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Aggarwal S, Agarwal P, Gupta N. A comprehensive narrative review of challenges and facilitators in the implementation of various HPV vaccination program worldwide. Cancer Med 2024; 13:e6862. [PMID: 38213086 PMCID: PMC10911072 DOI: 10.1002/cam4.6862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 11/08/2023] [Accepted: 11/25/2023] [Indexed: 01/13/2024] Open
Abstract
INTRODUCTION Cervical cancer has been considered as one of the most common cancers in women (15-44 years) globally, but the advent of the human papilloma virus (HPV) vaccine has raised the anticipation that eradication of cervical carcinoma might be achieved in the near future as several prophylactic cervical carcinoma vaccines have already been currently licensed in various countries. Countries should devise strategies, practices and policies to attain and sustain higher levels of HPV immunization coverage as still 68% countries have introduced HPV vaccine in their national immunization programs even after 17 years following the licensure of the first prophylactic HPV vaccine. METHODOLOGY A comprehensive literature analysis was conducted using various databases and search engines, to include the most relevant research articles and data available and critically discussed the operational gaps that need to be answered to achieve adequate coverage of HPV vaccination. RESULTS The present review highlights the existing HPV vaccination strategies, unmet needs and challenges needed to be addressed for proper implementation framework as well as the collaborations required to achieve decent vaccination coverage. Well-coordinated vaccination strategy with focus on adolescent girls and if possible, boys can lead to dramatic impact on disease reduction around the world.
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Affiliation(s)
- Sumit Aggarwal
- Division of ECD, Indian Council of Medical ResearchNew DelhiIndia
| | - Pragati Agarwal
- Division of ECD, Indian Council of Medical ResearchNew DelhiIndia
| | - Nivedita Gupta
- Division of ECD, Indian Council of Medical ResearchNew DelhiIndia
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Aggarwal S, Agarwal P, Singh AK. Human papilloma virus vaccines: A comprehensive narrative review. Cancer Treat Res Commun 2023; 37:100780. [PMID: 38006748 DOI: 10.1016/j.ctarc.2023.100780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 11/19/2023] [Indexed: 11/27/2023]
Abstract
Cervical cancer is one of the most common cancers in women aged 15-44 years in the world, with more than three-quarters of cases diagnosed at a locally advanced clinical stage with minor prospects of survival. Although only a small percentage of women with Human Papilloma Virus (HPV) develop cervical cancer and most of the HPV infections are cleared subsequently at primary stage itself, but seroconversion not always guarantees that the individual is immune to HPV. The advent of the cervical carcinoma vaccine has raised the expectations that eradication of cervical carcinoma might be possible in the near future as it exhibited remarkably high efficacy against the vaccine-specific types in naive women with no serious vaccine-related adverse events. Few prophylactic HPV vaccines are currently licensed in over 100 countries. It has also been suggested that vaccinating both men and women is more beneficial than vaccinating only females. Vaccination is a cost-effective strategy to reduce the incidence of cervical cancer and mortality compared to no vaccination based on the cost of cancer treatment. Well-coordinated vaccination strategy with focus on adolescent girls and if possible, boys can lead to dramatic impact on disease reduction around the world.
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Affiliation(s)
- Sumit Aggarwal
- Division of ECD, Indian Council of Medical Research, Ansari Nagar, New-Delhi, 110029, India.
| | - Pragati Agarwal
- Division of ECD, Indian Council of Medical Research, Ansari Nagar, New-Delhi, 110029, India
| | - Amit Kumar Singh
- National JALMA Institute of Leprosy And Other Mycobacterial Diseases, Agra, India
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3
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Nofal A, Nofal H, Alwirshiffani E, ElGhareeb MI. Treatment response and tolerability of intralesional quadrivalent versus bivalent human papillomavirus vaccine for recalcitrant warts: A randomized controlled trial. J Am Acad Dermatol 2023; 89:1051-1052. [PMID: 37422014 DOI: 10.1016/j.jaad.2023.06.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 05/26/2023] [Accepted: 06/04/2023] [Indexed: 07/10/2023]
Affiliation(s)
- Ahmad Nofal
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Hagar Nofal
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Zagazig University, Zagazig, Egypt; Biotechnology Program, School of Sciences and Engineering, the American University in Cairo, Cairo, Egypt.
| | - Esam Alwirshiffani
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Zagazig University, Zagazig, Egypt; Faculty of Medicine, University of Tripoli, Tripoli, Libya
| | - Mohamed I ElGhareeb
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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McGuire JK, Kabagenyi F, Peer S. Human papillomavirus vaccination in Africa: An airway perspective. Int J Pediatr Otorhinolaryngol 2023; 165:111423. [PMID: 36681046 DOI: 10.1016/j.ijporl.2022.111423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/30/2022] [Accepted: 12/17/2022] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Recurrent respiratory papillomatosis (RRP) is a chronic condition caused by Human papillomavirus six (HPV-6) and HPV-11 that involves the respiratory tract. Disease severity ranges from mild (hoarseness), through to severe (stridor, respiratory distress and airway emergencies). Africa has the fastest growing and youngest population of all the continents. It also has the greatest burden of cervical cancer. There is an association with infection of the oncogenic HPV strains and the strains responsible for RRP. It is reasonable to conclude that although RRP may be underestimated in low-to-middle-income countries, it poses a considerable health risk to Africa. The primary aim of this project was to assess the suitability of HPV vaccination coverage on the African continent. METHODS A prospective study was designed to consist of an online survey. It was distributed to 135 African otolaryngologists. Questions focussed on HPV vaccination programmes; whether they were government directed; and their rollout. Information from countries that had multiple otolaryngologists respond to the survey were compared. Additionally, data review and corroboration were performed. RESULTS There were 58 (43%) participants from 19 countries. Nine countries reported a national vaccination programme (NVP), five used Cervarix; four used quadrivalent Gardasil. Collateral data revealed 18 of 54 countries had NVP in Africa and 26 countries had completed HPV vaccine pilot or demonstration projects. CONCLUSIONS HPV vaccination in Africa should be urgently re-evaluated to include the HPV-6 and HPV-11 strains that cause JORRP, which have not been recognised during national vaccination programme planning.
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Affiliation(s)
- J K McGuire
- Division of Otolaryngology, Department of Surgery, University of Cape Town, South Africa.
| | - F Kabagenyi
- Division of Otolaryngology, Department of Surgery, University of Cape Town, South Africa
| | - S Peer
- Division of Otolaryngology, Department of Surgery, University of Cape Town, South Africa
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5
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Kim J, Kim ED, Shin HS, Han SJ, Jamiyansharav M, Yoon SC, Lee JS, Seo KY. Effectiveness and safety of injectable human papilloma virus vaccine administered as eyedrops. Vaccine 2023; 41:92-100. [PMID: 36402660 DOI: 10.1016/j.vaccine.2022.09.070] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 09/18/2022] [Accepted: 09/23/2022] [Indexed: 11/19/2022]
Abstract
Mucosal vaccines have the advantages of ease of administration and the induction of strong mucosal immunity and a systemic immune response. Recently, the eye mucosa has been shown to be an effective and safe alternative vaccination route against influenza, Toxoplasma gondii infection, and hemolytic uremic syndrome in mice. In this study, we showed that the commercially available human papilloma virus (HPV) vaccine, Cervarix, induced significant immune reactions in terms of anti-HPV antigen (Ag)-specific immunoglobulin G (IgG) and IgA antibody production following eyedrop (ED) vaccination in mice. The HPV ED vaccines (EDV) provoked no signs of inflammation within 24 h, as indicated by the inflammatory cytokine mRNA levels and infiltration of mononuclear cells in inoculation sites. Moreover, the morphology of the cornea and retina and intraocular pressure of mice did not change after the HPV EDV. The functions of photoreceptor cells, including rod and cone cells, were normal following the HPV EDV inoculation in mice. These results suggest that Cervarix EDV could be a potent, safe, and effective mucosal vaccine against HPV-associated cancers.
