HPV vaccine prevents infection, provides herd immunity

  • Spinner C et al
  • Pediatrics
  • 22 Jan 2019

  • curated by Liz Scherer
  • Clinical Essentials
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Takeaway

  • Revaccination with 9-valent HPV (9vHPV) vaccine may offer cross-protection against additional HPV types.
  • Significant declines in 4-valent HPV (4vHPV) types in unvaccinated women suggest that high vaccination uptake may confer herd protection.

Why this matters

  • Consider revaccination with 9vHPV in young females who completed >1 dose 4vHPV vaccine.

Key results

  • 1580 participants.
  • HPV vaccination rates (>1 dose) increased from 0%, 59.2%, 71.5%, and 83.4% in waves 1-4, respectively.
  • Proportion of vaccinated women infected with >1 9vHPV, >1 4vHPV vaccine-type, >5 types in 9- but not 4-vaccine-type HPV declined 71%, 80.9%, 68.8%, respectively.
    • Proportion of unvaccinated women infected with >1 4vHPV vaccine-type declined 40.1% (adjusted OR [aOR], 0.50; 95% CI, 0.26-0.97).
  • Vaccine effectiveness (VE) in waves 3, 4 was 90.6%, 80.1%, respectively.
  • Vaccinated: odds of infection decreased for 9vHPV vaccine (aOR, 0.18; 95% CI, 0.12-0.28), 5 additional HPV types for 9-valent (aOR, 0.26; 95% CI, 0.16-0.42).
  • Related editorial.

Study design

  • Surveillance study evaluating 4 cross-sectional cohorts of adolescents, young women (ages 13-26 years) to determine trends in vaccine-type HPV in vaccinated (to assess VE) and unvaccinated (to assess herd protection) from 2006 to 2017.
  • Funding: NIH.

Limitations

  • Limited ability to evaluate 9vHPV prevalence trends in wave 4.
  • Limited generalizability.
  • Self-report bias.

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