Efficacy of fewer than three doses of an HPV-16/18 AS04-adjuvanted vaccine: combined analysis of data from the Costa Rica Vaccine and PATRICIA trials

Kreimer, Aimée R.; Struyf, Frank; Rosario-Raymundo, Maria Rowena Del; Hildesheim, Allan; Skinner, S. Rachel; Wacholder, Sholom; Garland, Suzanne M.; Herrero, Rolando; David, Marie-Pierre; Wheeler, Cosette M.

doi:10.1016/s1470-2045(15)00047-9

Cited by 269 publications

(222 citation statements)

References 26 publications

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“…Early evidence indicates that fewer than 3 doses may be protective. 81 Adolescents in the United States may not be as undervaccinated as indicated by the current rate of HPVV completion; an estimated 50% of girls and 31% of boys have received 2 doses. 82 Until further research validates this finding, we should continue to adhere to international and national recommendations.…”

Section: Discussionmentioning

confidence: 99%

Interventions to Improve HPV Vaccine Uptake: A Systematic Review

Walling¹,

Benzoni²,

Dornfeld³

et al. 2016

Pediatrics

193

154

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CONTEXT: The human papillomavirus (HPV) vaccine is a safe, effective cancer prevention method that is underutilized in the United States. Despite increased understanding of barriers to vaccination, rates remain low. Globally, developed and developing nations have achieved high rates of vaccination.OBJECTIVE: Identification of effective strategies is necessary to optimize uptake of the HPV vaccine. We systematically reviewed the literature for national and international interventions that have successfully increased HPV vaccine uptake. DATA SOURCES:We used a standardized protocol to search for articles published between January 1, 2006, and April 30, 2015, in 3 electronic databases: PubMed, Scopus, and Embase. STUDY SELECTION:We identified interventions designed to increase HPV vaccine uptake among adolescents and young adults aged 11 to 26 years. All study designs were acceptable. Only articles that included postintervention vaccination rates were included. DATA EXTRACTION:Two authors independently reviewed each article for data extraction and quality assessment. Interventions were classified according to the Community Preventive Service Task Force guide. RESULTS:Results were reported according to the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework. Fifty-one articles met eligibility criteria: 2 informational interventions, 18 behavioral interventions, and 31 environmental interventions. Factors associated with HPV vaccine uptake were increased vaccine availability, decreased financial barriers, and interventions targeting both providers and patients.LIMITATIONS: Lack of consistent RE-AIM metric reporting, limiting our ability to assess intervention validity and quality.CONCLUSIONS: Population-based vaccination strategies that increased vaccine availability reached the greatest number of adolescents and were most successful in achieving high rates of vaccination.

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Section: Discussionmentioning

confidence: 99%

Interventions to Improve HPV Vaccine Uptake: A Systematic Review

Walling¹,

Benzoni²,

Dornfeld³

et al. 2016

Pediatrics

193

154

View full text Add to dashboard Cite

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“…No obstante, se ha demostrado que en la gran mayoría de los casos desaparece el VPH y se consideran citologías de bajo riesgo, salvo que se mantenga un perfil epidemiológico de riesgo en la conducta sexual. Si es positivo el test del VPH con lesiones de mayor grado, seguirá una atención estrecha para descartar o tratar lesiones que puedan presentar lesiones precursoras del cáncer de cuello cervical (36)(37)(38).…”

Section: Detección Y Cribado En La Infección Del Virus Del Papiloma Hunclassified

“…En un estudio reciente de parejas jóvenes, las cuales se exponen a relaciones sexuales, se divide la muestra poblacional en dos grupos: uno que no usa el preservativo durante las relaciones sexuales y otro que sí lo usa. Al estudiar los resultados de este estudio, se observó el doble de exposición al VPH en el grupo sin protección: alrededor del 80 % en parejas sin preservativo, frente a un 40 % de presencia del VPH en parejas con preservativo (38). Este resultado parcial en el manejo de la exposición del VPH no ha conseguido controlar, del todo, la prevalencia de la infección en VPH en pacientes jóvenes.…”

Section: Barreras Artificiales Que Influyen En La Infección Del Virusunclassified

Naprotecnología: ciencia y persona en la infección por el virus del papiloma humano (VPH) en mujeres y preadolescencentes

et al. 2017

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En la actualidad hay suficiente evidencia científica que relaciona directamente adquisición, exposición y prevalencia del virus del papiloma humano (VPH) con el cáncer del cuello de uterino. Por ello, el artículo aborda el VPH en la mujer teniendo en cuenta la naprotecnología, que permite conjugar evidencia científica y planteamientos éticos. Se busca que se tengan en cuenta tanto el aspecto biológico de la sexualidad como la capacidad de hacerse persona en su núcleo sexual. De ahí que se analicen programas dirigidos a la educación sexual, basados tanto en la prevención sanitaria como en la antropología de la sexualidad, y apoyados por las instituciones familiares, que han demostrado una mejor acogida ante los riesgos de las enfermedades de transmisión sexual, y entre ellas la infección por el VPH.

