Bivalent vaccine effectiveness against type-specific HPV positivity: evidence for cross-protection against oncogenic types among Dutch STI clinic visitors

Petra J Woestenberg, Audrey J King, Birgit H B van Benthem, Robine Donken, Suzan Leussink, Fiona R M van der Klis, Hester E de Melker, Marianne A B van der Sande, Christian J P A Hoebe, Johannes A Bogaards, Medical Microbiological Laboratories, and the Public Health Services

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: Observational post-marketing studies are important to assess vaccine effectiveness (VE). We estimated VE from the bivalent human papillomavirus (HPV) vaccine against HPV positivity of vaccine and non-vaccine types in a high-risk population.

Methods: We included all vaccine-eligible women from the PASSYON study, a biennial cross-sectional survey in Dutch sexually transmitted infection clinics. Vaginal swabs were analyzed using a PCR-based assay (SPF10-LiPA25) able to detect the 12 high-risk HPV (hrHPV) types 16/18/31/33/35/39/45/51/52/56/58/59. We compared hrHPV positivity between self-reported vaccinated (≥1 dose) and unvaccinated women, and estimated VE by a logistic mixed model.

Results: We included 1087 women of which 53% were hrHPV positive and 60% reported to be vaccinated. The adjusted pooled VE against HPV-16/18 was 89.9% (81.7-94.4). Moreover, we calculated significant VE against non-vaccine types HPV-45 (91%), HPV-35 (57%), HPV-31 (50%) and HPV-52 (37%). Among women who were offered vaccination 5/6 years ago, we estimated similar VE against HPV-16/18 (92%) and all hrHPV types (35%) compared to women who were offered vaccination <5 years ago (83% and 33% respectively).

Conclusion: We demonstrated high VE of the bivalent vaccine against HPV-16/18 and cross-protection against HPV-45/35/31/52. Protection against HPV-16/18 was sustained up to six years post-vaccination.

Original languageEnglish
Pages (from-to)213-222
Number of pages10
JournalJournal of Infectious Diseases
Volume217
Issue number2
Early online date11 Nov 2017
DOIs
Publication statusPublished - 15 Jan 2018

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