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Akhatova A, Azizan A, Atageldiyeva K, Ashimkhanova A, Marat A, Iztleuov Y, Suleimenova A, Shamkeeva S, Aimagambetova G. Prophylactic Human Papillomavirus Vaccination: From the Origin to the Current State. Vaccines (Basel) 2022; 10:1912. [PMID: 36423008 PMCID: PMC9696339 DOI: 10.3390/vaccines10111912] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/09/2022] [Accepted: 11/09/2022] [Indexed: 07/30/2023] Open
Abstract
Immunization is the most successful method in preventing and controlling infectious diseases, which has helped saving millions of lives worldwide. The discovery of the human papillomavirus (HPV) infection being associated with a variety of benign conditions and cancers has driven the development of prophylactic HPV vaccines. Currently, four HPV vaccines are available on the pharmaceutical market: Cervarix, Gardasil, Gardasil-9, and the recently developed Cecolin. Multiple studies have proven the HPV vaccines' safety and efficacy in preventing HPV-related diseases. Since 2006, when the first HPV vaccine was approved, more than 100 World Health Organization member countries reported the implementation of HPV immunization. However, HPV vaccination dread, concerns about its safety, and associated adverse outcomes have a significant impact on the HPV vaccine implementation campaigns all over the world. Many developed countries have successfully implemented HPV immunization and achieved tremendous progress in preventing HPV-related conditions. However, there are still many countries worldwide which have not created, or have not yet implemented, HPV vaccination campaigns, or have failed due to deficient realization plans associated with establishing successful HPV vaccination programs. Lack of proper HPV information campaigns, negative media reflection, and numerous myths and fake information have led to HPV vaccine rejection in many states. Thus, context-specific health educational interventions on HPV vaccination safety, effectiveness, and benefits are important to increase the vaccines' acceptance for efficacious prevention of HPV-associated conditions.
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Affiliation(s)
- Ayazhan Akhatova
- School of Medicine, Nazarbayev University, Astana 010000, Kazakhstan
| | - Azliyati Azizan
- Department of Basic Sciences, College of Osteopathic Medicine, Touro University, Henderson, NV 89014, USA
| | - Kuralay Atageldiyeva
- Department of Medicine, School of Medicine, Nazarbayev University, Astana 010000, Kazakhstan
- Clinical Academic Department of Internal Medicine, CF University Medical Center, Astana 10000, Kazakhstan
| | - Aiymkul Ashimkhanova
- Department of Medicine, School of Medicine, Nazarbayev University, Astana 010000, Kazakhstan
| | - Aizada Marat
- Department of Obstetrics and Gynecology #1, NJSC “Astana Medical University”, Astana 010000, Kazakhstan
| | - Yerbolat Iztleuov
- Medical Center, Marat Ospanov West-Kazakhstan Medical University, Aktobe 030000, Kazakhstan
| | - Assem Suleimenova
- Kazakh Institute of Oncology and Radiology, Almaty 050000, Kazakhstan
| | - Saikal Shamkeeva
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Leipzig University Hospital, 04103 Leipzig, Germany
| | - Gulzhanat Aimagambetova
- Department of Biomedical Sciences, School of Medicine, Nazarbayev University, Astana 010000, Kazakhstan
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Adult immunization. Med Lett Drugs Ther 2022; 64:161-8. [PMID: 36206162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
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8
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Gay J, Johnson N, Kavuru V, Phillips M. Utility of the Human Papillomavirus Vaccination in Management of HPV-associated Cutaneous Lesions. Skin Therapy Lett 2021; 26:6-8. [PMID: 33769773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Human papillomavirus (HPV)-induced cutaneous disease is a common complaint for patients presenting for dermatology evaluation. Infection by HPV is the major etiologic factor in the development of cutaneous warts, epidermodysplasia verruciformis, and possibly a subset of cutaneous squamous cell carcinoma. Carcinoma of the genitourinary tract, most notably cervical carcinoma, is the most severe manifestation of infection with specific serotypes of HPV. For this reason, the HPV immunization (Gardasil) was developed in 2006 and upgraded in 2018 to a nonavalent formulation that includes serotypes 6, 11, 16, 18, 31, 33, 45, 52, 58. While immunization is highly effective at preventing infection with serotypes included in the formulation, it is less clear if the immunization can aid in managing active HPV infection. This review examines the available literature regarding the role of HPV immunization in managing common warts, genital warts, keratinocyte carcinoma, and epidermodysplasia verruciformis.
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Affiliation(s)
- Jane Gay
- Virginia Tech Carilion School of Medicine; Roanoke, VA, USA
| | - Nathan Johnson
- Virginia Tech Carilion School of Medicine; Roanoke, VA, USA
- Section of Dermatology and Mohs Surgery, Department of Internal Medicine, Carilion Clinic; Roanoke, VA, USA
| | - Varun Kavuru
- Virginia Tech Carilion School of Medicine; Roanoke, VA, USA
| | - Mariana Phillips
- Virginia Tech Carilion School of Medicine; Roanoke, VA, USA
- Section of Dermatology and Mohs Surgery, Department of Internal Medicine, Carilion Clinic; Roanoke, VA, USA
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Azimi A, Heidarian S, Zamani H, Taleghani N, Dehghani M, Seyedjafari E. Optimized dose of synthetic analogues of Monophosphoryl lipid A as an effective alternative for formulating recombinant human papillomavirus vaccine. Biologicals 2020; 68:60-64. [PMID: 32859464 DOI: 10.1016/j.biologicals.2020.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 08/08/2020] [Accepted: 08/15/2020] [Indexed: 12/24/2022] Open
Abstract
Adjuvants are a crucial component of recombinant vaccines such as the human papillomavirus (HPV) vaccine. Monophosphoryl lipid A (MPL) extracted from Salmonella Minnesota lipopolysaccharide is used as an adjuvant for the HPV vaccine. Due to the limitations in accessibility and reproducibility of MPL, investigating synthetic analogues of MPL (synMPL) is urgently needed to overcome these limitations. In this study, female BALB/c mice were vaccinated by HPV vaccine formulated with synMPL and aluminum hydroxide gel in which the concentration of synMPL ranged from 0 to 100 μg/dose. Anti-HPV L1 VLP antibody was measured for each group through Indirect ELISA and compared with Cervarix and Gardasil vaccines as approved anti-HPV vaccines. SynMPL showed a concentration-dependent increase up to 50 μg/dose in the immunogenicity of the vaccine. Therefore, synMPL at concentration of 50 μg/dose was selected as optimum concentration. The GMT profiling of synMPL-formulated vaccine (named Papilloguard) and Cervarix was not statistically different (Mann-Whitney test). The Gardasil vaccine showed 10-fold lower GMT for anti-HPV 18 L1 VLP antibody but anti-HPV 16 L1 VLP antibody was similar to Cervarix and Papilloguard. The current findings suggest that the synMPL in combination with aluminum hydroxide could be used as a potential adjuvant candidate for human vaccine.
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Affiliation(s)
- Amin Azimi
- Department of Biotechnology, College of Science, University of Tehran, Tehran, Iran.
| | - Sheida Heidarian
- Department of Microbiology, School of Biology and Center of Excellence in Phylogeny of Living Organisms, College of Science, University of Tehran, Tehran, Iran
| | - Homa Zamani
- Department of Cell Therapy and Hematology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Nastaran Taleghani
- Department of Biotechnology, College of Science, University of Tehran, Tehran, Iran
| | - Mohsen Dehghani
- Department of Biotechnology, College of Science, University of Tehran, Tehran, Iran
| | - Ehsan Seyedjafari
- Department of Biotechnology, College of Science, University of Tehran, Tehran, Iran.
