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Human Papillomavirus Prevalence and Herd Immunity after Introduction of Vaccination Program, Scotland, 2009-2013.

Cameron RL, Kavanagh K, Pan J, Love J, Cuschieri K, Robertson C, Ahmed S, Palmer T, Pollock KG - Emerging Infect. Dis. (2016)

Bottom Line: Each year during 2009-2013, the surveillance program conducted HPV testing on a proportion of liquid-based cytology samples from women undergoing their first cervical screening test for precancerous cervical disease.By linking vaccination, cervical screening, and HPV testing data, over the study period we found a decline in HPV types 16 and 18, significant decreases in HPV types 31, 33, and 45 (suggesting cross-protection), and a nonsignificant increase in HPV 51.Our results preliminarily indicate herd immunity and sustained effectiveness of the bivalent vaccine on virologic outcomes at the population level.

View Article: PubMed Central - PubMed

ABSTRACT
In 2008, a national human papillomavirus (HPV) immunization program using a bivalent vaccine against HPV types 16 and 18 was implemented in Scotland along with a national surveillance program designed to determine the longitudinal effects of vaccination on HPV infection at the population level. Each year during 2009-2013, the surveillance program conducted HPV testing on a proportion of liquid-based cytology samples from women undergoing their first cervical screening test for precancerous cervical disease. By linking vaccination, cervical screening, and HPV testing data, over the study period we found a decline in HPV types 16 and 18, significant decreases in HPV types 31, 33, and 45 (suggesting cross-protection), and a nonsignificant increase in HPV 51. In addition, among nonvaccinated women, HPV types 16 and 18 infections were significantly lower in 2013 than in 2009. Our results preliminarily indicate herd immunity and sustained effectiveness of the bivalent vaccine on virologic outcomes at the population level.

No MeSH data available.


Related in: MedlinePlus

Analyses for 5,715 liquid-based cytology cervical samples from vaccinated and nonvaccinated women, for which valid human papillomavirus (HPV) testing results were available, Scotland, 2009–2013. A) Proportion and 95% CIs for samples with positive results for each HPV type. B) Difference in the proportion positive and associated 95% CIs for the difference between vaccinated and nonvaccinated women, by HPV type. Other than HPV types 16 and 18, the 95% CIs of the difference were corrected for multiple testing using by using the Bonferroni correction. *Significant change.
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Figure 1: Analyses for 5,715 liquid-based cytology cervical samples from vaccinated and nonvaccinated women, for which valid human papillomavirus (HPV) testing results were available, Scotland, 2009–2013. A) Proportion and 95% CIs for samples with positive results for each HPV type. B) Difference in the proportion positive and associated 95% CIs for the difference between vaccinated and nonvaccinated women, by HPV type. Other than HPV types 16 and 18, the 95% CIs of the difference were corrected for multiple testing using by using the Bonferroni correction. *Significant change.

Mentions: We analyzed 5,765 liquid-based cytology samples from women 20–21 years of age who underwent their first cervical smear testing during 2009–2013. The number of samples received each year was distributed evenly between the quintiles of the Scottish Index of Multiple Deprivation (≈20% samples/quintile) (Table 1). Overall, valid HPV test results were available for 5,715 samples, of which 57.1% (95% CI 55.8%–58.3%) were positive for any HPV type and 46.9% (95% CI 45.6%–48.2%) were positive for any high-risk HPV type (HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, or 68). As expected, because of eligibility criteria, vaccination status differed greatly by collection year; 38% of women received 3 doses in 2011, 67% in 2012, and 72% in 2013. The samples received in 2009 and 2010 were from women who were not eligible for the catch-up campaign; therefore, 98% and 94% of the samples from these years, respectively, came from nonvaccinated women (Figure).


Human Papillomavirus Prevalence and Herd Immunity after Introduction of Vaccination Program, Scotland, 2009-2013.

Cameron RL, Kavanagh K, Pan J, Love J, Cuschieri K, Robertson C, Ahmed S, Palmer T, Pollock KG - Emerging Infect. Dis. (2016)

Analyses for 5,715 liquid-based cytology cervical samples from vaccinated and nonvaccinated women, for which valid human papillomavirus (HPV) testing results were available, Scotland, 2009–2013. A) Proportion and 95% CIs for samples with positive results for each HPV type. B) Difference in the proportion positive and associated 95% CIs for the difference between vaccinated and nonvaccinated women, by HPV type. Other than HPV types 16 and 18, the 95% CIs of the difference were corrected for multiple testing using by using the Bonferroni correction. *Significant change.
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Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4696690&req=5

Figure 1: Analyses for 5,715 liquid-based cytology cervical samples from vaccinated and nonvaccinated women, for which valid human papillomavirus (HPV) testing results were available, Scotland, 2009–2013. A) Proportion and 95% CIs for samples with positive results for each HPV type. B) Difference in the proportion positive and associated 95% CIs for the difference between vaccinated and nonvaccinated women, by HPV type. Other than HPV types 16 and 18, the 95% CIs of the difference were corrected for multiple testing using by using the Bonferroni correction. *Significant change.
Mentions: We analyzed 5,765 liquid-based cytology samples from women 20–21 years of age who underwent their first cervical smear testing during 2009–2013. The number of samples received each year was distributed evenly between the quintiles of the Scottish Index of Multiple Deprivation (≈20% samples/quintile) (Table 1). Overall, valid HPV test results were available for 5,715 samples, of which 57.1% (95% CI 55.8%–58.3%) were positive for any HPV type and 46.9% (95% CI 45.6%–48.2%) were positive for any high-risk HPV type (HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, or 68). As expected, because of eligibility criteria, vaccination status differed greatly by collection year; 38% of women received 3 doses in 2011, 67% in 2012, and 72% in 2013. The samples received in 2009 and 2010 were from women who were not eligible for the catch-up campaign; therefore, 98% and 94% of the samples from these years, respectively, came from nonvaccinated women (Figure).

Bottom Line: Each year during 2009-2013, the surveillance program conducted HPV testing on a proportion of liquid-based cytology samples from women undergoing their first cervical screening test for precancerous cervical disease.By linking vaccination, cervical screening, and HPV testing data, over the study period we found a decline in HPV types 16 and 18, significant decreases in HPV types 31, 33, and 45 (suggesting cross-protection), and a nonsignificant increase in HPV 51.Our results preliminarily indicate herd immunity and sustained effectiveness of the bivalent vaccine on virologic outcomes at the population level.

View Article: PubMed Central - PubMed

ABSTRACT
In 2008, a national human papillomavirus (HPV) immunization program using a bivalent vaccine against HPV types 16 and 18 was implemented in Scotland along with a national surveillance program designed to determine the longitudinal effects of vaccination on HPV infection at the population level. Each year during 2009-2013, the surveillance program conducted HPV testing on a proportion of liquid-based cytology samples from women undergoing their first cervical screening test for precancerous cervical disease. By linking vaccination, cervical screening, and HPV testing data, over the study period we found a decline in HPV types 16 and 18, significant decreases in HPV types 31, 33, and 45 (suggesting cross-protection), and a nonsignificant increase in HPV 51. In addition, among nonvaccinated women, HPV types 16 and 18 infections were significantly lower in 2013 than in 2009. Our results preliminarily indicate herd immunity and sustained effectiveness of the bivalent vaccine on virologic outcomes at the population level.

No MeSH data available.


Related in: MedlinePlus