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Population-level effects of human papillomavirus vaccination programs on infections with nonvaccine genotypes

Mesher, David and Soldan, Kate and Lehtinen, Matti and Kavanagh, Kimberley and Beddows, Simon and Brisson, Marc and Brotherton, Julia M.L. and Chow, Eric P.F. and Cummings, Teresa and Drolet, Mélanie and Fairley, Christopher K. and Garland, Suzanne M. and Kahn, Jessica A. and Kavanagh, Kimberley and Markowitz, Lauri and Pollock, Kevin G. and Söderlund-Strand, Anna and Sonnenberg, Pam and Tabrizi, Sepehr N. and Tanton, Clare and Unger, Elizabeth and Thomas, Sara L. (2016) Population-level effects of human papillomavirus vaccination programs on infections with nonvaccine genotypes. Emerging Infectious Diseases, 22 (10). pp. 1732-1740. ISSN 1080-6059 (In Press)

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Abstract

We analyzed human papillomavirus (HPV) prevalences during prevaccination and postvaccination periods to consider possible changes in nonvaccine HPV genotypes after introduction of vaccines that confer protection against 2 high-risk types, HPV16 and HPV18. Our meta-analysis included 9 studies with data for 13,886 girls and women ≤19 years of age and 23,340 women 20–24 years of age. We found evidence of cross-protection for HPV31 among the younger age group after vaccine introduction but little evidence for reductions of HPV33 and HPV45. For the group this same age group, we also found slight increases in 2 nonvaccine high-risk HPV types (HPV39 and HPV52) and in 2 possible high-risk types (HPV53 and HPV73). However, results between age groups and vaccines used were inconsistent, and the increases had possible alternative explanations; consequently, these data provided no clear evidence for type replacement. Continued monitoring of these HPV genotypes is important.