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10
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Cheng L, Wang Y, Du J. Human Papillomavirus Vaccines: An Updated Review. Vaccines (Basel) 2020; 8:vaccines8030391. [PMID: 32708759 PMCID: PMC7565290 DOI: 10.3390/vaccines8030391] [Citation(s) in RCA: 102] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 07/11/2020] [Accepted: 07/14/2020] [Indexed: 12/17/2022] Open
Abstract
Human papillomavirus (HPV) vaccines, which were introduced in many countries in the past decade, have shown promising results in decreasing HPV infection and related diseases, such as warts and precancerous lesions. In this review, we present the updated information about current HPV vaccines, focusing on vaccine coverage and efficacy. In addition, pan-gender vaccination and current clinical trials are also discussed. Currently, more efforts should be put into increasing the vaccine’s coverage, especially in low- and middle-income countries. Provision of education on HPV and vaccination is one of the most important methods to achieve this. Vaccines that target HPV types not included in current vaccines are the next stage in vaccine development. In the future, all HPV-related cancers, such as head and neck cancer, and anal cancer, should be tracked and evaluated, especially in countries that have introduced pan-gender vaccination programs. Therapeutic vaccines, in combination with other cancer treatments, should continue to be investigated.
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Demir M, Ince O, Yilmaz B, Decleer W, Osmanagaoglu K. The effect of human papilloma virus vaccination on embryo yield and clinical in vitro fertilisation outcomes: a matched retrospective cohort study. J OBSTET GYNAECOL 2020; 41:421-427. [PMID: 32662316 DOI: 10.1080/01443615.2020.1739008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The effects of HPV vaccination on embryo yield and pregnancy outcomes in IVF cycles with fresh embryo transfer (ET) were investigated. First, embryo yielding rates (EYR) in 2795 cycles with and without HPV vaccination were compared by retrospective cohort study design. EYR of HPV vaccinated and non-vaccinated patients were not significantly different (OR, 1.66; 95% CI, 0.76-3.63). Second, ET outcomes were compared for 155 HPV vaccine + cycles and 465 HPV vaccine - cycles after matching for ages and cycle attempt number. The differences in the number of retrieved oocytes (10.2 ± 6.1, 11.2 ± 6.7; p = .161), mature (MII) oocytes (8.7 ± 5.7, 9.8 ± 6.3; p = .088), two pronuclear zygotes (2PN) (5.4 ± 4.1, 6.1 ± 4.6; p = .110) and fertilisation rates (0.62 ± 0.23, 0.62 ± 0.23; p = .539) were insignificant between the two groups. Moreover, positive (OR, 0.74; 95% CI, 0.47-1.16), clinical (0.60; 0.36-1.01) and the ongoing pregnancy (0.55; 0.30-1.01) rates were lower in the HPV vaccinated group but the difference was not statistically significant.IMPACT STATEMENTWhat is already known on this subject? There are recent case studies that report premature ovarian insufficiency (POI) following a post-vaccination autoimmune response against the HPV vaccine. These studies suggest that the possible trigger for the immune reaction might be the immunogen content of the vaccine. However, the number of clinical studies investigating the effects of the HPV vaccine on reproductive function and in vitro fertilisation outcomes is limited.What do the results of this study add? In contrast to the case reports suggesting impaired reproductive and ovarian functions in HPV vaccinated patients, this study finds that in IVF patients HPV vaccinated and non-vaccinated women have similar EYR, MII, 2PN, oocyte counts, fertilisation rates, positive, clinical and ongoing pregnancy rates.What are the implications of these findings for clinical practice and/or further research? The results suggest the HPV vaccine does not have a negative impact on embryo yielding rates oocyte counts and fertilisation rates, positive, clinical and ongoing pregnancy rates in IVF treatments. Hence, they can be safely used for primary prevention against cervical cancer.
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Affiliation(s)
- Mustafa Demir
- Department of Obstetrics and Gynecology, Anka Hospital, Gaziantep, Turkey.,IVF Centrum, AZ Jan Palfijn Hospital, Gent, Belgium
| | - Onur Ince
- Department of Obstetrics and Gynecology, Kutahya Health Sciences University, Kutahya, Turkey
| | - Bulent Yilmaz
- Faculty of Medicine, Department of Obstetrics and Gynecology, Recep Tayyip Erdogan University, Rize, Turkey
| | - Wim Decleer
- IVF Centrum, AZ Jan Palfijn Hospital, Gent, Belgium
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Woestenberg PJ, King AJ, van Benthem BHB, Donken R, Leussink S, van der Klis FRM, de Melker HE, van der Sande MAB, Hoebe CJPA, Bogaards JA. Bivalent Vaccine Effectiveness Against Type-Specific HPV Positivity: Evidence for Cross-Protection Against Oncogenic Types Among Dutch STI Clinic Visitors. J Infect Dis 2019; 217:213-222. [PMID: 29140439 PMCID: PMC5853250 DOI: 10.1093/infdis/jix582] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 11/06/2017] [Indexed: 01/11/2023] Open
Abstract
Background Observational postmarketing studies are important to assess vaccine effectiveness (VE). We estimated VE from the bivalent human papillomavirus (HPV) vaccine against HPV positivity of vaccine and nonvaccine types in a high-risk population. Methods We included all vaccine-eligible women from the PASSYON study, a biennial cross-sectional survey in Dutch sexually transmitted infection clinics. Vaginal swabs were analyzed using a polymerase chain reaction-based assay (SPF10-LiPA25) able to detect the 12 high-risk HPV (hrHPV) types 16/18/31/33/35/39/45/51/52/56/58/59. We compared hrHPV positivity between self-reported vaccinated (≥1 dose) and unvaccinated women, and estimated VE by a logistic mixed model. Results We included 1087 women of which 53% were hrHPV positive and 60% reported to be vaccinated. The adjusted pooled VE against HPV-16/18 was 89.9% (81.7%-94.4%). Moreover, we calculated significant VE against nonvaccine types HPV-45 (91%), HPV-35 (57%), HPV-31 (50%), and HPV-52 (37%). Among women who were offered vaccination 5/6 years ago, we estimated similar VE against HPV-16/18 (92%) and all hrHPV types (35%) compared to women who were offered vaccination <5 years ago (83% and 33%, respectively). Conclusion We demonstrated high VE of the bivalent vaccine against HPV-16/18 and cross-protection against HPV-45/35/31/52. Protection against HPV-16/18 was sustained up to 6 years postvaccination.
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Affiliation(s)
- Petra J Woestenberg
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Maastricht University Medical Center, Amsterdam, The Netherlands.,Care and Public Health Research Institute, Maastricht University Medical Center, Amsterdam, The Netherlands
| | - Audrey J King
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Maastricht University Medical Center, Amsterdam, The Netherlands
| | - Birgit H B van Benthem
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Maastricht University Medical Center, Amsterdam, The Netherlands
| | - Robine Donken
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Maastricht University Medical Center, Amsterdam, The Netherlands.,Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands
| | - Suzan Leussink
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Maastricht University Medical Center, Amsterdam, The Netherlands
| | - Fiona R M van der Klis
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Maastricht University Medical Center, Amsterdam, The Netherlands
| | - Hester E de Melker
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Maastricht University Medical Center, Amsterdam, The Netherlands
| | - Marianne A B van der Sande
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Maastricht University Medical Center, Amsterdam, The Netherlands.,Julius Center, University Medical Center Utrecht, The Netherlands.,Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Christian J P A Hoebe
- Care and Public Health Research Institute, Maastricht University Medical Center, Amsterdam, The Netherlands.,Department of Sexual Health, Infectious Diseases and Environment, South Limburg Public Health Service, Geleen
| | - Johannes A Bogaards
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Maastricht University Medical Center, Amsterdam, The Netherlands.,Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
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13
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Geier DA, Kern JK, Geier MR. A cross-sectional study of the relationship between reported human papillomavirus vaccine exposure and the incidence of reported asthma in the United States. SAGE Open Med 2019; 7:2050312118822650. [PMID: 30671241 PMCID: PMC6329017 DOI: 10.1177/2050312118822650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 12/11/2018] [Indexed: 01/30/2023] Open
Abstract
Objectives: Asthma is a chronic disorder that affects persons of all ages impacting the quality of their lives. This cross-sectional hypothesis-testing study evaluated the relationship between human papillomavirus vaccine and the risk of an incident asthma diagnosis in a defined temporal period post-vaccination. Methods: The 2015–2016 National Health and Nutrition Examination Survey data were examined for a group of 60,934,237 weighted persons between 9 and 26 years old in Statistical Analysis Software. Results: Reported incident asthma significantly clustered in the year of reported human papillomavirus vaccination. When the data were separated by gender, the effects observed remained significant for males but not females. Conclusion: The results suggest that human papillomavirus vaccination resulted in an excess of 261,475 asthma cases with an estimated direct excess lifetime cost of such persons being US$42 billion. However, it is unclear what part of the vaccine and/or vaccine medium may have increased an individual’s susceptibility to an asthma episode, whether the asthma diagnosis represented one asthma episode or if it is chronic, and how much therapeutic support was needed (if any) and for how long, which would impact cost. Despite the negative findings in this study, routine vaccination is an important public health tool, and the results observed need to be viewed in this context.
