Bivalent Human Papillomavirus Vaccine Effectiveness in a Japanese Population: High Vaccine-TypeSpecific Effectiveness and Evidence of Cross-Protection
Bivalent Human Papillomavirus Vaccine Effectiveness in a Japanese Population: High Vaccine-TypeSpecific Effectiveness and Evidence of Cross-Protection
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DOI：
10.1093/infdis/jiy516
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发表时间：
2019-02-01
影响因子：
6.4
通讯作者：
Enomoto, Takayuki
中科院分区：
文献类型：
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作者：
Kudo, Risa;Yamaguchi, Manako;Enomoto, Takayuki
背景资料。出于安全考虑，日本对人乳头瘤病毒(HPV)疫苗的积极建议已暂停5年。虽然没有科学证据证实这些担忧，但没有恢复建议的一个原因是在日本人口中缺乏可靠的疫苗有效性(VE)数据。这项研究报告了2022岁日本女性接种双价HPV疫苗的VE情况。在2014至2016年间的宫颈筛查期间，女性进行了巴氏涂片和HPV检测，并提供了有关她们性史的数据。计算了疫苗靶向HPV16型和18型(HPV16型和18型)的VE估计值以及对其他类型的交叉保护。总共测试了2197名女性，其中1814人被纳入分析。其中，1355人(74.6%)接种了疫苗，1295人(95.5%)完成了三剂计划。在接种性幼稚的女性中，HPV16和18以及HPV31、45和52的总感染率分别为95.5%(P<0.01)和71.9%(P<；0.01)。在调整了性伴数量和出生年份后，HPV16、18和HPV31、45、52的混合VE分别为93.9%(P=.01)和67.7%(P=.01)。双价HPV疫苗对HPV16和18高效。此外，对HPV31、45和52有显著的交叉保护作用，并持续到接种后6年。这些发现应该会让政客们对二价HPV疫苗在日本人群中的VE放心。日本对人乳头状瘤病毒(HPV)疫苗的主动建议已被搁置。在这项研究中，双价HPV疫苗对HPV16型和18型高效，对HPV31、45和52型有显著的交叉保护作用。这些发现应该会让政客们放心，疫苗在日本人群中是有效的。
Background. Proactive recommendations for human papillomavirus (HPV) vaccines in Japan have been suspended for 5 years because of safety concerns. While no scientific evidence exists to substantiate these concerns, one reason given for not reinstating recommendations is the lack of reliable vaccine effectiveness (VE) data in a Japanese population. This study reports the VE of the bivalent HPV vaccine in Japanese women aged 2022 years.During cervical screening between 2014 and 2016, women had Papanicolaou smears and HPV tests performed and provided data about their sexual history. Estimates of VE for vaccine-targeted HPV type 16 (HPV16) and 18 and cross-protection against other types were calculated.Overall, 2197 women were tested, and 1814 were included in the analysis. Of these, 1355 (74.6%) were vaccinated, and 1295 (95.5%) completed the 3-dose schedule. In women sexually naive at vaccination, the pooled VEs against HPV16 and 18 and for HPV31, 45, and 52 were 95.5% (P < .01) and 71.9% (P < .01), respectively. When adjusted for number of sex partners and birth year, pooled VEs were 93.9% (P = .01) and 67.7% (P = .01) for HPV16 and 18 and HPV31, 45, and 52, respectively.The bivalent HPV vaccine is highly effective against HPV16 and 18. Furthermore, significant cross-protection against HPV31, 45, and 52 was demonstrated and sustained up to 6 years after vaccination. These findings should reassure politicians about the VE of bivalent HPV vaccine in a Japanese population.Proactive recommendations for human papillomavirus (HPV) vaccines in Japan have been suspended. In this study, bivalent HPV vaccine is highly effective against HPV types 16 (HPV16) and 18, and significant cross-protection against HPV31, 45, and 52 was demonstrated. These findings should reassure politicians of vaccine effectiveness in a Japanese population.