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Gender‐neutral vaccination provides improved control of human papillomavirus types 18/31/33/35 through herd immunity: Results of a community randomized trial (III)

Authors: Matti Lehtinen; Tapio Luostarinen; Simopekka Vänskä; Anna Söderlund‐Strand; Tiina Eriksson; Kari Natunen; Dan Apter; +16 Authors

Gender‐neutral vaccination provides improved control of human papillomavirus types 18/31/33/35 through herd immunity: Results of a community randomized trial (III)

Abstract

With optimal strategy, human papillomavirus (HPV) vaccines have the potential to control HPV. We have assessed vaccine efficacy (VE), herd effect (HE) of HPV vaccination and overall protective effectiveness (PE) against high‐risk HPV infections by HPV type and vaccination strategy in a community‐randomized trial using the bivalent HPV16/18 vaccine. We randomized 33 communities to gender‐neutral HPV vaccination (Arm A), HPV vaccination of girls and hepatitis B‐virus (HBV) vaccination of boys (Arm B) and gender‐neutral HBV vaccination (Arm C). Entire 1992–1995 male (40,852) and female (39,420) birth cohorts were invited, and 11,662 males and 20,513 females vaccinated with 20–30% and 45% coverage in 2007–2010. During 2010–2014, 11,396 cervicovaginal samples were collected from 13,545 18.5‐year‐old attendees. HPV typing was performed by a high‐throughput PCR. VE was calculated for HPV vaccinated women and HE for non‐HPV‐vaccinated women, using the HBV vaccinated, for HE all non‐HPV vaccinated, Arm C women as controls. PE was calculated as coverage rate‐weighted mean of VE + HE. HPV16/18/45 and 31/33/35 VEs varied between 86–94% and 30–66%, respectively. Only the gender‐neutral vaccination provided significant HEs against HPV18 (61%) and HPV31 (72%) in the 1995 birth cohort—increased HEs against HPV33 (39%) and HPV35 (42%) were also observed. Due to the increased HEs, PEs for HPV16/18/45 and HPV31/33/35 were comparable in the gender‐neutral arm 1995 birth cohort. High vaccine efficacy against HPV16/18/45 and, gender‐neutral vaccination‐enforced, herd effect against HPV18/31/33/35 by the bivalent vaccine rapidly provides comparable overall protective effectiveness against six oncogenic HPV types: 16/18/31/33/35/45.

Keywords

Immunity, Herd, Male, Adolescent, gender-neutral, Papillomavirus Infections, herd effect, vaccination, Prognosis, Cohort Studies, Sex Factors, impact, randomized trial, Humans, Female, Papillomavirus Vaccines, human papillomavirus, Child, Papillomaviridae, Finland, Follow-Up Studies

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    selected citations
    These citations are derived from selected sources.
    This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    55
    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Top 10%
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Top 1%
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
55
Top 10%
Top 10%
Top 1%
bronze