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Affiliation(s)
- David A Geier
- Institute of Chronic Illnesses, Inc., Silver Spring, MD, USA.,CoMeD, Inc., Silver Spring, MD, USA
| | - Janet K Kern
- Institute of Chronic Illnesses, Inc., Silver Spring, MD, USA.,CoMeD, Inc., Silver Spring, MD, USA
| | - Mark R Geier
- Institute of Chronic Illnesses, Inc., Silver Spring, MD, USA.,CoMeD, Inc., Silver Spring, MD, USA
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14
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Adult immunization. Med Lett Drugs Ther 2018; 60:73-82. [PMID: 29746447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Huang LM, Puthanakit T, Cheng-Hsun C, Ren-Bin T, Schwarz T, Pellegrino A, Esposito S, Frenette L, McNeil S, Durando P, Rheault P, Giaquinto C, Horn M, Petry KU, Peters K, Azhar T, Hillemanns P, De Simoni S, Friel D, Pemmaraju S, Hezareh M, Thomas F, Descamps D, Folschweiller N, Struyf F. Sustained Immunogenicity of 2-dose Human Papillomavirus 16/18 AS04-adjuvanted Vaccine Schedules in Girls Aged 9-14 Years: A Randomized Trial. J Infect Dis 2017; 215:1711-1719. [PMID: 28591778 PMCID: PMC5853959 DOI: 10.1093/infdis/jix154] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 04/20/2017] [Indexed: 01/20/2023] Open
Abstract
Background. We previously reported the noninferiority 1 month after the last dose of 2-dose human papillomavirus 16/18 AS04-adjuvanted (AS04-HPV-16/18) vaccine schedules at months 0 and 6 (2D_M0,6) and months 0 and 12 (2D_M0,12) in girls aged 9–14 years compared with a 3-dose schedule at months 0, 1, and 6 (3D_M0,1,6) in women aged 15–25 years. Here, we report the results at study end (month 36 [M36]). Methods. Girls were randomized 1:1 and received 2 vaccine doses either 6 months (2D_M0,6) or 12 months apart (2D_M0,12); women received 3 doses at months 0, 1, and 6 (3D_M0,1,6). Endpoints included noninferiority of HPV-16/18 antibodies for 2D_M0,6 versus 3D_M0,1,6; 2D_M0,12 versus 3D_M0,1,6; and 2D_M0,12 versus 2D_M0,6; and assessment of neutralizing antibodies, T cells, B cells, and safety. Results. At M36, the 2D_M0,6 and 2D_M0,12 schedules remained noninferior to the 3D_M0,1,6 schedule in terms of seroconversion rates and 3D/2D geometric mean titers for anti-HPV-16 and anti-HPV-18. All schedules elicited sustained immune responses up to M36. Conclusions. Both 2-dose schedules in young girls remained noninferior to the 3-dose schedule in women up to study conclusion at M36. The AS04-HPV-16/18 vaccine administered as a 2-dose schedule was immunogenic and well tolerated in young girls.
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Affiliation(s)
- Li-Min Huang
- Department of Pediatrics, National Taiwan University Children's Hospital, National Taiwan University, Taipei
| | - Thanyawee Puthanakit
- Division of Infectious Diseases, Department of Pediatrics, Faculty of Medicine, and Research Unit in Pediatric Infectious Diseases and Vaccines, Chulalongkorn University, Thailand
| | - Chiu Cheng-Hsun
- Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University, Taoyuan
| | - Tang Ren-Bin
- Department of Pediatrics, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Tino Schwarz
- Central Laboratory and Vaccination Centre, Klinikum Würzburg Mitte, Standort Juliusspital, Würzburg
| | - Angelo Pellegrino
- Department Distretto di Dronero, Azienda Sanitaria Locale Cuneo 1, Cuneo
| | - Susanna Esposito
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' GrandaOspedale Maggiore Policlinico, Milan
| | | | - Shelly McNeil
- Canadian Center for Vaccinology, IWK Health Centre and Capital Health, Dalhousie University, Halifax
| | - Paolo Durando
- Department of Health Sciences, University of Genoa and IRCCS AOU San Martino-IST, Genoa
| | | | - Carlo Giaquinto
- Department of Women's and Children's Health, University of Padova, Padua, Italy
| | | | - Karl Ulrich Petry
- Department of Gynaecology and Obstetrics, Klinikum Wolfsburg, Wolfsburg
| | - Klaus Peters
- Facharzt für Frauenheilkunde und Geburtshilfe, Hamburg
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McGhee E, Harper H, Ume A, Baker M, Diarra C, Uyanne J, Afework S, Partlow K, Tran L, Okoro J, Doan A, Tate K, Rouse M, Tyler M, Evans K, Sanchez T, Hasan I, Smith-Joe E, Maniti J, Zarate L, King C, Alugbue A, Opara C, Wissa B, Maniti J, Pattillo R. Elimination of Cancer Health Disparities through the Acceleration of HPV Vaccines and Vaccinations: A Simplified Version of the President's Cancer Panel Report on HPV Vaccinations. ACTA ACUST UNITED AC 2017; 8. [PMID: 28845336 PMCID: PMC5568095 DOI: 10.4172/2157-7560.1000361] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The human papillomavirus (HPV) is a major public health concern affecting
both females and males. HPV is associated with cervical, anal, head and neck
cancers. About 99% of all cervical cancers are related to HPV. HPV
vaccines, Gardasil, Cervarix, and Gardasil 9 are used in the primary prevention
of HPV related cancers. Gardasil and Gardasil 9 are available for use in both
females and males ages 9 to 26, while Cervarix is available for females ages 9
to 25. Gardasil 9 was approved by the FDA for prevention against additional HPV
types. Despite the availability of this preventative measure against cervical
cancer, the rate of HPV vaccination in the United States remains lower than that
of other industrialized nations. The purpose of this study is to elucidate
mechanisms to help increase the HPV vaccination rate by using education as a
tool; by simplifying the president report so that lay person can understand the
information presented in the report. Through the quantitative examination of the
data from the states with the lowest and highest vaccination rates, using SPSS
statistical analysis; we analyzed several factors involved with the low uptake
of the vaccines. The results collected show that socioeconomic status,
misconceptions about HPV, and misconceptions about the safety of the vaccines
were identified as possible obstacles to the effective uptake of HPV
vaccinations. The proposals made by the President’s Cancer Panel to
accelerate the uptake of vaccines include, increasing coverage of the vaccines
through government-sponsored programs, and the Affordable Care Act; increasing
accessibility to vaccines through pharmacies, schools, and clinics; and
disseminating more information on HPV to healthcare providers, parents,
caregivers, and patients. Allowing greater accessibility to the vaccines for all
populations regardless of income, education, and eliminating misconceptions of
the vaccines would play a significant role in eliminating cancer.
