subjects, 243 females and 69 males were aged 12-24 years (median age, 18.6 years), with 189 (78%) females and no males vaccinated against HPV. Overall, oropharyngeal HPV-16 prevalence was significantly lower in vaccinated versus unvaccinated females (0.5% vs 5.6%, P = .04). In contrast, prevalence of any oropharyngeal HPV type was similar in vaccinated and unvaccinated females (19% vs 20%, P = .76). Oropharyngeal HPV-16 prevalence in unvaccinated males was similar to vaccinated females (0% vs 0.5%, P > .99), and lower than unvaccinated females (0% vs 5.6%, P = .08).
Our findings indicate that the UK female-only vaccination program is associated with significant reductions in oropharyngeal HPV-16 infections. These are also the first data to suggest potential herd immunity from female-only vaccination against oropharyngeal HPV infection in contemporaneously aged males.
由于人乳头瘤病毒16型（HPV-16）感染，口咽癌的发病率正在迅速上升。关于全国仅针对女性的疫苗接种计划在预防口腔HPV感染方面的有效性以及未接种疫苗的男性中潜在的群体免疫的数据匮乏，导致了关于男性是否需要接种疫苗的相当大的争议，尤其是在女性疫苗接种覆盖率高的国家。
在英国的6家医院招募了因非恶性指征接受扁桃体切除术的0至65岁的受试者。按以下方式收集口腔样本：口腔冲洗液、舌根和咽壁刷检样本，然后是扁桃体组织（扁桃体切除术样本）。疫苗接种数据来自地区卫生当局。所有样本均通过聚合酶链反应进行HPV DNA的集中检测。
在940名受试者中，243名女性和69名男性年龄在12至24岁之间（中位年龄18.6岁），其中189名（78%）女性接种了HPV疫苗，男性均未接种。总体而言，接种疫苗的女性与未接种疫苗的女性相比，口咽HPV-16感染率显著更低（0.5%对5.6%，P = 0.04）。相比之下，接种疫苗和未接种疫苗的女性中任何口咽HPV类型的感染率相似（19%对20%，P = 0.76）。未接种疫苗的男性的口咽HPV-16感染率与接种疫苗的女性相似（0%对0.5%，P > 0.99），且低于未接种疫苗的女性（0%对5.6%，P = 0.08）。
我们的研究结果表明，英国仅针对女性的疫苗接种计划与口咽HPV-16感染的显著减少有关。这些也是首批表明仅针对女性的疫苗接种可能对同时期年龄的男性口咽HPV感染产生群体免疫的数据。
