Early Evidence of the Effectiveness of the Human Papillomavirus Vaccination Program Against Anogenital Warts in Manitoba, Canada: A Registry Cohort Study

Willows, Karla; Bozat-Emre, Songul; Righolt, Christiaan H.; Kliewer, Erich V.; Mahmud, Salaheddin M.

doi:10.1097/olq.0000000000000742

Cited by 14 publications

(31 citation statements)

References 22 publications

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“…26 Clinical markers suggestive of prior sexual activity were determined using a composite measure of pregnancy, STIs, Pap testing, or contraceptive drug use. 25 Any female with evidence of any of these outcomes prior to the index date was considered "sexually active" for the purpose of this study. Information on STIs was obtained from the provinicial Communicable Disease Surveillance Database.…”

Section: Other Covariatesmentioning

confidence: 99%

“…3 In 2013, vaccine uptake in this age group was slightly lower (65%) in Manitoba than the national average (73%). 9 Another publicly funded program targeted at [19][20][21][22][23][24][25][26] old women at higher risk of HPV infection was initiated in November 2012, and lasted for 2 years. 10 Eligibility for the "high-risk" catch-up program was at the discretion of the care provider, but the program's literature emphasized vaccinating women with a history of early onset sexual activity, multiple sex partners, adolescent pregnancy, immune-compromising illness, previous STIs or abnormal cervical cytology or family history of HPV-associated cancers.…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of school‐based and high‐risk human papillomavirus vaccination programs against cervical dysplasia in Manitoba, Canada

Righolt

Bozat-Emre

Mahmud

2019

Intl Journal of Cancer

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The effectiveness of a vaccination program is influenced by its design and implementation details and by the target population characteristics. Using routinely collected population‐based individual‐level data, we assessed the effectiveness (against cervical dysplasia) of Manitoba's quadrivalent human papillomavirus (qHPV) routine school‐based vaccination program and a short‐lived campaign that targeted women at high‐risk of developing cervical cancer. Females ≥9 years old who received the qHPV vaccine in Manitoba (Canada) between September 1, 2006, and March 31, 2013 (N = 31,442) were matched on age and area of residence to up to three unvaccinated females. Cox proportional hazards models were used to estimate qHPV VE against high‐grade (HSILs) and low‐grade squamous intraepithelial lesions (LSILs) and atypical squamous cells of undetermined significance (ASCUS). Among 14–17‐year‐old participants who had Pap cytology after enrollment, the adjusted qHPV VE estimates were 30% (17–58%) and 36% (21–48%) against the detection of HSILs and LSILs, respectively. There was, however, no evidence of program effectiveness among females vaccinated at ≥18 years of age and among those with a history of abnormal cytology, who were mostly vaccinated as part of the high‐risk program. Estimates of VE for females vaccinated in the school‐based program are consistent with the expected benefits from qHPV vaccination. No similar benefits were detected among women vaccinated at an older age, and those with abnormal cytology, who were targeted by the high‐risk program. Further efforts should be targeted at achieving higher vaccine coverage among preadolescents, prior to the initiation of sexual activity.

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Section: Other Covariatesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effectiveness of school‐based and high‐risk human papillomavirus vaccination programs against cervical dysplasia in Manitoba, Canada

Righolt

Bozat-Emre

Mahmud

2019

Intl Journal of Cancer

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“…Evaluations were in countries that used 2vHPV (seven), 4vHPV (27) or both (one). Nine studies evaluated effectiveness for prevention of prevalent (detected at a single time point) or incident vaccine-type (4vHPV or 2vHPV) HPV infection [11,12,[25][26][27][28][29][30][31], ten anogenital warts [13][14][15][16][17][18][32][33][34][35], and 16 cervical cytological or histological abnormalities [19][20][21][22][23][24][36][37][38][39][40][41][42][43][44][45].…”

Section: Search Resultsmentioning

confidence: 99%

Human papillomavirus vaccine effectiveness by number of doses: Updated systematic review of data from national immunization programs

Markowitz

Drolet

Lewis

et al. 2022

Vaccine

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“…Estimates of vaccine effectiveness in the US were also comparable to that observed in other counties; a provincial cohort study in Canada found a 56% vaccine effectiveness against anogenital warts among those who received three doses before the age of 18. 26 Similarly, an effectiveness study set in Sweden found a 76% vaccine effectiveness for those who received three doses before the age of 20. 27…”

Section: Discussionmentioning

confidence: 98%

Human Papillomavirus Vaccination and Anogenital Warts: A Systematic Review of Impact and Effectiveness in the United States

Yakely

Avni-Singer²,

Oliveira

et al. 2019

Sexual Trans Dis

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Background: Assessing the impact and effectiveness of HPV vaccines on anogenital warts in the United States can provide early indication of the success of vaccination programs as well as identify potential areas for improvement. Methods: Articles were identified from the PubMed, Medline, and Embase databases. Exclusion criteria were applied, and remaining studies were then classified as impact or effectiveness studies. Results: Eight eligible studies published through March 2018 were included. Population-based impact studies examining trends in diagnoses reported consistent declines in females ages 25 years and younger after 2006 when routine female vaccination began in the United States. Declines in males ages 25 years and younger were also seen; however, these declines were lower than those in females and more evident after routine male vaccination began in 2011. Among females and males older than 25 years, little to no change has been seen in the trends of anogenital warts since 2006. Studies that included the pre-vaccine era (before 2006) reported increasing trends during this period. After vaccine introduction, a reversal in these trends was observed. Effectiveness studies that included individual-level vaccination histories consistently demonstrated a lower risk of anogenital warts for those receiving at least one dose of the vaccine compared to those unvaccinated. Conclusions: These findings suggest that the degree of HPV vaccine impact has varied substantially by age and sex. Achieving the full prevention potential of HPV vaccines will likely require greater coverage among both females and males. Post-licensure estimates of effectiveness demonstrate the real-world benefit of the vaccine.

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Early Evidence of the Effectiveness of the Human Papillomavirus Vaccination Program Against Anogenital Warts in Manitoba, Canada: A Registry Cohort Study

Abstract: Women vaccinated at an older (≥19 years) age may be less protected against AGWs, particularly if sexually active before vaccine administration. Further efforts should be targeted at increasing vaccine uptake among preadolescents before the initiation of sexual activity.

Cited by 14 publications

References 22 publications

Effectiveness of school‐based and high‐risk human papillomavirus vaccination programs against cervical dysplasia in Manitoba, Canada

Effectiveness of school‐based and high‐risk human papillomavirus vaccination programs against cervical dysplasia in Manitoba, Canada

Human papillomavirus vaccine effectiveness by number of doses: Updated systematic review of data from national immunization programs

Human Papillomavirus Vaccination and Anogenital Warts: A Systematic Review of Impact and Effectiveness in the United States

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