Vaccines Research Unit. Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana, FISABIO-Public Health, Valencia, Spain.
Vaccines Research Unit. Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana, FISABIO-Public Health, Valencia, Spain; Universidad Católica de Valencia San Vicente Mártir, Spain.
Vaccine. 2022 Jan 21;40(2):316-324. doi: 10.1016/j.vaccine.2021.11.062. Epub 2021 Dec 2.
To assess the effectiveness of the HPV vaccines in preventing genital warts (GW) in women aged 14-23 years and to estimate the incidence of GW in the whole population aged from 14 to 65.
Population-based retrospective cohort study using real-world data from the Valencia health system Integrated Databases (VID).
All subjects aged 14-65 years residing in the Valencia Region during 2009-2017 (n = 4,492,724), including a cohort of 563,240 females aged 14-23 years followed-up for the vaccine effectiveness (VE) estimations.
Incident cases of GW defined as the first activation of GW-related codes (ICD-9-CM 078.11 or ICD-10-CM A63.0) in hospital, primary and specialized care during the study period. Adjusted VE was estimated as (1-Relative Risk (RR)) × 100 by a negative binomial Bayesian model.
There were 23,049 cases of GW in the overall population and 2,565 in the females' cohort 14-23 years old. The incidence rate (IR) (in 100,000 persons-year) was 69.1 (95% CI 68.21-69.99) in the population overall, being higher in men (72.73; 95% CI 71.45-74.04). The IR of GW was 104.08 (95% CI 100.79-108.94) in the cohort of young women. The RR of GW increased with age from 14 to 21 years, reaching a plateau from 21 to 23. The VE of a complete schedule was 74% (95% CrI 68-79) for quadrivalent HPV vaccine (HPV4v). No effectiveness was seen with a full vaccination course with the bivalent HPV vaccine (HPV2v) in girls up to 21 years old. GW IR tends to be higher in unvaccinated cohorts covered by HPV4v vaccine than in unvaccinated cohorts not covered by HPV4v vaccine.
A complete HPV4v vaccination schedule was 74% effective in reducing GW in our population. Our results also suggest an indirect protection to unvaccinated and HPV2v vaccinated girls.
评估 HPV 疫苗在预防 14-23 岁女性生殖器疣（GW）方面的有效性，并估计整个 14-65 岁人群中 GW 的发病率。
使用瓦伦西亚卫生系统综合数据库（VID）的真实世界数据进行基于人群的回顾性队列研究。
2009-2017 年期间居住在瓦伦西亚地区的所有 14-65 岁人群（n=4492724 人），包括一个 563240 名 14-23 岁女性队列，对疫苗有效性（VE）进行估计。
GW 的发病病例定义为研究期间医院、初级和专科护理中首次激活与 GW 相关的代码（ICD-9-CM 078.11 或 ICD-10-CM A63.0）。采用负二项贝叶斯模型估计调整后的 VE，计算方法为（1-相对风险（RR））×100。
GW 在总体人群中有 23049 例，14-23 岁女性队列中有 2565 例。总体人群的发病率（IR）（每 10 万人年）为 69.1（95%CI 68.21-69.99），男性更高（72.73；95%CI 71.45-74.04）。年轻女性队列中 GW 的 IR 为 104.08（95%CI 100.79-108.94）。GW 的 RR 从 14 岁到 21 岁随着年龄的增长而增加，从 21 岁到 23 岁达到平台期。四价 HPV 疫苗（HPV4v）的完全接种方案 VE 为 74%（95%CrI 68-79）。在 21 岁以下女孩中，二价 HPV 疫苗（HPV2v）的完全接种方案没有效果。GW 的 IR 在接种 HPV4v 疫苗的未接种队列中比未接种 HPV4v 疫苗的未接种队列中更高。
HPV4v 疫苗的完整接种方案在降低本地区 GW 发病率方面的有效性为 74%。我们的结果还表明对未接种和 HPV2v 接种女孩有间接保护作用。
