Who's Not Protected in the Herd? Factors Associated with Vaccine-Type HPV in Unvaccinated Women - 20/03/18
Abstract |
Study Objective |
Evidence suggests that vaccine-type human papillomavirus (HPV) prevalence may decrease in unvaccinated women after HPV vaccine introduction, indicating herd protection. The aim of this study was to determine factors associated with vaccine-type HPV (i.e. absence of herd protection) after vaccine introduction.
Design |
We conducted three cross-sectional studies from 2006-2014 (n = 1180): wave 1 (2006-2007), wave 2 (2009-2010), and wave 3 (2013-2014).
Setting |
Participants were recruited from a hospital-based teen health center and a community health department.
Participants |
We recruited 13-26 year-old young women; those included in this analysis had not received an HPV vaccine.
Interventions and Main Outcome Measures |
The outcome measure was infection with at least one vaccine-type HPV (HPV6, 11, 16, 18).
Results |
Multivariable logistic regression demonstrated that in wave 1 (before vaccine introduction), history of anal intercourse (OR = 1.8, 95% CI = 1.1-3.0), age 18-21 vs 13-17 years (OR = 2.1, CI = 1.2-3.6), and Black/multiracial vs White race (OR = 1.8, CI = 1.1-3.0) were associated with vaccine-type HPV in unvaccinated women. In wave 2, no variables were associated with HPV. In wave 3, sexually transmitted infection history (OR = 3.6, CI = 1.3-9.7) was associated with HPV.
Conclusion |
We did not identify a consistent set of modifiable risk factors associated with vaccine-type HPV after vaccine introduction across the three study waves, underscoring the urgency of vaccination for primary HPV prevention and the limitations of relying on herd protection.
Le texte complet de cet article est disponible en PDF.Key Words : Human papillomavirus, Herd protection, Vaccine, Women
Plan
| Dr Kahn has cochaired 2 National Institutes of Health-funded human papillomavirus (HPV) vaccine clinical trials in HIV-infected individuals, for which Merck & Co, Inc, provided vaccine and immunogenicity titers. Dr Franco has served as occasional advisor to companies involved with HPV vaccination (Merck, GlaxoSmithKline) and HPV and cervical cancer diagnostics (Roche, Becton Dickinson, Qiagen). His institution has received unconditional funding from Merck for investigator-initiated studies carried out in his unit. The remaining authors indicate no conflicts of interest. |
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| Ms Smith is now at North Carolina State University. |
Vol 31 - N° 2
P. 89-93 - avril 2018 Retour au numéro
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