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Vaccination effective against human papillomavirus

Despite vaccine effectiveness against human papillomavirus, many individuals do not receive vaccination prior to sexual debut, as recommended by the ACIP.

Timely vaccination is effective against human papillomavirus (HPV), according to a recent study.

Vaccination against HPV is currently recommended for pediatric patients aged 9 to 12 years by the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices (ACIP). Timely vaccination protects patients from HPV types 16 and 18, which are the genotypes found in 70% of cervical cancers.

Despite the importance of timely vaccination, with evidence of early-age vaccine decreasing risk of cervical precancer and cancer incidence, patients are often vaccinated later than the recommended age range.

To determine the effectiveness of vaccines against HPV, investigators gathered data from the National Health and Nutrition Examination Survey, a biennial cross-sectional multistage probability sample with data on the noninstitutionalized civilian United States population.

Data was analyzed for how many female individuals received vaccination prior to sexual debut. Then, the association between delay in vaccination and prevalence of HPV types 16 and 18 was estimated, accounting for disparities in timely vaccination because of race and ethnicity.

Written informed consent was provided by patients or their legal guardians, along with information on race, ethnicity, sexual history, and HPV vaccination. Participants also underwent vaginal HPV testing.

Participants were aged 26 years or less in 2006, the year HPV vaccination begun, and were eligible for routine vaccination (RV) if aged 9 to 12 years or catch-up inspection if aged 13 to 26 years, based on recommendation from the ACIP.

Investigators compared rates of HPV types 16 and 18 among unvaccinated, vaccinated before sexual debut, and vaccinated after sexual debut groups. Vaccine uptake was measured by racial and ethnic subgroupsfor participants with vaccine eligibility.

Of the 4727 female participants, those unvaccinated had an HPV 16 and 18 prevalence of 6%, while prevalence for those vaccinated after sexual debut decreased to 3%. For those vaccinated before sexual debut, prevalence decreased to less than 1%.

Compared with the unvaccinated group, prevalence was 41% lower in the group vaccinated after sexual debut and 89% lower in the group vaccinated before sexual debut. However, only 38% of eligible individuals were vaccinated, which increased to 56% when restricted to participants eligible for RV.

Of female adults eligible for RV, only 21% reported receiving their first dose within the age range recommended by the ACIP. Vaccination before sexual debut was reported by 33% of these individuals, and vaccination after sexual debut by 23%. There were no significant differences based on race and ethnicity.

These results indicate effectiveness from vaccination against HPV, but low rates of timely vaccination. Investigators encouraged vaccination prior to sexual debut.

Reference

Egemen D, Katki HA, Chaturvedi AK, Landy R, Cheung LC. Variation in human papillomavirus vaccination effectiveness in the US by age at vaccination. JAMA Netw Open. 2022;5(10):e2238041. doi:10.1001/jamanetworkopen.2022.38041