Reduction in Human Papillomavirus (HPV) Prevalence Among Young Women Following HPV Vaccine Introduction in the United States, National Health and Nutrition Examination Surveys, 2003-2010
Reduction in Human Papillomavirus (HPV) Prevalence Among Young Women Following HPV Vaccine Introduction in the United States, National Health and Nutrition Examination Surveys, 2003-2010
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DOI：
10.1093/infdis/jit192
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发表时间：
2013-08-01
影响因子：
6.4
通讯作者：
Unger, Elizabeth R.
中科院分区：
文献类型：
--
作者：
Markowitz, Lauri E.;Hariri, Susan;Unger, Elizabeth R.
背景2006年底，美国将人乳头瘤病毒（HPV）疫苗接种纳入11或12岁女性的常规免疫接种计划，并建议13-26岁的女性进行追加接种。2010年，13-17岁儿童的3剂疫苗覆盖率仅为32%。四价疫苗靶向的HPV类型（HPV-6、-11、-16和-18）的流行率的降低将是疫苗影响的首要措施之一。我们分析了疫苗时代（2007-2010年）和疫苗前时代（2003-2006年）的HPV流行率数据，这些数据是在国家健康和营养检查调查期间收集的。HPV感染率通过线性阵列HPV检测法测定14-59岁女性宫颈阴道拭子样本; 2003-2006年提供了4150份样本，2007- 2010年提供了4253份样本。在14-19岁的女性中，（HPV-6、-11、-16或-18）从11.5%（95%置信区间[CI]，9.2-14.4）降至2007-2010年的5.1%（95% CI，3.8-6.6），下降了56%（95% CI，38-69）。在其他年龄组中，患病率在两个时间段之间没有显著差异（P > 0.05）。至少1剂疫苗的有效率为82%（95%CI，53-93）。结论。在疫苗引入的4年内，尽管疫苗接种率较低，但14-19岁女性的疫苗型HPV患病率有所下降。估计疫苗的有效性很高。
Background. Human papillomavirus (HPV) vaccination was introduced into the routine immunization schedule in the United States in late 2006 for females aged 11 or 12 years, with catch-up vaccination recommended for those aged 13-26 years. In 2010, 3-dose vaccine coverage was only 32% among 13-17 year-olds. Reduction in the prevalence of HPV types targeted by the quadrivalent vaccine (HPV-6, -11, -16, and -18) will be one of the first measures of vaccine impact.Methods. We analyzed HPV prevalence data from the vaccine era (2007-2010) and the prevaccine era (2003-2006) that were collected during National Health and Nutrition Examination Surveys. HPV prevalence was determined by the Linear Array HPV Assay in cervicovaginal swab samples from females aged 14-59 years; 4150 provided samples in 2003-2006, and 4253 provided samples in 2007-2010.Results. Among females aged 14-19 years, the vaccine-type HPV prevalence (HPV-6, -11, -16, or -18) decreased from 11.5% (95% confidence interval [CI], 9.2-14.4) in 2003-2006 to 5.1% (95% CI, 3.8-6.6) in 2007-2010, a decline of 56% (95% CI, 38-69). Among other age groups, the prevalence did not differ significantly between the 2 time periods (P > .05). The vaccine effectiveness of at least 1 dose was 82% (95% CI, 53-93).Conclusions. Within 4 years of vaccine introduction, the vaccine-type HPV prevalence decreased among females aged 14-19 years despite low vaccine uptake. The estimated vaccine effectiveness was high.