Vaccine-type human papillomavirus and evidence of herd protection after vaccine introduction.
Pediatrics
; 130(2): e249-56, 2012 Aug.
Article
em En
| MEDLINE
| ID: mdl-22778297
ABSTRACT
OBJECTIVES:
The aims of this study were to compare prevalence rates of human papillomavirus (HPV) in young women before and after HPV vaccine introduction to determine the following (1) whether vaccine-type HPV infection decreased, (2) whether there was evidence of herd protection, and (3) whether there was evidence for type-replacement (increased prevalence of nonvaccine-type HPV).METHODS:
Young women 13 to 26 years of age who had had sexual contact were recruited from 2 primary care clinics in 2006-2007 for a prevaccination surveillance study (N = 368, none were vaccinated) and 2009-2010 for a postvaccination surveillance study (N = 409, 59% were vaccinated). Participants completed a questionnaire and were tested for cervicovaginal HPV DNA. HPV prevalence rates were compared in the pre- versus postsurveillance studies by using χ(2) tests. Propensity score weighting was used to balance differences in covariates between the 2 surveillance studies.RESULTS:
The mean age was â¼19 years for both groups of participants and most were African American and non-Hispanic. After propensity score weighting, the prevalence rate for vaccine-type HPV decreased substantially (31.7%-13.4%, P < .0001). The decrease in vaccine-type HPV not only occurred among vaccinated (31.8%-9.9%, P < .0001) but also among unvaccinated (30.2%-15.4%, P < .0001) postsurveillance study participants. Nonvaccine-type HPV increased (60.7%-75.9%, P < .0001) for vaccinated postsurveillance study participants.CONCLUSIONS:
Four years after licensing of the quadrivalent HPV vaccine, there was a substantial decrease in vaccine-type HPV prevalence and evidence of herd protection in this community. The increase in nonvaccine-type HPV in vaccinated participants should be interpreted with caution but warrants further study.
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
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Prevencao_e_fatores_de_risco
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Atos_sexuais
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Saude_da_mulher
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Colo_do_utero
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Tipos_de_cancer
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Colo_do_utero
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Outros_tipos
Base de dados:
MEDLINE
Assunto principal:
Papiloma
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Displasia do Colo do Útero
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Imunidade Coletiva
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Vacinas contra Papillomavirus
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Neoplasias dos Genitais Femininos
Tipo de estudo:
Observational_studies
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Prevalence_studies
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Prognostic_studies
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Risk_factors_studies
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Screening_studies
Limite:
Adolescent
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Adult
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Female
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Humans
Idioma:
En
Revista:
Pediatrics
Ano de publicação:
2012
Tipo de documento:
Article
País de afiliação:
Estados Unidos