Prevalence of Human Papillomavirus Among Females After Vaccine Introduction-National Health and Nutrition Examination Survey, United States, 2003-2014

Overview

Journal J Infect Dis

Publisher Oxford University Press

Specialty Infectious Diseases

Date 2017 Sep 22

PMID 28931217

Citations 71

Authors

Sara E Oliver

Elizabeth R Unger

Rayleen Lewis

Darius McDaniel

Julia W Gargano

Martin Steinau

Lauri E Markowitz

Affiliations

Soon will be listed here.

Abstract

Background: Human papillomavirus (HPV) vaccine was recommended in 2006 for routine vaccination of US females aged 11-12 years. Most vaccine used through 2014 was quadrivalent vaccine (4vHPV), which prevents HPV-6, -11, -16, and -18 infection. To evaluate vaccine impact, we measured HPV prevalence in the National Health and Nutrition Examination Survey (NHANES).

Methods: We analyzed HPV DNA types detected in self-collected cervicovaginal specimens and demographic, sexual behavior, and self-reported vaccination data from females 14-34 years old. We estimated HPV prevalence in the prevaccine (2003-2006) and vaccine eras (2007-2010 and 2011-2014).

Results: Among 14- to 19-year-olds, 4vHPV-type prevalence decreased from 11.5% (95% confidence interval [CI], 9.1%-14.4%) in 2003-2006 to 3.3% (95% CI, 1.9%-5.8%) in 2011-2014, when ≥1-dose coverage was 55%. Among 20- to 24-year-olds, prevalence decreased from 18.5% (95% CI, 14.9%-22.8%) in 2003-2006 to 7.2% (95% CI, 4.7%-11.1%) in 2011-2014, when ≥1-dose coverage was 43%. Compared to 2003-2006, 4vHPV prevalence in sexually active 14- to 24-year-olds in 2011-2014 decreased 89% among those vaccinated and 34% among those unvaccinated. Vaccine effectiveness was 83%.

Conclusions: Within 8 years of vaccine introduction, 4vHPV-type prevalence decreased 71% among 14- to 19-year-olds and 61% among 20- to 24-year-olds. Estimated vaccine effectiveness was high. The decrease in 4vHPV-type prevalence among unvaccinated females suggests herd protection.

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References

Garland S, Hernandez-Avila M, Wheeler C, Perez G, Harper D, Leodolter S . Quadrivalent vaccine against human papillomavirus to prevent anogenital diseases. N Engl J Med. 2007; 356(19):1928-43. DOI: 10.1056/NEJMoa061760. View

Cameron R, Kavanagh K, Pan J, Love J, Cuschieri K, Robertson C . Human Papillomavirus Prevalence and Herd Immunity after Introduction of Vaccination Program, Scotland, 2009-2013. Emerg Infect Dis. 2015; 22(1):56-64. PMC: 4696690. DOI: 10.3201/eid2201.150736. View

. Recommendations on the use of quadrivalent human papillomavirus vaccine in males--Advisory Committee on Immunization Practices (ACIP), 2011. MMWR Morb Mortal Wkly Rep. 2011; 60(50):1705-8. View

Flagg E, Torrone E, Weinstock H . Ecological Association of Human Papillomavirus Vaccination with Cervical Dysplasia Prevalence in the United States, 2007-2014. Am J Public Health. 2016; 106(12):2211-2218. PMC: 5105011. DOI: 10.2105/AJPH.2016.303472. View

Flagg E, Schwartz R, Weinstock H . Prevalence of anogenital warts among participants in private health plans in the United States, 2003-2010: potential impact of human papillomavirus vaccination. Am J Public Health. 2013; 103(8):1428-35. PMC: 4007878. DOI: 10.2105/AJPH.2012.301182. View

Wheeler C, Castellsague X, Garland S, Szarewski A, Paavonen J, Naud P . Cross-protective efficacy of HPV-16/18 AS04-adjuvanted vaccine against cervical infection and precancer caused by non-vaccine oncogenic HPV types: 4-year end-of-study analysis of the randomised, double-blind PATRICIA trial. Lancet Oncol. 2011; 13(1):100-10. DOI: 10.1016/S1470-2045(11)70287-X. View

