TY - JOUR
T1 - Assessment of herd effects among women and heterosexual men after girls-only HPV16/18 vaccination in the Netherlands
T2 - A repeated cross-sectional study
AU - Woestenberg, Petra J.
AU - Bogaards, Johannes A.
AU - King, Audrey J.
AU - Leussink, Suzan
AU - van der Sande, Marianne A. B.
AU - Hoebe, Christian J. P. A.
AU - van Benthem, Birgit H. B.
AU - Adema, D.
AU - Buist-Arkema, R.
AU - Luijt, D.
AU - Meijer, S.
AU - Schirm, J.
AU - Buiting, Tilburg A.
AU - Verbakel, H.
AU - van Esch, P.
AU - Verweij, J.
AU - van der Eijk, A.
AU - Lunel, F. Verduyn
AU - Lakbiach, S.
AU - Schuurman, R.
AU - Abma, D.
AU - Adams, K.
AU - Bruisten, S.
AU - Linde, P.
AU - Oostvogel, P.
AU - Touwen, C.
AU - Vermeulen, W.
AU - Nelissen, J.
AU - Wolffs, P.
AU - van Duijvendijk, N.
AU - Schneeberger, P.
AU - Dinnissen-van Poppel, M.
AU - Melchers, W.
AU - Hooghiemstra, M.
AU - Huisman, H.
AU - Weel, J.
AU - Bosma, F.
AU - Geeraedts, F.
AU - Polman, null
AU - van Goor, P.
AU - Wolthagen, M.
AU - de Mooij, C.
AU - van Koolwijk, E.
AU - Peters, M.
AU - Swanink, C.
AU - Janssen, J.
AU - Pelsers, M.
AU - Niekamp, A. M.
AU - Smit, M.
AU - van Rooijen, M.
AU - Membership of the Medical Microbiological Laboratories and Public Health Services
N1 - Funding Information:
The authors thank Hein Boot (deceased), Elske van Logchem, Naomi van Marm and Rianne Vriend for their valuable contributions to the design or execution of the study and Susan T. Landry for editorial assistance in the preparation of this report. Furthermore, the STI clinics, including all nurses and physicians, within the Public Health Services and the hospitals are acknowledged for their permission to collect data from their patients and their effort. The authors acknowledge the medical microbiologic laboratories and the analysts for storage and testing of the samples. Medical Microbiological Laboratories: Certe: D Adema, R Buist-Arkema, D Luijt, S Meijer, J Schirm. ETZ Hospital Tilburg: A Buiting, H Verbakel, P van Esch, J Verweij. Erasmus Medical Center: A van der Eijk. University Medical Center Utrecht: F Verduyn Lunel, S Lakbiach, R Schuurman. Public Health Laboratory Amsterdam: D Abma, K Adams, S Bruisten, I Linde, P Oostvogel, C Touwen, W Vermeulen. Maastricht University Medical Center: J Nelissen, P Wolffs. Jeroen Bosch Hospital: N van Duijvendijk, P Schneeberger. Radboud University Medical center: M Dinnissen - van Poppel, W Melchers. Izore: M Hooghiemstra, H Huisman, J Weel. LabMicTA: F. Bosma, F. Geeraedts, I.Polman. Isala: P van Goor, M Wolfhagen. Rijnstate: C de Mooij, E van Koolwijk, M Peters, C Swanink, R Tiemessen. Medical laboratory dr. Stein & Collegae: J Janssen, M Pelsers. Canisius Wilhelmina Hospital: W de Waal. Public Health Services: PHS Drenthe: G Aalfs. PHS IJsselland: H van Buel. PHS Gelderland-Zuid: C van Bokhoven-Rombouts, P Cornelissen, M Kersten, C van Ruitenbeek, I Molenaar. University Medical Center Utrecht: E Doorn. PHS Rotterdam-Rijnmond: H G?tz, M Illidge, J Stam, E Swaders. PHS Groningen: F Postma. PHS Zuid Limburg: AM Niekamp, M Smit. PHS Frysl?n: D Bukasa, M Chirandjilal, T Taconis. PHS Twente: M de Graas, I Hondelink, C Kampman. PHS Hart voor Brabant: M van de Pas. PHS Amsterdam: T Heijman, A Hogewoning, M van Rooijen. PHS Gelderland-Midden: F Neienhuijsen, M Pelgrim.
Publisher Copyright:
© 2018 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.