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“…A similar unfavorable case split was seen for HPV 33 and also for HPV 45. In an analysis of 2 phase III studies of the bivalent vaccine cross-protection efficacy for persistent HPV 31/33/45 infection was not found in women vaccinated with a 2-dose regimen of the bivalent vaccine, 7 adding evidence of the relatively weak nature of the immune response to cross-protective antigens in the vaccines.…”

mentioning

confidence: 99%

Clarification on the Impact of Cervarix Vaccination on Human Papillomavirus Infection and Cervical Cancer in the United Kingdom

Brown

Kulkarni

Pillsbury

et al. 2016

Human Vaccines & Immunotherapeutics

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This Letter to the Editor comments upon a recent publication on the impact of Cervarix vaccination on Human Papillomavirus (HPV) infection and cervical cancer in the United Kingdom in which estimates of long-term, crossprotection against non-vaccine HPV types of 20 y were provided. However, the article fails to cite several studies regarding the durability of cross-protection. Overall, studies have shown that while virus-like particle (VLP) HPV vaccines have demonstrated consistently high and long-lasting type-specific protection against the included HPV types, cross-protection efficacy against non-vaccine types is lower and wanes over time. It is also noted that cross-protection antigens are not specifically manufactured, quality-controlled or potency tested as are the vaccine HPV VLPs that undergo such testing before release of product.The report by Van Effelterre, et al. (2016) presented various 'vaccine scenarios' for the efficacy of the bivalent Human Papillomavirus (HPV) vaccine in order to inform the health economics model presented in the paper.1 Estimates of efficacy included impact of vaccination on lifelong, 20-year cross-protection versus no protection against cervical intraepithelial neoplasia (CIN2C) and cancer due to HPV 31/33/45 and 9 other HPV types. Estimates of efficacy were drawn from the end of study results of the phase III study, PATRICIA, which lasted 4 y. Unfortunately, the authors failed to cite some important findings regarding the likely durability of cross-protection, including reports from study-extension data on the long term effectiveness of the bivalent HPV vaccine. Although long-term studies have demonstrated continued protection against those specifically manufactured HPV types present in a quadrivalent HPV vaccine (6/11/16/18) through 8 y of follow-up 3 and the bivalent HPV vaccine (16/18) for up to 9 years, 4 long-term follow-up studies that have evaluated continued effectiveness due to cross-protection post-vaccination are more limited, and have shown at best, partial protection that markedly wanes over time.For example, Malagon, et al., performed a meta-analysis of HPV vaccine clinical trials including the 4-year PATRICIA trial and longer-term trials of the bivalent vaccine. 5 The analysis reported that while the bivalent vaccine conferred cross-protection for HPV types 31, 33, and 45 at varying degrees, estimates of efficacy were lost by 6 y of follow-up. An evaluation of a long-term extension of a Phase II study of the bivalent vaccine by Naud, et al. showed no cross-protection against persistent infection and high-grade disease for any non-vaccine type, including 31, 33, and 45 at 9 y of follow-up. 4 Another analysis of the efficacy across these HPV types for the bivalent vaccine using extension study and registry data by Saah et al., similarly showed a waning of response in non-vaccine types (see Table 1). 6 Estimates of efficacy based on persistent infection were assessed, which obviated complications of HPV attribution in tissue specimens tested by PCR. Efficacy again...

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Efficacy of fewer than three doses of an HPV-16/18 AS04-adjuvanted vaccine: combined analysis of data from the Costa Rica Vaccine and PATRICIA trials

Cited by 269 publications

References 26 publications

Interventions to Improve HPV Vaccine Uptake: A Systematic Review

Interventions to Improve HPV Vaccine Uptake: A Systematic Review

Naprotecnología: ciencia y persona en la infección por el virus del papiloma humano (VPH) en mujeres y preadolescencentes

Clarification on the Impact of Cervarix Vaccination on Human Papillomavirus Infection and Cervical Cancer in the United Kingdom

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