Vaccination With Moderate Coverage Eradicates Oncogenic Human Papillomaviruses If a Gender-Neutral Strategy Is Applied.
Female
Human papillomavirus 16
/ immunology
Human papillomavirus 18
/ immunology
Humans
Immunity, Herd
Male
Models, Theoretical
Papillomaviridae
/ classification
Papillomavirus Infections
/ complications
Papillomavirus Vaccines
/ immunology
Prevalence
Sex Factors
Tumor Virus Infections
/ complications
Vaccination
Vaccination Coverage
/ statistics & numerical data
elimination
eradication
gender-neutral vaccination
herd effects
human papillomavirus
Journal
The Journal of infectious diseases
ISSN: 1537-6613
Titre abrégé: J Infect Dis
Pays: United States
ID NLM: 0413675
Informations de publication
Date de publication:
17 08 2020
17 08 2020
Historique:
received:
01
11
2019
accepted:
03
03
2020
pubmed:
13
3
2020
medline:
9
3
2021
entrez:
13
3
2020
Statut:
ppublish
Résumé
Human papillomavirus (HPV) vaccination of girls with very high (>90%) coverage has the potential to eradicate oncogenic HPVs, but such high coverage is hard to achieve. However, the herd effect (HE) depends both on the HPV type and the vaccination strategy. We randomized 33 Finnish communities into gender-neutral HPV16/18 vaccination, girls-only HPV16/18 vaccination, and hepatitis B virus vaccination arms. In 2007-2010, 11 662 of 20 513 of 40 852 of 39 420 resident boys/girls from 1992 to 1995 birth cohorts consented. In 2010-2014, cervicovaginal samples from vaccinated and unvaccinated girls at age 18.5 years were typed for HPV6/11/16/18/31/33/35/39/45/51/52/56/58/59/66/68. Vaccine efficacy for vaccinated girls, HE for unvaccinated girls, and the protective effectiveness (PE) for all girls were estimated. We extended the community-randomized trial results about vaccination strategy with mathematical modeling to assess HPV eradication. The HE and PE estimates in the 1995 birth cohort for HPV18/31/33 were significant in the gender-neutral arm and 150% and 40% stronger than in the girls-only arm. Concordantly, HPV18/31/33 eradication was already predicted in adolescents/young adults in 20 years with 75% coverage of gender-neutral vaccination. With the 75% coverage, eventual HPV16 eradication was also predicted, but only with the gender-neutral strategy. Gender-neutral vaccination is superior for eradication of oncogenic HPVs.
Sections du résumé
BACKGROUND
Human papillomavirus (HPV) vaccination of girls with very high (>90%) coverage has the potential to eradicate oncogenic HPVs, but such high coverage is hard to achieve. However, the herd effect (HE) depends both on the HPV type and the vaccination strategy.
METHODS
We randomized 33 Finnish communities into gender-neutral HPV16/18 vaccination, girls-only HPV16/18 vaccination, and hepatitis B virus vaccination arms. In 2007-2010, 11 662 of 20 513 of 40 852 of 39 420 resident boys/girls from 1992 to 1995 birth cohorts consented. In 2010-2014, cervicovaginal samples from vaccinated and unvaccinated girls at age 18.5 years were typed for HPV6/11/16/18/31/33/35/39/45/51/52/56/58/59/66/68. Vaccine efficacy for vaccinated girls, HE for unvaccinated girls, and the protective effectiveness (PE) for all girls were estimated. We extended the community-randomized trial results about vaccination strategy with mathematical modeling to assess HPV eradication.
RESULTS
The HE and PE estimates in the 1995 birth cohort for HPV18/31/33 were significant in the gender-neutral arm and 150% and 40% stronger than in the girls-only arm. Concordantly, HPV18/31/33 eradication was already predicted in adolescents/young adults in 20 years with 75% coverage of gender-neutral vaccination. With the 75% coverage, eventual HPV16 eradication was also predicted, but only with the gender-neutral strategy.
CONCLUSIONS
Gender-neutral vaccination is superior for eradication of oncogenic HPVs.
Identifiants
pubmed: 32161969
pii: 5803245
doi: 10.1093/infdis/jiaa099
pmc: PMC7430169
doi:
Substances chimiques
Papillomavirus Vaccines
0
Banques de données
ClinicalTrials.gov
['NCT00534638']
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
948-956Commentaires et corrections
Type : CommentIn
Informations de copyright
© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America.
Références
N Engl J Med. 2015 Feb 19;372(8):711-23
pubmed: 25693011
Lancet Infect Dis. 2017 Dec;17(12):1293-1302
pubmed: 28965955
J Infect Dis. 2005 Feb 1;191 Suppl 1:S97-106
pubmed: 15627236
Lancet Public Health. 2019 Jan;4(1):e19-e27
pubmed: 30291040
Vaccine. 2016 Mar 18;34(13):1559-1565
pubmed: 26896686
Nat Rev Clin Oncol. 2013 Jul;10(7):400-10
pubmed: 23736648
J Clin Epidemiol. 1993 Feb;46(2):123-31
pubmed: 8437028
Int J Cancer. 2018 Nov 1;143(9):2299-2310
pubmed: 29845626
Int J Cancer. 2018 May 15;142(10):2186-2187
pubmed: 29280138
Lancet Public Health. 2016 Nov;1(1):e8-e17
pubmed: 29253379
Math Biosci. 2015 Dec;270(Pt A):115-25
pubmed: 26518265
PLoS One. 2013 Nov 29;8(11):e81171
pubmed: 24400036
Vaccine. 2015 Mar 30;33(14):1673-81
pubmed: 25720792
PLoS One. 2013 Aug 29;8(8):e72088
pubmed: 24009669
Vaccine. 2015 Mar 3;33(10):1284-90
pubmed: 25593103
J Infect Dis. 2013 Nov 1;208(9):1397-403
pubmed: 24092908
J Infect Dis. 2019 Jan 29;219(4):582-589
pubmed: 30239832
Med Health Care Philos. 2011 Feb;14(1):19-27
pubmed: 20853152
Int J Cancer. 2018 Mar 1;142(5):949-958
pubmed: 29055031
MMWR Surveill Summ. 2017 May 05;66(11):1-28
pubmed: 28472027
Lancet. 2011 Jun 18;377(9783):2085-92
pubmed: 21684381
Vaccine. 2018 Sep 18;36(39):5926-5933
pubmed: 30115524
Papillomavirus Res. 2017 Dec;4:72-78
pubmed: 29179873
PLoS One. 2013 May 01;8(5):e61825
pubmed: 23650505
J Epidemiol Community Health. 2014 Jan;68(1):57-63
pubmed: 23986492
J Infect Dis. 2016 Jan 15;213(2):199-205
pubmed: 26142436