Effectiveness of 1, 2, and 3 Doses of Human Papillomavirus Vaccine Against High-Grade Cervical Lesions Positive for Human Papillomavirus 16 or 18.
Effectiveness of 1, 2, and 3 Doses of Human Papillomavirus Vaccine Against High-Grade Cervical Lesions Positive for Human Papillomavirus 16 or 18.
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DOI：
10.1093/aje/kwz253
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发表时间：
2020-04-02
影响因子：
5
通讯作者：
HPV-IMPACT Working Group
中科院分区：
文献类型：
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作者：
Johnson Jones ML;Gargano JW;Powell M;Park IU;Niccolai LM;Bennett NM;Griffin MR;Querec T;Unger ER;Markowitz LE;HPV-IMPACT Working Group
在2016年之前，人乳头瘤病毒（HPV）疫苗接种建议按3剂接种。然而，许多符合疫苗条件的美国女性接种的疫苗少于3剂，这为评估1剂、2剂和3剂疫苗的实际有效性（VE）提供了机会。我们分析了来自HPV疫苗影响监测项目（HPV- Impact; 2008-2014）的宫颈上皮内瘤变（CIN） 2-3级和原位腺癌（指定为CIN2+）的数据。对CIN2+病变的存档组织进行37种HPV检测。根据CIN2+检测前≥24个月接受的剂量数对妇女进行分类。使用阴性试验设计，VE估计为1减去从逻辑回归模型调整的优势比，该模型比较HPV-16/18病变检测阳性的妇女（疫苗型病例）与所有其他CIN2+病变的妇女（对照组）的疫苗接种史。在3300名有CIN2+、分型结果和疫苗史数据的妇女中，1561名（47%）为HPV-16/18阳性，136名（4%）接种了1剂HPV疫苗，108名（3%）接种了2剂，325名（10%）接种了3剂。接种1、2和3剂疫苗的校正优势比为0.53(95%可信区间（CI）： 0.37, 0.76；VE = 47%), 0.45 （95% CI: 0.30, 0.69; VE = 55%）和0.26 （95% CI: 0.20, 0.35; VE = 74%）。我们发现接种3剂HPV疫苗后对疫苗型CIN2+有显著的VE，接种1剂或2剂疫苗后VE较低但显著。
Before 2016, human papillomavirus (HPV) vaccination was recommended on a 3-dose schedule. However, many vaccine-eligible US females received fewer than 3 doses, which provided an opportunity to evaluate the real-world vaccine effectiveness (VE) of 1, 2, and 3 doses. We analyzed data on cervical intraepithelial neoplasia (CIN) grades 2–3 and adenocarcinoma in situ (designated CIN2+) from the HPV Vaccine Impact Monitoring Project (HPV-IMPACT; 2008–2014). Archived tissue from CIN2+ lesions was tested for 37 types of HPV. Women were classified by number of doses received ≥24 months before CIN2+ detection. Using a test-negative design, VE was estimated as 1 minus the adjusted odds ratio from a logistic regression model that compared vaccination history for women whose lesions tested positive for HPV-16/18 (vaccine-type cases) with that for women who had all other CIN2+ lesions (controls). Among 3,300 women with available data on CIN2+, typing results, and vaccine history, 1,561 (47%) were HPV-16/18–positive, 136 (4%) received 1 dose of HPV vaccine, 108 (3%) received 2 doses, and 325 (10%) received 3 doses. Adjusted odds ratios for vaccination with 1, 2, and 3 doses were 0.53 (95% confidence interval (CI): 0.37, 0.76; VE = 47%), 0.45 (95% CI: 0.30, 0.69; VE = 55%), and 0.26 (95% CI: 0.20, 0.35; VE = 74%), respectively. We found significant VE against vaccine-type CIN2+ after 3 doses of HPV vaccine and lower but significant VE with 1 or 2 doses.
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DOI：
10.1136/bmj.g1458
发表时间：
2014-03-04
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Crowe E;Pandeya N;Brotherton JM;Dobson AJ;Kisely S;Lambert SB;Whiteman DC
通讯作者：
Whiteman DC
DOI：
10.1093/infdis/jix244
发表时间：
2017-09-01
期刊：
The Journal of infectious diseases
影响因子：
--
作者：
Oliver SE;Unger ER;Lewis R;McDaniel D;Gargano JW;Steinau M;Markowitz LE
通讯作者：
Markowitz LE
影响因子：
3.2
作者：
Brotherton, Julia M. L.;Budd, Alison;Saville, Marion
通讯作者：
Saville, Marion
影响因子：
11.8
作者：
Mesher, David;Soldan, Kate;Thomas, Sara L.
通讯作者：
Thomas, Sara L.
影响因子：
11.8
作者：
Hariri S;Markowitz LE;Bennett NM;Niccolai LM;Schafer S;Bloch K;Park IU;Scahill MW;Julian P;Abdullah N;Levine D;Whitney E;Unger ER;Steinau M;Bauer HM;Meek J;Hadler J;Sosa L;Powell SE;Johnson ML;Hpv-Impact Working Group
通讯作者：
Hpv-Impact Working Group