Center for Observational and Real-world Evidence, Merck & Co. Inc., Kenilworth, NJ, USA.
P95 Epidemiology & Pharmacovigilance, Leuven, Belgium.
Expert Rev Vaccines. 2022 Feb;21(2):227-240. doi: 10.1080/14760584.2022.2008243. Epub 2021 Dec 13.
Vaccine effectiveness and impact studies are typically observational, generating evidence after vaccine launch in a real-world setting. For human papillomavirus (HPV) vaccination studies, the variety of data sources and methods used is pronounced. Careful selection of study design, data capture and analytical methods can mitigate potential bias in such studies.
We systematically reviewed the different study designs, methods, and data sources in published evidence (1/2007-3/2020), which assessed the quadrivalent HPV vaccine effectiveness and impact on cervical/cervicovaginal, anal, and oral HPV infections, anogenital warts, lesions in anus, cervix, oropharynx, penis, vagina or vulva, and recurrent respiratory papillomatosis.
The rapid growth in access to real-world data allows global monitoring of effects of different public health interventions, including HPV vaccination programs. But the use of data which are not collected or organized to support research also underscore a need to develop robust methodology that provides insight of vaccine effects and consequences of different health policy decisions. To achieve the WHO elimination goal, we foresee a growing need to evaluate HPV vaccination programs globally. A critical appraisal summary of methodology used will provide timely guidance to researchers who want to initiate research activities in various settings.
疫苗效力和影响研究通常是观察性的,在真实环境中疫苗推出后才产生证据。对于人乳头瘤病毒(HPV)疫苗研究,使用的数据来源和方法种类繁多。仔细选择研究设计、数据采集和分析方法可以减轻此类研究中的潜在偏差。
我们系统地回顾了已发表证据(2007 年 1 月至 2020 年 3 月)中不同的研究设计、方法和数据源,这些证据评估了四价 HPV 疫苗对宫颈/阴道、肛门和口腔 HPV 感染、生殖器疣、肛门、宫颈、口咽、阴茎、阴道或外阴和复发性呼吸道乳头瘤病的效力和影响。
越来越多的人可以获得真实世界的数据,这使得可以对包括 HPV 疫苗接种计划在内的不同公共卫生干预措施的效果进行全球监测。但是,使用并非为支持研究而收集或组织的数据也突显了需要制定稳健的方法,以提供对疫苗效果和不同卫生政策决策后果的深入了解。为了实现世界卫生组织的消除目标,我们预计需要在全球范围内评估 HPV 疫苗接种计划。对所使用方法的方法学进行批判性评估总结,将为希望在不同环境中开展研究活动的研究人员提供及时的指导。