PDF(Pubmed)
Abstract：
UNASSIGNED: In 2008/9, Fiji vaccinated >30,000 girls aged 9-12 years with the quadrivalent human papillomavirus (4vHPV) vaccine coverage for at least one dose was >60% (one dose only was 14%, two dose only was 13%, three doses was 35%). We calculated vaccine effectiveness (VE) of one, two and three doses of 4vHPV against oncogenic HPV genotypes 16/18, eight years following vaccination.
UNASSIGNED: A retrospective cohort study was undertaken (2015-2019) in pregnant women ≤23 years old, eligible to receive 4vHPV in 2008/9, with confirmed vaccination status. The study was restricted to pregnant women due to the cultural sensitivity of asking about sexual behavior in Fiji. For each participant a clinician collected a questionnaire, vaginal swab and genital warts examination, a median eight (range 6-11) years post vaccination. HPV DNA was detected by molecular methods. Adjusted VE (aVE) against the detection of vaccine HPV genotypes (16/18), the comparison group of non-vaccine genotypes (31/33/35/39/45/51/52/56/58/59/66/68), and genital warts were calculated. Covariates included in the adjusted model were: age, ethnicity and smoking, according to univariate association with any HPV detection.
UNASSIGNED: Among 822 participants the prevalence of HPV 16/18 in the unvaccinated, one, two and three-dose groups were 13.3% (50/376), 2.5% (4/158), 0% (0/99) and 1.6% (3/189), respectively; and for the non-vaccine high-risk genotypes, the detection rate was similar across dosage groups (33.2%-40.4%, p = 0.321). The aVE against HPV 16/18 for one, two and three doses were 81% (95% CI; 48-93%), 100% (95% CI; 100-100%), and 89% (95% CI; 64-96%), respectively. Prevalence of HPV 16/18 was lower among women with longer time since vaccination.
UNASSIGNED: A single dose 4vHPV vaccine is highly effective against HPV genotypes 16 and 18 eight years following vaccination. Our results provide the longest duration of protection for reduced dose 4vHPV schedule in a low- or middle-income country in the Western Pacific region.
UNASSIGNED: This study was supported by the Bill & Melinda Gates Foundation and the Department of Foreign Affairs and Trade of the Australian Government and Fiji Health Sector Support Program (FHSSP). FHSSP is implemented by Abt JTA on behalf of the Australian Government.
UNASSIGNED: A retrospective cohort study was undertaken (2015-2019) in pregnant women ≤23 years old, eligible to receive 4vHPV in 2008/9, with confirmed vaccination status. The study was restricted to pregnant women due to the cultural sensitivity of asking about sexual behavior in Fiji. For each participant a clinician collected a questionnaire, vaginal swab and genital warts examination, a median eight (range 6-11) years post vaccination. HPV DNA was detected by molecular methods. Adjusted VE (aVE) against the detection of vaccine HPV genotypes (16/18), the comparison group of non-vaccine genotypes (31/33/35/39/45/51/52/56/58/59/66/68), and genital warts were calculated. Covariates included in the adjusted model were: age, ethnicity and smoking, according to univariate association with any HPV detection.
UNASSIGNED: Among 822 participants the prevalence of HPV 16/18 in the unvaccinated, one, two and three-dose groups were 13.3% (50/376), 2.5% (4/158), 0% (0/99) and 1.6% (3/189), respectively; and for the non-vaccine high-risk genotypes, the detection rate was similar across dosage groups (33.2%-40.4%, p = 0.321). The aVE against HPV 16/18 for one, two and three doses were 81% (95% CI; 48-93%), 100% (95% CI; 100-100%), and 89% (95% CI; 64-96%), respectively. Prevalence of HPV 16/18 was lower among women with longer time since vaccination.
UNASSIGNED: A single dose 4vHPV vaccine is highly effective against HPV genotypes 16 and 18 eight years following vaccination. Our results provide the longest duration of protection for reduced dose 4vHPV schedule in a low- or middle-income country in the Western Pacific region.
