TY - JOUR
T1 - Risk of delayed human papillomavirus vaccination in inner-city adolescent women
AU - Schlecht, Nicolas F.
AU - Diaz, Angela
AU - Shankar, Viswanathan
AU - Szporn, Arnold H.
AU - Wu, Maoxin
AU - Nucci-Sack, Anne
AU - Peake, Ken
AU - Strickler, Howard D.
AU - Burk, Robert D.
N1 - Publisher Copyright:
© The Author 2016.
PY - 2016/12/1
Y1 - 2016/12/1
N2 - Background. Uptake of human papillomavirus (HPV) vaccine in the United States is slow, and the effectiveness of the vaccine has not been assessed in high-risk adolescent populations. Methods. We conducted a longitudinal study of 1139 sexually active, inner-city adolescent women receiving the 3-dose quadrivalent (4vHPV) vaccine. Cervical and anal specimens collected semiannually were tested using an L1-specific polymerase chain reaction assay. Postvaccination incidence of 4vHPV vaccine and nonvaccine HPV types, and risk of cervical cytological abnormalities, were assessed in relation to time to completion of all 3 vaccine doses. Results. Compared to vaccine naive women at enrollment, vaccinated women had significantly lower incidence rate ratios of cervical infection with HPV6/11/16/18 (0.2; 95% confidence interval [CI], .1-.4) and the related types HPV31 and HPV45 (0.4 [95% CI, .2-1.0] and 0.3 [95% CI, .1-.6], respectively), as well as significantly lower incidence rate ratios of anal infection with HPV6/11/16/18 (0.4; 95% CI, .2-.7). Notably, we observed higher risks of cervical HPV6/11/16/18 infection (hazards ratio [HR], 2.9; 95% CI, 1.0-8.0) and associated cytological abnormalities (HR, 4.5; 95% CI, .7-26.0) among women immunized at ?15 years of age who took ?12 months (vs <12 months) to complete the 3-dose regimen. Conclusions. Among adolescents immunized at ?15 years of age, a longer time to complete the 3-dose schedule was associated with an increased risk of anogenital HPV6/11/16/18 infection and an increased incidence of associated cervical cytological abnormalities.
AB - Background. Uptake of human papillomavirus (HPV) vaccine in the United States is slow, and the effectiveness of the vaccine has not been assessed in high-risk adolescent populations. Methods. We conducted a longitudinal study of 1139 sexually active, inner-city adolescent women receiving the 3-dose quadrivalent (4vHPV) vaccine. Cervical and anal specimens collected semiannually were tested using an L1-specific polymerase chain reaction assay. Postvaccination incidence of 4vHPV vaccine and nonvaccine HPV types, and risk of cervical cytological abnormalities, were assessed in relation to time to completion of all 3 vaccine doses. Results. Compared to vaccine naive women at enrollment, vaccinated women had significantly lower incidence rate ratios of cervical infection with HPV6/11/16/18 (0.2; 95% confidence interval [CI], .1-.4) and the related types HPV31 and HPV45 (0.4 [95% CI, .2-1.0] and 0.3 [95% CI, .1-.6], respectively), as well as significantly lower incidence rate ratios of anal infection with HPV6/11/16/18 (0.4; 95% CI, .2-.7). Notably, we observed higher risks of cervical HPV6/11/16/18 infection (hazards ratio [HR], 2.9; 95% CI, 1.0-8.0) and associated cytological abnormalities (HR, 4.5; 95% CI, .7-26.0) among women immunized at ?15 years of age who took ?12 months (vs <12 months) to complete the 3-dose regimen. Conclusions. Among adolescents immunized at ?15 years of age, a longer time to complete the 3-dose schedule was associated with an increased risk of anogenital HPV6/11/16/18 infection and an increased incidence of associated cervical cytological abnormalities.
KW - Adolescent medicine
KW - Cervical neoplasia
KW - Human papillomavirus
KW - Vaccination
KW - Women's health
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U2 - 10.1093/infdis/jiw486
DO - 10.1093/infdis/jiw486
M3 - Article
C2 - 27738056
AN - SCOPUS:85016053210
SN - 0022-1899
VL - 214
SP - 1952
EP - 1960
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 12
ER -