Brown D, Kjaer S, Sigurdsson K, Iversen O, Hernandez-Avila M, Wheeler C . The impact of quadrivalent human papillomavirus (HPV; types 6, 11, 16, and 18) L1 virus-like particle vaccine on infection and disease due to oncogenic nonvaccine HPV types in generally HPV-naive women aged 16-26 years. J Infect Dis. 2009; 199(7):926-35. DOI: 10.1086/597307. View

Curtin L, Mohadjer L, Dohrmann S, Montaquila J, Kruszan-Moran D, Mirel L . The National Health and Nutrition Examination Survey: Sample Design, 1999-2006. Vital Health Stat 2. 2012; (155):1-39. View

Fine P, Eames K, Heymann D . "Herd immunity": a rough guide. Clin Infect Dis. 2011; 52(7):911-6. DOI: 10.1093/cid/cir007. View

10.

Meites E, Kempe A, Markowitz L . Use of a 2-Dose Schedule for Human Papillomavirus Vaccination - Updated Recommendations of the Advisory Committee on Immunization Practices. MMWR Morb Mortal Wkly Rep. 2016; 65(49):1405-1408. DOI: 10.15585/mmwr.mm6549a5. View

11.

Gargano J, Unger E, Liu G, Steinau M, Meites E, Dunne E . Prevalence of Genital Human Papillomavirus in Males, United States, 2013-2014. J Infect Dis. 2017; 215(7):1070-1079. DOI: 10.1093/infdis/jix057. View

12.

Stokley S, Jeyarajah J, Yankey D, Cano M, Gee J, Roark J . Human papillomavirus vaccination coverage among adolescents, 2007-2013, and postlicensure vaccine safety monitoring, 2006-2014--United States. MMWR Morb Mortal Wkly Rep. 2014; 63(29):620-4. PMC: 5779422. View

13.

Bieler G, Brown G, Williams R, Brogan D . Estimating model-adjusted risks, risk differences, and risk ratios from complex survey data. Am J Epidemiol. 2010; 171(5):618-23. DOI: 10.1093/aje/kwp440. View

14.

Curtin L, Mohadjer L, Dohrmann S, Kruszon-Moran D, Mirel L, Carroll M . National Health and Nutrition Examination Survey: sample design, 2007-2010. Vital Health Stat 2. 2014; (160):1-23. View

15.

Markowitz L, Dunne E, Saraiya M, Chesson H, Curtis C, Gee J . Human papillomavirus vaccination: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2014; 63(RR-05):1-30. View

16.

Kavanagh K, Pollock K, Potts A, Love J, Cuschieri K, Cubie H . Introduction and sustained high coverage of the HPV bivalent vaccine leads to a reduction in prevalence of HPV 16/18 and closely related HPV types. Br J Cancer. 2014; 110(11):2804-11. PMC: 4037824. DOI: 10.1038/bjc.2014.198. View

17.

Paavonen J, Naud P, Salmeron J, Wheeler C, Chow S, Apter D . Efficacy of human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine against cervical infection and precancer caused by oncogenic HPV types (PATRICIA): final analysis of a double-blind, randomised study in young women. Lancet. 2009; 374(9686):301-14. DOI: 10.1016/S0140-6736(09)61248-4. View

18.

Kahn J, Widdice L, Ding L, Huang B, Brown D, Franco E . Substantial Decline in Vaccine-Type Human Papillomavirus (HPV) Among Vaccinated Young Women During the First 8 Years After HPV Vaccine Introduction in a Community. Clin Infect Dis. 2016; 63(10):1281-1287. PMC: 5091346. DOI: 10.1093/cid/ciw533. View

19.

Johnson C, Dohrmann S, Burt V, Mohadjer L . National health and nutrition examination survey: sample design, 2011-2014. Vital Health Stat 2. 2015; (162):1-33. View

20.

Korn E, Graubard B . Epidemiologic studies utilizing surveys: accounting for the sampling design. Am J Public Health. 1991; 81(9):1166-73. PMC: 1405642. DOI: 10.2105/ajph.81.9.1166. View