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Affiliation(s)
- Eva McGhee
- Department of Internal Medicine, Charles Drew University of Medicine and Science, Los Angeles, USA
| | - Hill Harper
- Department of Internal Medicine, Charles Drew University of Medicine and Science, Los Angeles, USA
| | - Adaku Ume
- Department of Internal Medicine, Charles Drew University of Medicine and Science, Los Angeles, USA
| | - Melanie Baker
- Department of Internal Medicine, Charles Drew University of Medicine and Science, Los Angeles, USA
| | - Cheick Diarra
- Department of Internal Medicine, Charles Drew University of Medicine and Science, Los Angeles, USA
| | - John Uyanne
- Department of Internal Medicine, Charles Drew University of Medicine and Science, Los Angeles, USA
| | - Sebhat Afework
- Department of Internal Medicine, Charles Drew University of Medicine and Science, Los Angeles, USA
| | - Keosha Partlow
- Department of Internal Medicine, Charles Drew University of Medicine and Science, Los Angeles, USA
| | - Lucy Tran
- Department of Internal Medicine, Charles Drew University of Medicine and Science, Los Angeles, USA
| | - Judith Okoro
- Department of Internal Medicine, Charles Drew University of Medicine and Science, Los Angeles, USA
| | - Anh Doan
- Department of Internal Medicine, Charles Drew University of Medicine and Science, Los Angeles, USA
| | - Karen Tate
- Department of Internal Medicine, Charles Drew University of Medicine and Science, Los Angeles, USA
| | - Mechelle Rouse
- Department of Internal Medicine, Charles Drew University of Medicine and Science, Los Angeles, USA
| | - Meidrah Tyler
- Department of Internal Medicine, Charles Drew University of Medicine and Science, Los Angeles, USA
| | - Kamilah Evans
- Department of Internal Medicine, Charles Drew University of Medicine and Science, Los Angeles, USA
| | - Tonya Sanchez
- Department of Internal Medicine, Charles Drew University of Medicine and Science, Los Angeles, USA
| | - Ishmum Hasan
- Department of Internal Medicine, Charles Drew University of Medicine and Science, Los Angeles, USA
| | - Enijah Smith-Joe
- Department of Internal Medicine, Charles Drew University of Medicine and Science, Los Angeles, USA
| | - Jasmine Maniti
- Department of Internal Medicine, Charles Drew University of Medicine and Science, Los Angeles, USA
| | - Liliana Zarate
- Department of Internal Medicine, Charles Drew University of Medicine and Science, Los Angeles, USA
| | - Camille King
- Department of Internal Medicine, Charles Drew University of Medicine and Science, Los Angeles, USA
| | - Antoinette Alugbue
- Department of Internal Medicine, Charles Drew University of Medicine and Science, Los Angeles, USA
| | - Chiamaka Opara
- Department of Internal Medicine, Charles Drew University of Medicine and Science, Los Angeles, USA
| | - Bileko Wissa
- Department of Internal Medicine, Charles Drew University of Medicine and Science, Los Angeles, USA
| | - Joanne Maniti
- Department of Internal Medicine, Charles Drew University of Medicine and Science, Los Angeles, USA
| | - Roland Pattillo
- Department of Internal Medicine, Charles Drew University of Medicine and Science, Los Angeles, USA
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17
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Harper DM, DeMars LR. HPV vaccines - A review of the first decade. Gynecol Oncol 2017; 146:196-204. [PMID: 28442134 DOI: 10.1016/j.ygyno.2017.04.004] [Citation(s) in RCA: 249] [Impact Index Per Article: 35.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Revised: 04/03/2017] [Accepted: 04/06/2017] [Indexed: 02/01/2023]
Abstract
Pre-adolescent girls (9-15years) have the option of receiving a two dose HPV vaccine series at either a six month or one year interval to provide protection from HPV 16, the most prevalent type associated with cervical cancers, as well as several other less prevalent types. This series of vaccinations is highly likely to protect her from HPV infection until she enters the routine screening program, whether that be primary HPV testing or a combination of HPV testing and cytology. The two dose program has been recommended by the World Health Organization (WHO) since 2015. For women 15years and older, the three dose vaccine schedule is still recommended. The past ten years of Gardasil use has provided evidence of reduced HPV 16/18 infections in countries where there has been high coverage. Gardasil9 has replaced Gardasil. Gardasil9 has the same rapid anti-HPV 18 and HPV45 titer loss as Gardasil did. Cervarix remains equivalent to Gardasil9 in the prevention of HPV infections and precancers of any HPV type; Cervarix also has demonstrated sustained high antibody titers for at least 10years. One dose of Cervarix provides protection against HPV 16/18 infection with robust antibody titers well above natural infection titers. This may offer the easiest and most cost effective vaccination program over time, especially in low and lower middle income countries. Cervical cancer screening must continue to control cancer incidence over the upcoming decades. Future studies of prophylactic HPV vaccines, as defined by the WHO, must demonstrate protection against six month type specific persistent infections, not actual cervical cancer precursor disease endpoints, such as cervical intraepithelial neoplasia grade 3 (CIN 3) or adenocarcinoma in situ (AIS). This simplifies and makes less expensive future comparative studies between existing and new generic vaccines.
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Affiliation(s)
- Diane M Harper
- School of Medicine, Departments of Family and Geriatric Medicine and Obstetrics and Gynecology, Speed School of Engineering, School of Public Health, Epidemiology and Population Health, Health Promotion and Behavioral Sciences, University of Louisville, Louisville, KY, United States.
| | - Leslie R DeMars
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
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18
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Kolben TM, Dannecker C, Baltateanu K, Goess C, Starrach T, Semmlinger A, Ditsch N, Gallwas J, Mahner S, Friese K, Kolben T. HPV Vaccination: Attitude and Knowledge among German Gynecologists. Geburtshilfe Frauenheilkd 2016; 76:1074-1080. [PMID: 27761028 PMCID: PMC5065419 DOI: 10.1055/s-0042-112813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 07/17/2016] [Accepted: 07/18/2016] [Indexed: 10/20/2022] Open
Abstract
Purpose: In order to achieve a higher vaccination rate, education on HPV as well as options for prophylaxis performed by doctors is of great importance. One opportunity to increase the protection against HPV would be vaccinating boys. This study evaluated attitude and knowledge among German gynecologists regarding HPV vaccination, especially in boys. Material and Methods: A questionnaire with 42 questions about demographics, attitude and knowledge about HPV and HPV vaccination was sent to members of the German Society for Gynecology and Obstetrics (DGGG). Results: 998 out of 6567 addressed gynecologists participated. Knowledge about HPV, associated diseases and possible HPV vaccines was high among participants. The attitude towards vaccination in boys as well as girls was positive. Only 8.2 % refused to vaccinate their sons whereas 2.2 % refused to do this for their daughters. However, only few gynecologists vaccinated their daughters and sons against HPV. Main reason for girls was an age outside of vaccination guidelines; for boys it was the lack of cost coverage. Conclusion: The willingness of gynecologists to perform HPV vaccination in boys is as high as for girls. However, sons of gynecologists are only rarely vaccinated against HPV. Main reason is the lack of cost coverage. Vaccinating boys could decrease the disease burden in males, as well as protect women by interrupting ways of transmission. Since the main argument against vaccination of boys is only of financial nature, the necessity of a vaccination recommendation for boys needs to be re-evaluated taking into account the cost-reduced 2-dose vaccination scheme.
