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Measuring vaccine effectiveness against persistent HPV infections: a comparison of different statistical approaches.
- Source :
-
BMC infectious diseases [BMC Infect Dis] 2020 Jul 08; Vol. 20 (1), pp. 482. Date of Electronic Publication: 2020 Jul 08. - Publication Year :
- 2020
-
Abstract
- Background: Persistent high-risk human papillomavirus (HPV) infection is endorsed by the World Health Organization as an intermediate endpoint for evaluating HPV vaccine effectiveness/efficacy. There are different approaches to estimate the vaccine effectiveness/efficacy against persistent HPV infections.<br />Methods: We performed a systematic literature search in Pubmed to identify statistical approaches that have been used to estimate the vaccine effectiveness/efficacy against persistent HPV infections. We applied these methods to data of a longitudinal observational study to assess their performance and compare the obtained vaccine effectiveness (VE) estimates.<br />Results: Our literature search identified four approaches: the conditional exact test for comparing two independent Poisson rates using a binomial distribution, Generalized Estimating Equations for Poisson regression, Prentice Williams and Peterson total time (PWP-TT) and Cox proportional hazards regression. These approaches differ regarding underlying assumptions and provide different effect measures. However, they provided similar effectiveness estimates against HPV16/18 and HPV31/33/45 persistent infections in a cohort of young women eligible for routine HPV vaccination (range VE 93.7-95.1% and 60.4-67.7%, respectively) and seemed robust to violations of underlying assumptions.<br />Conclusions: As the rate of subsequent infections increased in our observational cohort, we recommend PWP-TT as the optimal approach to estimate the vaccine effectiveness against persistent HPV infections in young women. Confirmation of our findings should be undertaken by applying these methods after longer follow-up in our study, as well as in different populations.
- Subjects :
- Adolescent
Adult
Female
Follow-Up Studies
Humans
Immunogenicity, Vaccine
Longitudinal Studies
Papillomavirus Infections virology
Prevalence
Treatment Outcome
Young Adult
Human papillomavirus 18 immunology
Human papillomavirus 31 immunology
Papillomavirus Infections epidemiology
Papillomavirus Infections prevention & control
Papillomavirus Vaccines immunology
Papillomavirus Vaccines therapeutic use
Vaccination
Subjects
Details
- Language :
- English
- ISSN :
- 1471-2334
- Volume :
- 20
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- BMC infectious diseases
- Publication Type :
- Academic Journal
- Accession number :
- 32640998
- Full Text :
- https://doi.org/10.1186/s12879-020-05083-7