UNASSIGNED: This study was supported by the Bill & Melinda Gates Foundation and the Department of Foreign Affairs and Trade of the Australian Government and Fiji Health Sector Support Program (FHSSP). FHSSP is implemented by Abt JTA on behalf of the Australian Government.
摘要：
■在2008/9年，斐济为30,000名9-12岁的女孩接种了至少一剂四价人乳头瘤病毒（4vHPV）疫苗，覆盖率>60％（一剂仅为14％，两次剂量仅为13%，三次剂量为35%）。我们计算了一种疫苗的有效性（VE），接种疫苗八年后，两剂和三剂4vHPV对抗致癌HPV基因型16/18。
■在≤23岁的孕妇中进行了一项回顾性队列研究（2015-2019年），2008/9年度有资格接受4vHPV，并已确认疫苗接种状态。由于询问斐济性行为的文化敏感性，该研究仅限于孕妇。临床医生为每个参与者收集了一份问卷，阴道拭子和生殖器疣检查，接种疫苗后8年（6-11年）的中位数。通过分子方法检测HPVDNA。针对疫苗HPV基因型检测的调整VE（AVE）（16/18），非疫苗基因型的对照组（31/33/35/39/45/51/52/56/58/59/66/68），并计算了生殖器疣。调整后模型中包含的协变量为：年龄，种族和吸烟,根据与任何HPV检测的单变量关联。
■在822名参与者中，未接种疫苗的人中HPV16/18的患病率，一,两个和三个剂量组为13.3%（50/376），2.5%（4/158），0%(0/99)和1.6%(3/189)，分别；对于非疫苗高风险基因型，各剂量组的检出率相似(33.2%-40.4%，p=0.321）。针对HPV16/18的AVE之一，两剂和三剂为81%(95%CI;48-93%)，100%（95%CI；100-100%），和89%（95%CI；64-96%），分别。在接种疫苗时间较长的女性中，HPV16/18的患病率较低。
■单剂量4vHPV疫苗在接种8年后对HPV基因型16和18非常有效。我们的结果为西太平洋区域的低收入或中等收入国家的减量4vHPV计划提供了最长的保护持续时间。
这项研究得到了比尔和梅琳达·盖茨基金会以及澳大利亚政府外交和贸易部和斐济卫生部门支持计划（FHSSP）的支持。FHSSP由AbtJTA代表澳大利亚政府实施。
■在≤23岁的孕妇中进行了一项回顾性队列研究（2015-2019年），2008/9年度有资格接受4vHPV，并已确认疫苗接种状态。由于询问斐济性行为的文化敏感性，该研究仅限于孕妇。临床医生为每个参与者收集了一份问卷，阴道拭子和生殖器疣检查，接种疫苗后8年（6-11年）的中位数。通过分子方法检测HPVDNA。针对疫苗HPV基因型检测的调整VE（AVE）（16/18），非疫苗基因型的对照组（31/33/35/39/45/51/52/56/58/59/66/68），并计算了生殖器疣。调整后模型中包含的协变量为：年龄，种族和吸烟,根据与任何HPV检测的单变量关联。
■在822名参与者中，未接种疫苗的人中HPV16/18的患病率，一,两个和三个剂量组为13.3%（50/376），2.5%（4/158），0%(0/99)和1.6%(3/189)，分别；对于非疫苗高风险基因型，各剂量组的检出率相似(33.2%-40.4%，p=0.321）。针对HPV16/18的AVE之一，两剂和三剂为81%(95%CI;48-93%)，100%（95%CI；100-100%），和89%（95%CI；64-96%），分别。在接种疫苗时间较长的女性中，HPV16/18的患病率较低。
■单剂量4vHPV疫苗在接种8年后对HPV基因型16和18非常有效。我们的结果为西太平洋区域的低收入或中等收入国家的减量4vHPV计划提供了最长的保护持续时间。
这项研究得到了比尔和梅琳达·盖茨基金会以及澳大利亚政府外交和贸易部和斐济卫生部门支持计划（FHSSP）的支持。FHSSP由AbtJTA代表澳大利亚政府实施。