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Affiliation(s)
- T. M. Kolben
- Department for Obstetrics and Gynecology, University Hospital of Munich, Ludwig-Maximilians-University, Munich, Germany
| | - C. Dannecker
- Department for Obstetrics and Gynecology, University Hospital of Munich, Ludwig-Maximilians-University, Munich, Germany
| | - K. Baltateanu
- Department for Obstetrics and Gynecology, University Hospital of Munich, Ludwig-Maximilians-University, Munich, Germany
| | - C. Goess
- Department for Obstetrics and Gynecology, University Hospital of Munich, Ludwig-Maximilians-University, Munich, Germany
| | - T. Starrach
- Department for Obstetrics and Gynecology, University Hospital of Munich, Ludwig-Maximilians-University, Munich, Germany
| | - A. Semmlinger
- Department for Obstetrics and Gynecology, University Hospital of Munich, Ludwig-Maximilians-University, Munich, Germany
| | - N. Ditsch
- Department for Obstetrics and Gynecology, University Hospital of Munich, Ludwig-Maximilians-University, Munich, Germany
| | - J. Gallwas
- Department for Obstetrics and Gynecology, University Hospital of Munich, Ludwig-Maximilians-University, Munich, Germany
| | - S. Mahner
- Department for Obstetrics and Gynecology, University Hospital of Munich, Ludwig-Maximilians-University, Munich, Germany
| | - K. Friese
- Department for Obstetrics and Gynecology, University Hospital of Munich, Ludwig-Maximilians-University, Munich, Germany
| | - T. Kolben
- Department for Obstetrics and Gynecology, University Hospital of Munich, Ludwig-Maximilians-University, Munich, Germany
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19
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Maleki Z. Human papilloma virus vaccination: Review article and an update. World J Obstet Gynecol 2016; 5:16-27. [DOI: 10.5317/wjog.v5.i1.16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 11/07/2015] [Accepted: 01/04/2016] [Indexed: 02/05/2023] Open
Abstract
Human papilloma virus (HPV) is sexually transmitted and associated with uterine cervix, vaginal, and vulvar cancers in females, oropharyngeal and anal cancer in both genders, and penile cancer in males. Moreover, genital warts are benign tumors which are HPV-related and can occur in both genders. This is a review of HPV structure, HPV infection transmission, the global impact of HPV and its associated diseases, HPV vaccines and their efficacy and safety, public acceptance of HPV vaccines, the obstacles for its acceptance and strategies to address the barriers. Cervarix (a bivalent vaccine with protection against HPV types 16 and 18) and Gardasil (a quadrivalent vaccine with protection against HPV types 6, 11, 16 and 18) are 2 recommended vaccines. The longest follow up of 9.4 years has shown efficacy and protection of the vaccine against HPV types 16 and 18. The adverse effects have been minimal and the vaccine is considered safe. Numerous studies are conducted to follow the vaccinated individuals to better understand the effect of HPV vaccine on incidence of HPV-related cancers and precancerous lesions.
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20
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Handler NS, Handler MZ, Majewski S, Schwartz RA. Human papillomavirus vaccine trials and tribulations: Vaccine efficacy. J Am Acad Dermatol 2016; 73:759-67; quiz 767-8. [PMID: 26475535 DOI: 10.1016/j.jaad.2015.05.041] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 04/27/2015] [Accepted: 05/14/2015] [Indexed: 11/19/2022]
Abstract
As of December 2014, there were 3 approved vaccines for human papillomavirus (HPV): bivalent Cervarix (GlaxoSmithKline, New York, NY), quadrivalent Gardasil (Merck and Co, Kenilworth, NJ), and 9-valent Gardasil-9 (Merck and Co). The average cost per dose is $120, with a recommended 3-dose course. The quadrivalent vaccine is the most widely administered worldwide. As with the bivalent and 9-valent vaccines, the vaccine is considered safe, although concerns have been raised. In addition to immunization against the targeted HPV types, there is evidence that there is cross protection against other types of HPV. This continuing medical education review evaluates the differences in vaccines that are currently on the market; part II focuses on the cost-effectiveness of vaccination, the HPV vaccination programs currently instituted around the globe, efficacy, and safety.
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Affiliation(s)
- Nancy S Handler
- Dermatology, Rutgers University New Jersey Medical School, Newark, New Jersey; University of Nebraska Medical Center, College of Medicine, Omaha, Nebraska
| | - Marc Z Handler
- Dermatology, Rutgers University New Jersey Medical School, Newark, New Jersey
| | - Slawomir Majewski
- Department of Dermatology and Venereology, Medical University of Warsaw, Warsaw, Poland
| | - Robert A Schwartz
- Dermatology, Rutgers University New Jersey Medical School, Newark, New Jersey; Pathology, Rutgers University New Jersey Medical School, Newark, New Jersey; Pediatrics, Rutgers University New Jersey Medical School, Newark, New Jersey; Medicine, Rutgers University New Jersey Medical School, Newark, New Jersey; Preventive Medicine and Community Health, Rutgers University New Jersey Medical School, Newark, New Jersey.
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21
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Handler MZ, Handler NS, Majewski S, Schwartz RA. Human papillomavirus vaccine trials and tribulations: Clinical perspectives. J Am Acad Dermatol 2016; 73:743-56; quiz 757-8. [PMID: 26475534 DOI: 10.1016/j.jaad.2015.05.040] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 05/20/2015] [Accepted: 05/23/2015] [Indexed: 01/05/2023]
Abstract
Human papillomavirus (HPV) affects hundreds of millions of people worldwide and is associated with both benign and malignant neoplasms in men and women. It is a double-stranded DNA virus with an icosahedral capsid. Forty HPV types are known to infect mucosal keratinocytes. If not cured by the immune system, the infection can lead to genital warts, mucosal dysplasia, or cancer. The most common oncogenic types are 16 and 18. The vaccine to prevent HPV and its associated morbidity and mortality has existed since 2006. Several variations protect against an increasing number of HPV types. The recommended vaccination age is before sexual exposure; administration of the vaccine to children has been controversial. This continuing medical education review evaluates the current HPV vaccines available to clinicians. Part I focuses on the debate over who should be vaccinated, at what age, and in which populations.
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Affiliation(s)
- Marc Z Handler
- Dermatology, Rutgers University New Jersey Medical School, Newark, New Jersey
| | - Nancy S Handler
- Dermatology, Rutgers University New Jersey Medical School, Newark, New Jersey; University of Nebraska Medical Center, College of Medicine, Omaha, Nebraska
| | - Slawomir Majewski
- Department of Dermatology and Venereology, Medical University of Warsaw, Warsaw, Poland
| | - Robert A Schwartz
- Dermatology, Rutgers University New Jersey Medical School, Newark, New Jersey; Pathology, Rutgers University New Jersey Medical School, Newark, New Jersey; Pediatrics, Rutgers University New Jersey Medical School, Newark, New Jersey; Preventive Medicine and Community Health, Rutgers University New Jersey Medical School, Newark, New Jersey; School of Public Affairs and Administration, Rutgers University, Newark, New Jersey.
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22
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Schwarz TM, Honsberg T, Stephan N, Dannecker C, Gallwas J, Crispin A, Weißenbacher ER, Kolben T. HPV vaccination: acceptance and influencing factors among young men in Germany. Future Microbiol 2015; 11:227-34. [PMID: 26673226 DOI: 10.2217/fmb.15.132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIMS This study aims to determine the factors that influence the acceptance of the HPV vaccination among German males. PATIENT & METHODS In 2014, we conducted a population-based cross-sectional study in men aged 15-25 years. A questionnaire was mailed to male trainees of the Bayerische Motorenwerke AG (BMW) insured at the BMW health insurance company. RESULTS The response rate was 10.8%. Of the 378 included men, 74.1% would agree to receive HPV vaccination. Most men primarily consult their physician for health-related topics, but 92.9% had never been informed about HPV infection, risk factors and prevention methods by their doctor. CONCLUSION Our results demonstrate a high acceptance of male HPV vaccination. Education about HPV infection is low and should be intensified by medical professionals.
