Post-vaccination HPV prevalence, genotype distribution, and associated factors among vaccinated women in China: A cross-sectional study

This study aimed to evaluate human papillomavirus (HPV) prevalence and genotype distribution among vaccinated women and to identify the factors associated with post-vaccination HPV infection. Women who received HPV vaccine and had the thin-layer liquid-based cytology test (TCT) and HPV genotype testing before HPV vaccination were recruited. Each participant was required to complete an online questionnaire, and cervical specimen was collected for TCT and HPV genotype testing. The epidemiology of HPV infection and genotype was described. The factors associated with HPV infection post-vaccination were identified through multivariate analysis, presenting the adjusted odds ratio (AOR) with its 95% confidence interval (95%CI). A total of 893 eligible women participated. The prevalence of HPV post-vaccination was 8.51%. The common high-risk HPV (hr-HPV) were HPV52, HPV59, HPV58 and the common low-risk HPV (lr-HPV) was HPV53. Factors associated with HPV infection post-vaccination included aged ≥40y (AOR = 2.92), married status (AOR = 1.56), receiving the first dose of HPV vaccine after sexual debut (OR = 2.57), lr-HPV positive pre-vaccination (AOR = 2.35) and hr-HPV positive pre-vaccination (AOR = 5.72). The prevalence of HPV post-vaccination was lower than that of pre-vaccination and the common genotypes changed to those not covered by HPV vaccine administrated. Age, marital status, timing of HPV vaccination and prior HPV infection before HPV vaccination were identified as the factors associated with HPV infection post-vaccination. Receiving HPV vaccination before sexual debut and ongoing HPV screening after vaccination were recommended.