1. Assessment of herd effects among women and heterosexual men after girls-only HPV16/18 vaccination in the Netherlands: A repeated cross-sectional study
- Author
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Woestenberg, Petra J., Bogaards, Johannes A., King, Audrey J., Leussink, Suzan, van der Sande, Marianne A. B., Hoebe, Christian J. P. A., van Benthem, Birgit H. B., Adema, D., Buist-Arkema, R., Luijt, D., Meijer, S., Schirm, J., Buiting, Tilburg A., Verbakel, H., van Esch, P., Verweij, J., van der Eijk, A., Lunel, F. Verduyn, Lakbiach, S., Schuurman, R., Abma, D., Adams, K., Bruisten, S., Linde, P., Oostvogel, P., Touwen, C., Vermeulen, W., Nelissen, J., Wolffs, P., van Duijvendijk, N., Schneeberger, P., Dinnissen-van Poppel, M., Melchers, W., Hooghiemstra, M., Huisman, H., Weel, J., Bosma, F., Geeraedts, F., Polman, van Goor, P., Wolthagen, M., de Mooij, C., van Koolwijk, E., Peters, M., Swanink, C., Janssen, J., Pelsers, M., Niekamp, A. M., Smit, M., van Rooijen, M., Virology, Promovendi PHPC, Med Microbiol, Infect Dis & Infect Prev, RS: CAPHRI - R4 - Health Inequities and Societal Participation, RS: NUTRIM - R3 - Respiratory & Age-related Health, MUMC+: DA MMI Moleculaire dia (9), MUMC+: DA MMI Management (9), Epidemiology and Data Science, CCA - Cancer Treatment and quality of life, AII - Infectious diseases, and APH - Methodology
- Subjects
Male ,Cancer Research ,Outcome Assessment (Health Care)/statistics & numerical data ,Cross-sectional study ,Prevalence ,Uterine Cervical Neoplasms ,Gee ,Men who have sex with men ,0302 clinical medicine ,Epidemiology ,Outcome Assessment, Health Care ,PROGRAM ,Non-U.S. Gov't ,human papillomavirus ,Netherlands ,education.field_of_study ,Human papillomavirus 16 ,Uterine Cervical Neoplasms/immunology ,Human papillomavirus 18 ,Research Support, Non-U.S. Gov't ,public health ,virus diseases ,HUMAN-PAPILLOMAVIRUS VACCINATION ,Human papillomavirus 18/immunology ,PREVALENCE ,Vaccination ,Infectious Causes of Cancer ,Oncology ,INFECTIONS ,030220 oncology & carcinogenesis ,Female ,HEALTH ,BURDEN ,Adult ,medicine.medical_specialty ,Adolescent ,Population ,Sexually Transmitted Diseases ,Netherlands/epidemiology ,IMMUNITY ,Research Support ,Mass Vaccination ,03 medical and health sciences ,Young Adult ,SDG 3 - Good Health and Well-being ,POPULATION-LEVEL IMPACT ,medicine ,Journal Article ,Humans ,Papillomavirus Vaccines ,education ,population effects ,Papillomavirus Vaccines/administration & dosage ,business.industry ,Papillomavirus Infections ,Sexually Transmitted Diseases/epidemiology ,vaccination ,Human papillomavirus 16/immunology ,Cross-Sectional Studies ,Papillomavirus Infections/epidemiology ,Mass Vaccination/methods ,Herd ,herd protection ,business ,FEMALES ,Demography ,Program Evaluation - Abstract
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.
- Published
- 2019