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Affiliation(s)
- Theresa Maria Schwarz
- Department for Obstetrics and Gynecology, University Hospital Munich, Grosshadern, Ludwig-Maximilians-University, Munich, Germany
| | - Thomas Honsberg
- Department for Obstetrics and Gynecology, University Hospital Munich, Grosshadern, Ludwig-Maximilians-University, Munich, Germany
| | - Nicolas Stephan
- INSEAD - The Business School for the World, Boulevard de Constance, 77300 Fontainebleau, France
| | - Christian Dannecker
- Department for Obstetrics and Gynecology, University Hospital Munich, Grosshadern, Ludwig-Maximilians-University, Munich, Germany
| | - Julia Gallwas
- Department for Obstetrics and Gynecology, University Hospital Munich, Grosshadern, Ludwig-Maximilians-University, Munich, Germany
| | - Alexander Crispin
- Department of Medical Informatics, Biometry and Epidemiology, University of Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Ernst-Rainer Weißenbacher
- Department for Obstetrics and Gynecology, University Hospital Munich, Grosshadern, Ludwig-Maximilians-University, Munich, Germany
| | - Thomas Kolben
- Department for Obstetrics and Gynecology, University Hospital Munich, Grosshadern, Ludwig-Maximilians-University, Munich, Germany
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Kash N, Lee MA, Kollipara R, Downing C, Guidry J, Tyring SK. Safety and Efficacy Data on Vaccines and Immunization to Human Papillomavirus. J Clin Med 2015; 4:614-33. [PMID: 26239350 DOI: 10.3390/jcm4040614] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 02/09/2015] [Accepted: 02/17/2015] [Indexed: 12/21/2022] Open
Abstract
Since the discovery of the causal association between human papillomavirus (HPV) and cervical cancer, efforts to develop an effective prophylactic vaccine to prevent high-risk HPV infections have been at the forefront of modern medical research. HPV causes 530,000 cervical cancer cases worldwide, which is the second most common cause of cancer deaths in women; a worldwide collaboration among epidemiologists, molecular biologists, vaccinologists, virologists, and clinicians helped lead to the development of two highly effective prophylactive HPV vaccines. The first, Gardasil, is a quadrivalent vaccine made up of recombinant HPV L1 capsid proteins from the two high-risk HPV types (16/18) responsible for 70% of cervical cancer cases as well as two low-risk HPV types (6/11) which are the causative agent for genital warts. The second, Cervarix, is a bivalent vaccine that was FDA approved three years after Gardasil and is also composed of L1 capsid proteins from HPV types 16/18. This review article focuses on the safety and efficacy data of both FDA-approved vaccines, as well as highlighting a few advances in future HPV vaccines that show promise in becoming additional treatment options for this worldwide disease.
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24
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Kram YA, Schmidt TH, Saghezchi S, Russell MD. Attitudes toward Human Papilloma Virus Vaccination and Head and Neck Cancer Prevention in a Diverse, Urban Population. Otolaryngol Head Neck Surg 2015; 153:538-43. [PMID: 25779468 DOI: 10.1177/0194599815574821] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 02/05/2015] [Indexed: 11/15/2022]
Abstract
OBJECTIVE (1) To understand if awareness of the human papilloma virus (HPV) vaccination's potential to prevent head and neck cancer improves acceptability of the vaccine in a large urban population and (2) to identify characteristics of those in whom such discussions would have the greatest impact. STUDY DESIGN In-person, anonymous survey. SETTING Academic public hospital between March 2014 and June 2014. SUBJECTS Patients aged 12 to 24 years and their parents or guardians awaiting scheduled outpatient pediatric appointments. METHODS Demographics and modified Carolina HPV Immunization Attitudes and Beliefs Scales data were cross-analyzed, followed by univariate binomial logistic regression to identify predictors for major outcomes of interest. RESULTS More than 78% of those surveyed indicated they would be more receptive to the HPV vaccine if given strong evidence that it prevented head and neck cancer. Respondents were more likely to increase receptivity to HPV vaccination if they held the belief that they did not have enough information about the vaccine or indicated they preferred to wait because the vaccine was too new. CONCLUSION Increasing public awareness of head and neck cancer prevention with HPV vaccination could increase HPV vaccination acceptance.
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Affiliation(s)
- Yoseph A Kram
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA University of California, San Francisco School of Medicine, San Francisco, California, USA
| | - Timothy H Schmidt
- University of California, San Francisco School of Medicine, San Francisco, California, USA
| | - Sohail Saghezchi
- University of California, San Francisco School of Medicine, San Francisco, California, USA Department of Oral & Maxillofacial Surgery, University of California, San Francisco, California, USA
| | - Marika D Russell
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA
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25
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Toft L, Tolstrup M, Müller M, Sehr P, Bonde J, Storgaard M, Østergaard L, Søgaard OS. Comparison of the immunogenicity of Cervarix® and Gardasil® human papillomavirus vaccines for oncogenic non-vaccine serotypes HPV-31, HPV-33, and HPV-45 in HIV-infected adults. Hum Vaccin Immunother 2014; 10:1147-54. [PMID: 24553190 DOI: 10.4161/hv.27925] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Individuals infected with human immunodeficiency virus (HIV) have excess risk of developing human papillomavirus (HPV)-related disease. A substantial fraction of HPV-associated cancers is caused by HPV serotypes not included in the currently available vaccines. Among healthy women, both Cervarix(®) (HPV-16/18, GlaxoSmithKline Biologicals, GSK) and Gardasil(®) (HPV-6/11/16/18, Merck) have demonstrated partial cross-protection against certain oncogenic non-vaccine HPV-types. Currently, there are no available data on vaccine-induced cross-protection in men and little is known about cross-reactive immunity after HPV-vaccination of HIV-infected individuals. In an investigator-initiated trial, we randomized 91 HIV-positive men and women to receive vaccination with Cervarix(®) or Gardasil(®). The HPV-DNA status of the participants was determined with pcr before and after immunization. Cross-reactive antibody responses against HPV-31, HPV-33, and HPV-45 were evaluated for up to 12 months using a pseudovirion-based neutralization assay (PBNA). Geometric mean antibody titers (GMTs) were compared among vaccine groups and genders at 7 and 12 months.: Both vaccines induced anti-HPV-31, -33, and -45 neutralizing antibodies in participants who were seronegative and HPV-DNA negative for those types at study entry. Geometric mean antibody titers were comparable between vaccine groups. Interestingly, anti-HPV-31 and -33 antibody titers were higher among women compared with men at 7 and 12 months.: In conclusion, both licensed HPV-vaccines induced cross-neutralizing antibodies against frequent oncogenic non-vaccine serotypes HPV-31, HPV-33, and HPV-45 in HIV-infected adults, and women had greater serological responses against HPV-31 and -33 compared with men.
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Affiliation(s)
- Lars Toft
- Department of Infectious Diseases; Aarhus University Hospital; Aarhus, Denmark
| | - Martin Tolstrup
- Department of Infectious Diseases; Aarhus University Hospital; Aarhus, Denmark
| | - Martin Müller
- Research Program Infection and Cancer; German Cancer Research Center; Heidelberg, Germany
| | - Peter Sehr
- Chemical Biology Core Facility; European Molecular Biology Laboratory; Heidelberg, Germany
| | - Jesper Bonde
- Department of Pathology; Copenhagen University Hospital; Hvidovre, Denmark; Clinical Research Centre; Copenhagen University Hospital; Hvidovre, Denmark
| | - Merete Storgaard
- Department of Infectious Diseases; Aarhus University Hospital; Aarhus, Denmark
| | - Lars Østergaard
- Department of Infectious Diseases; Aarhus University Hospital; Aarhus, Denmark
| | - Ole S Søgaard
- Department of Infectious Diseases; Aarhus University Hospital; Aarhus, Denmark
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Toft L, Storgaard M, Müller M, Sehr P, Bonde J, Tolstrup M, Østergaard L, Søgaard OS. Comparison of the immunogenicity and reactogenicity of Cervarix and Gardasil human papillomavirus vaccines in HIV-infected adults: a randomized, double-blind clinical trial. J Infect Dis 2013; 209:1165-73. [PMID: 24273179 DOI: 10.1093/infdis/jit657] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND We compared the immunogenicity and reactogenicity of Cervarix or Gardasil human papillomavirus (HPV) vaccines in adults infected with the human immunodeficiency virus (HIV). METHODS This was a double-blind, controlled trial randomizing HIV-positive adults to receive 3 doses of Cervarix or Gardasil at 0, 1.5, and 6 months. Immunogenicity was evaluated for up to 12 months. Neutralizing anti-HPV-16/18 antibodies were measured by pseudovirion-based neutralization assay. Laboratory tests and diary cards were used for safety assessment. The HPV-DNA status of the participants was determined before and after immunization. RESULTS Ninety-two participants were included in the study. Anti-HPV-18 antibody titers were higher in the Cervarix group compared with the Gardasil group at 7 and 12 months. No significant differences in anti-HPV-16 antibody titers were found among vaccine groups. Among Cervarix vaccinees, women had higher anti-HPV-16/18 antibody titers compared to men. No sex-specific differences in antibody titers were found in the Gardasil group. Mild injection site reactions were more common in the Cervarix group than in the Gardasil group (91.1% vs 69.6%; P = .02). No serious adverse events occurred. CONCLUSIONS Both vaccines were immunogenic and well tolerated. Compared with Gardasil, Cervarix induced superior vaccine responses among HIV-infected women, whereas in HIV-infected men the difference in immunogenicity was less pronounced.
