No evidence for cross-protection of the HPV-16/18 vaccine against HPV-6/11 positivity in female STI clinic visitors

Petra J Woestenberg,M Dinnissen-Van Poppel,F Neienhuijsen,M Van Rooijen,G Aalfs,V Sigurdsson,P Van Esch,M Mattijssen,T Taconis,M Pelsers,Johannes A Bogaards,A Botraby,D Bukasa,Robine Donken,S Lakbiach,M Hooghiemstra,D Adema,Audrey J King,E Pannekoek,N Duijvendijk,P Van Goor,Suzan Leussink,Fiona R.M Van Der Klis,H Van Buel-Bruins,Y Poort,F Postma,S Meijer,I Polman,W De Waal,C De Haan,F Verduyn-Lunel,D Abma,M De Graas,A Gelissen-Hansen,C Kerkhof,H Verbakel,C De Mooij,M Illidge-Onder De Linden,E Swaders,C Van Bokhoven-Rombouts,R Kleinspenkelink,P Hut-Van Vliet,C Touwen,I Hondelink,H Korff,R Buist-Arkema,H Van Kruchten,R Tiemessen,C Van Ruitenbeek,L Masthoff,D Luijt,Robin C Huisman ,Jordy J S Kiewiet ,Jaco J Verweij ,Arjan Hogewoning ,Carolina J G Kampman ,Elfi E H G Brouwers ,Tl Van Zwet ,Peter M Schneeberger ,P J G Cornelissen ,Marianne A B Van Der Sande ,W Vermeulen ,Tyler Haas ,C.m.a Swanink ,Eva Van Doorn ,Jord C Stam ,Patricia R Sanders ,Jelly Nelissen ,Tinus Smits ,Christian J P A Hoebe ,Antoinette A T P Brink ,Paul M Oostvogel ,Marie José Kersten ,Rob Schuurman ,H G Huisman ,Marieke Smit ,Maja Paš ,Jans Velzing ,Elly Van Koolwijk ,Astrid Van Leeuwen ,Willem J G Melchers ,Kandice Smith ,M Y L Peeters ,Anne-Marie Niekamp ,Inge De Koning ,Peter Van Rosmalen ,Harrie C M Van Den Bosch ,Petra Wolffs ,Titia Heijman ,Martin Schutten ,A G M Buiting ,I Quintus Molenaar ,H Fennema ,F De Groot ,Jan Janssen ,Sylvia M Bruisten ,Jan Weel ,Birgit H B Van Benthem ,J Schirm ,Michael Peters ,Annemiek Van Der Eijk ,John W A Rossen ,Ian Van Der Linde ,Anne-Sophie Beerens ,M J H M Wolfhagen ,Hannelore M Götz ,Manon T M Pelgrim

doi:10.1016/j.jinf.2017.01.007

Abstract

Data from a vaccine trial and from post-vaccine surveillance in the United Kingdom have suggested that the bivalent HPV-16/18 vaccine offers cross-protection against HPV-6/11 and protection against anogenital warts (AGW). We studied the effect of the bivalent vaccine on genital HPV-6/11 positivity and AGW in the Netherlands. We included all vaccine-eligible women from the PASSYON study, a biennial cross-sectional study among 16- to 24-year-old sexually transmitted infection (STI) clinic attendants. Vaginal self-swabs were analyzed for type specific HPV and AGW were diagnosed at the STI-clinic. Prevalence of HPV-6 and/or HPV-11 and AGW were compared between self-reported vaccinated and unvaccinated women by log-binomial regression analysis, adjusted for demographics and risk behavior. Of the 1198 women included, 56% reported to be vaccinated at least once. Relative to unvaccinated women, the adjusted prevalence ratio (PR) for HPV-6/11 was 1.03 (95% confidence interval [CI] 0.74-1.43) for women vaccinated at least once. The crude PR for AGW was 0.67 (95% CI 0.22-2.07) for women vaccinated at least once. Adjustment did not change these results. We observed no cross-protective effect of the bivalent vaccine on genital HPV-6/11 positivity and a non-significant partially protective effect on AGW.

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