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Different population-level vaccination effectiveness for HPV types 16, 18, 6 and 11

Abstract

Background Given that the human papillomavirus (HPV) vaccine types have different durations of infectiousness and infectivity, the population-level vaccine effectiveness of these types may differ even if vaccine efficacy is identical.

Objective To compare the type-specific effectiveness of vaccination against HPV types 16, 18, 6 and 11.

Methods An individual-based stochastic model of HPV transmission (18 HPV-types) in a population stratified by age, gender and sexual activity was developed. Multiple parameter sets were identified by fitting the model to sexual behaviour data and age- and type-specific HPV prevalence.

Results Under base case assumptions (70% coverage, 99% vaccine efficacy per act and 20 years' duration of protection), vaccinating 12-year-old girls is predicted to reduce HPV-16, HPV-18 and HPV-6/11 prevalence by 61% (80% uncertainty interval (UI) 53–77), 92% (80% UI 65–100) and 100% (80% UI 97–100), respectively, 50 years after the start of the vaccination programme. Differences in type-specific vaccine effectiveness increased over time, and decreased with improved vaccine efficacy characteristics.

Conclusions For the same vaccine efficacy, the population-level impact of HPV vaccination will most likely be different, with HPV-16, the most oncogenic type, having the lowest effectiveness. These results should be taken into account when designing and interpreting post-vaccination surveillance studies.

  • Human papillomavirus (HPV)
  • vaccine
  • mathematical model
  • cervical cancer
  • genital warts

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