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Affiliation(s)
- Lars Toft
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
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Howell-Jones R, Soldan K, Wetten S, Mesher D, Williams T, Gill ON, Hughes G. Declining genital Warts in young women in england associated with HPV 16/18 vaccination: an ecological study. J Infect Dis 2013; 208:1397-403. [PMID: 24092908 PMCID: PMC3789575 DOI: 10.1093/infdis/jit361] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background. Diagnoses of genital warts (GW) in genitourinary medicine (GUM) clinics have been increasing in England for many years. In 2008, an HPV immunization program began with a bivalent vaccine (Cervarix). This was expected to markedly reduce infections and disease due to human papillomavirus (HPV) 16/18 but not HPV 6/11 infections or disease. However, from 2009 to 2011 there were decreases in reported diagnoses of GW in young females at GUM clinics. Methods. Using data from GUM clinics and a sample of general practices (GPs) throughout England, we analyzed rates of GW diagnoses by age, year of diagnosis, and estimated immunization coverage. Results. The overall reduction in GW diagnoses at GUM clinics between 2008 and 2011 was 13.3% among 16- to 19-year-old females, with the greatest decline of 20.8% in 17-year-olds. Declines were positively associated with estimated immunization coverage. A similar pattern was seen in GP diagnoses, but not among older women, and for other GUM consultations. Conclusions. Several factors might contribute to declines in GW. However, the size and pattern of the declines strongly suggest that we are observing an unexpected, moderately protective effect of HPV 16/18 vaccination against GW.
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Mesher D, Soldan K, Howell-Jones R, Panwar K, Manyenga P, Jit M, Beddows S, Gill ON. Reduction in HPV 16/18 prevalence in sexually active young women following the introduction of HPV immunisation in England. Vaccine 2013; 32:26-32. [PMID: 24211166 PMCID: PMC3898718 DOI: 10.1016/j.vaccine.2013.10.085] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 10/21/2013] [Accepted: 10/24/2013] [Indexed: 12/12/2022]
Abstract
We monitor HPV infection in sexually active young women in England. The prevalence of HPV 16/18 has reduced within 3 years of HPV immunisation. Reductions in HPV 16/18 were greatest at ages with highest immunisation coverage. The data suggest reductions in HPV 16/18 amongst unvaccinated young women and men.
Background Reduction in the prevalence of vaccine type HPV infection in young women is an early indication of the impact of the HPV immunisation programme and a necessary outcome if the subsequent impact on cervical cancer is to be realised. Methods Residual vulva-vaginal swab (VVS) specimens from young women aged 16–24 years undergoing chlamydia screening in community sexual health services (formerly known as family planning clinics), general practice (GP), and youth clinics in 2010–2012 were submitted from 10 laboratories in seven regions around England. These specimens were linked to demographic and sexual behaviour data reported with the chlamydia test, anonymised, and tested for type-specific HPV DNA using a multiplex PCR and Luminex-based genotyping test. Estimated immunisation coverage was calculated and findings were compared to a baseline survey conducted prior to the introduction of HPV immunisation in 2008. Results A total of 4664 eligible specimens were collected and 4178 had a valid test result. The post-immunisation prevalence of HPV 16/18 infection was lowest in this youngest age group (16–18 years) and increased with age. This increase with age was a reversal of the pattern seen prior to immunisation and was inversely associated with estimates of age-specific immunisation coverage (65% for 16–18 year olds). The prevalence of HPV 16/18 infection in the post-immunisation survey was 6.5% amongst 16–18 year olds, compared to 19.1% in the similar survey conducted prior to the introduction of HPV immunisation. Conclusions These findings are the first indication that the national HPV immunisation programme is successfully preventing HPV 16/18 infection in sexually active young women in England. The reductions seen suggest, for the estimated coverage, high vaccine effectiveness and some herd-protection benefits. Continued surveillance is needed to determine the effects of immunisation on non-vaccine HPV types.
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Affiliation(s)
- D Mesher
- Public Health England, HIV & STI Department, 61 Colindale Avenue, London NW9 5EQ, UK.
| | - K Soldan
- Public Health England, HIV & STI Department, 61 Colindale Avenue, London NW9 5EQ, UK
| | - R Howell-Jones
- Public Health England, HIV & STI Department, 61 Colindale Avenue, London NW9 5EQ, UK
| | - K Panwar
- Public Health England, Virus Reference Department, 61 Colindale Avenue, London NW9 5EQ, UK
| | - P Manyenga
- Public Health England, Virus Reference Department, 61 Colindale Avenue, London NW9 5EQ, UK
| | - M Jit
- Public Health England, Statistics and Modelling Economics Department, 61 Colindale Avenue, London NW9 5EQ, UK
| | - S Beddows
- Public Health England, Virus Reference Department, 61 Colindale Avenue, London NW9 5EQ, UK
| | - O N Gill
- Public Health England, HIV & STI Department, 61 Colindale Avenue, London NW9 5EQ, UK
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Monie A, Hung CF, Roden R, Wu TC. Cervarix: a vaccine for the prevention of HPV 16, 18-associated cervical cancer. Biologics 2008; 2:97-105. [PMID: 19707432 PMCID: PMC2727782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Cervical cancer continues to be the second largest cause of cancer deaths in women worldwide. Persistent infection with high-risk types of human papillomavirus (HPV) is a necessary cause of cervical cancer. Thus, prophylactic vaccination against HPV is an attractive strategy to prevent cervical cancer. Current strategies for the development of safe and effective preventive vaccines are based on the induction of neutralizing antibodies against the major capsid protein, L1 of HPV. Cervarix() is one of the preventive HPV vaccines that has been approved in the Europe and Australia and is currently under review by the US Food and Drug Administration. Cervarix is composed of HPV16 and HPV18 L1 virus-like particles (VLPs) formulated in ASO4 adjuvant. Vaccination with Cervarix has been shown to protect women against a high proportion of precursor lesions of cervical cancer caused by these two HPV types. This review explores the various features of this new vaccine candidate and discusses the future directions in the field of HPV vaccine development.
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Affiliation(s)
| | - Chien-Fu Hung
- Departments of Pathology, Obstetrics and Gynecology
| | - Richard Roden
- Departments of Pathology, Obstetrics and Gynecology, Oncology
| | - T-C Wu
- Departments of Pathology, Obstetrics and Gynecology, Molecular Microbiology and Immunology, Oncology,Correspondence: T-C Wu, Department of Pathology, Johns Hopkins Hospital, CRB II Room 309, 1550 Orleans Street, Baltimore, Maryland 21231, USA, Tel +1 410 614 3899, Fax +1 443 287 4295, Email
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