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Quadrivalent Human Papillomavirus Vaccine Effectiveness: A Swedish National Cohort Study.

Leval, Amy; Herweijer, Eva; Ploner, Alexander; Eloranta, Sandra; Fridman Simard, Julia; Dillner, Joakim LU ; Young, Cecilia; Netterlid, Eva LU ; Sparén, Pär and Arnheim-Dahlström, Lisen (2013) In Journal of the National Cancer Institute 105(7). p.469-474
Abstract
BackgroundIncidence of condyloma, or genital warts (GW), is the earliest possible disease outcome to measure when assessing the effectiveness of human papillomavirus (HPV) vaccination strategies. Efficacy trials that follow prespecified inclusion and exclusion criteria may not be fully generalizable to real-life HPV vaccination programs, which target a broader segment of the population. We assessed GW incidence after on-demand vaccination with quadrivalent HPV vaccine using individual-level data from the entire Swedish population.MethodsAn open cohort of girls and women aged 10 to 44 years living in Sweden between 2006 and 2010 (N > 2.2 million) was linked to multiple population registers to identify incident GW in relation to HPV... (More)
BackgroundIncidence of condyloma, or genital warts (GW), is the earliest possible disease outcome to measure when assessing the effectiveness of human papillomavirus (HPV) vaccination strategies. Efficacy trials that follow prespecified inclusion and exclusion criteria may not be fully generalizable to real-life HPV vaccination programs, which target a broader segment of the population. We assessed GW incidence after on-demand vaccination with quadrivalent HPV vaccine using individual-level data from the entire Swedish population.MethodsAn open cohort of girls and women aged 10 to 44 years living in Sweden between 2006 and 2010 (N > 2.2 million) was linked to multiple population registers to identify incident GW in relation to HPV vaccination. For vaccine effectiveness, incidence rate ratios of GW were estimated using time-to-event analyses with adjustment for attained age and parental education level, stratifying on age at first vaccination.ResultsA total of 124 000 girls and women were vaccinated between 2006 and 2010. Girls and women with at least one university-educated parent were 15 times more likely to be vaccinated before age 20 years than girls and women whose parents did not complete high school (relative risk ratio = 15.45, 95% confidence interval [CI] = 14.65 to 16.30). Among those aged older than 20 years, GW rates declined among the unvaccinated, suggesting that HPV vaccines were preferentially used by women at high risk of GW. Vaccination effectiveness was 76% (95% CI = 73% to 79%) among those who received three doses of the vaccine with their first dose before age 20 years. Vaccine effectiveness was highest in girls vaccinated before age 14 years (effectiveness = 93%, 95% CI = 73% to 98%).ConclusionsYoung age at first vaccination is imperative for maximizing quadrivalent HPV vaccine effectiveness. (Less)
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author
organization
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type
Contribution to journal
publication status
published
subject
in
Journal of the National Cancer Institute
volume
105
issue
7
pages
469 - 474
publisher
Oxford University Press
external identifiers
  • wos:000317620500007
  • pmid:23486550
  • scopus:84876008961
ISSN
1460-2105
DOI
10.1093/jnci/djt032
language
English
LU publication?
yes
id
83a4e21b-60b1-4cc2-8c5b-c7107bdc64d8 (old id 3628229)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/23486550?dopt=Abstract
date added to LUP
2013-04-04 16:18:46
date last changed
2018-05-13 03:10:37
@article{83a4e21b-60b1-4cc2-8c5b-c7107bdc64d8,
  abstract     = {BackgroundIncidence of condyloma, or genital warts (GW), is the earliest possible disease outcome to measure when assessing the effectiveness of human papillomavirus (HPV) vaccination strategies. Efficacy trials that follow prespecified inclusion and exclusion criteria may not be fully generalizable to real-life HPV vaccination programs, which target a broader segment of the population. We assessed GW incidence after on-demand vaccination with quadrivalent HPV vaccine using individual-level data from the entire Swedish population.MethodsAn open cohort of girls and women aged 10 to 44 years living in Sweden between 2006 and 2010 (N > 2.2 million) was linked to multiple population registers to identify incident GW in relation to HPV vaccination. For vaccine effectiveness, incidence rate ratios of GW were estimated using time-to-event analyses with adjustment for attained age and parental education level, stratifying on age at first vaccination.ResultsA total of 124 000 girls and women were vaccinated between 2006 and 2010. Girls and women with at least one university-educated parent were 15 times more likely to be vaccinated before age 20 years than girls and women whose parents did not complete high school (relative risk ratio = 15.45, 95% confidence interval [CI] = 14.65 to 16.30). Among those aged older than 20 years, GW rates declined among the unvaccinated, suggesting that HPV vaccines were preferentially used by women at high risk of GW. Vaccination effectiveness was 76% (95% CI = 73% to 79%) among those who received three doses of the vaccine with their first dose before age 20 years. Vaccine effectiveness was highest in girls vaccinated before age 14 years (effectiveness = 93%, 95% CI = 73% to 98%).ConclusionsYoung age at first vaccination is imperative for maximizing quadrivalent HPV vaccine effectiveness.},
  author       = {Leval, Amy and Herweijer, Eva and Ploner, Alexander and Eloranta, Sandra and Fridman Simard, Julia and Dillner, Joakim and Young, Cecilia and Netterlid, Eva and Sparén, Pär and Arnheim-Dahlström, Lisen},
  issn         = {1460-2105},
  language     = {eng},
  number       = {7},
  pages        = {469--474},
  publisher    = {Oxford University Press},
  series       = {Journal of the National Cancer Institute},
  title        = {Quadrivalent Human Papillomavirus Vaccine Effectiveness: A Swedish National Cohort Study.},
  url          = {http://dx.doi.org/10.1093/jnci/djt032},
  volume       = {105},
  year         = {2013},
}