PY - 2019/6/1
Y1 - 2019/6/1
N2 - Data on the impact of human papillomavirus (HPV) vaccination on the population HPV prevalence are largely obtained from women. We assessed the impact of the girls-only HPV16/18 vaccination program in the Netherlands that started in 2009, on trends in HPV prevalence among women and heterosexual men, using data from the PASSYON study. In this cross-sectional study, the HPV prevalence among 16- to 24-year-old visitors to sexually transmitted infection clinics was assessed in 2009, 2011, 2013, and 2015. We compared the genital postvaccination HPV prevalence with the prevaccination prevalence (2009) using Poisson GEE models. In total, we included 4,996 women and 1,901 heterosexual men. The percentage of women who reported to be vaccinated increased from 2.3% in 2009 to 37% in 2015. Among all women, the HPV16/18 prevalence decreased from 23% prevaccination to 15% in 2015 (adjusted prevalence ratio [aPR] 0.62, p(trend) <0.01). Among heterosexual men, the HPV16/18 prevalence decreased from 17% prevaccination to 11% in 2015 (aPR 0.52, p(trend) <0.01). Of the heterosexual men with a steady partner, HPV16/18 prevalence was lower among those whose steady partner had been vaccine-eligible in the national immunization program (aPR 0.13). Among unvaccinated women, the HPV16/18 prevalence in 2015 was not different from prevaccination. The decreasing HPV16/18 prevalence among heterosexual men and the reduced HPV16/18 prevalence among heterosexual men with a vaccine-eligible steady partner strongly suggests herd protection from girls-only vaccination. Absence of notable herd effects among unvaccinated women 6 years postvaccination may be due to the moderate vaccine uptake among girls in the Netherlands.What's new? Human papillomavirus (HPV) is a sexually transmitted virus that plays a causal role in the development of anogenital and oropharyngeal cancers in both men and women. The population-level impact of HPV vaccination programs on the HPV prevalence has however mainly been studied in women. This study shows decreasing trends in the HPV16 and HPV18 prevalence among both women and heterosexual men after the introduction of a girls-only HPV16/18 vaccination program in the Netherlands. The findings provide compelling evidence for herd protection in men. Because HPV16/18 are the most oncogenic types, HPV-related cancers are expected to decline in both sexes after girls-only HPV vaccination.
AB - Data on the impact of human papillomavirus (HPV) vaccination on the population HPV prevalence are largely obtained from women. We assessed the impact of the girls-only HPV16/18 vaccination program in the Netherlands that started in 2009, on trends in HPV prevalence among women and heterosexual men, using data from the PASSYON study. In this cross-sectional study, the HPV prevalence among 16- to 24-year-old visitors to sexually transmitted infection clinics was assessed in 2009, 2011, 2013, and 2015. We compared the genital postvaccination HPV prevalence with the prevaccination prevalence (2009) using Poisson GEE models. In total, we included 4,996 women and 1,901 heterosexual men. The percentage of women who reported to be vaccinated increased from 2.3% in 2009 to 37% in 2015. Among all women, the HPV16/18 prevalence decreased from 23% prevaccination to 15% in 2015 (adjusted prevalence ratio [aPR] 0.62, p(trend) <0.01). Among heterosexual men, the HPV16/18 prevalence decreased from 17% prevaccination to 11% in 2015 (aPR 0.52, p(trend) <0.01). Of the heterosexual men with a steady partner, HPV16/18 prevalence was lower among those whose steady partner had been vaccine-eligible in the national immunization program (aPR 0.13). Among unvaccinated women, the HPV16/18 prevalence in 2015 was not different from prevaccination. The decreasing HPV16/18 prevalence among heterosexual men and the reduced HPV16/18 prevalence among heterosexual men with a vaccine-eligible steady partner strongly suggests herd protection from girls-only vaccination. Absence of notable herd effects among unvaccinated women 6 years postvaccination may be due to the moderate vaccine uptake among girls in the Netherlands.What's new? Human papillomavirus (HPV) is a sexually transmitted virus that plays a causal role in the development of anogenital and oropharyngeal cancers in both men and women. The population-level impact of HPV vaccination programs on the HPV prevalence has however mainly been studied in women. This study shows decreasing trends in the HPV16 and HPV18 prevalence among both women and heterosexual men after the introduction of a girls-only HPV16/18 vaccination program in the Netherlands. The findings provide compelling evidence for herd protection in men. Because HPV16/18 are the most oncogenic types, HPV-related cancers are expected to decline in both sexes after girls-only HPV vaccination.
KW - human papillomavirus
KW - vaccination
KW - herd protection
KW - population effects
KW - public health
KW - HUMAN-PAPILLOMAVIRUS VACCINATION
KW - POPULATION-LEVEL IMPACT
KW - PREVALENCE
KW - PROGRAM
KW - INFECTIONS
KW - IMMUNITY
KW - FEMALES
KW - BURDEN
KW - HEALTH
U2 - 10.1002/ijc.31989
DO - 10.1002/ijc.31989
M3 - Article
C2 - 30426502
SN - 0020-7136
VL - 144
SP - 2718
EP - 2727
JO - International Journal of Cancer
JF - International Journal of Cancer
IS - 11
ER -