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October 21, 2017International Journal of Cancer

Impact of gender‐neutral or girls‐only vaccination against human papillomavirus—Results of a community‐randomized clinical trial (I)

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Authors

ASAnna Söderlund‐StrandLund UniversitySVSimopekka VänskäFinnish Institute for Health and WelfareTLTapio LuostarinenFinnish Cancer Registry

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Implication

Randomized trial reveals gender-neutral HPV vaccination enhances cross-protection against non-vaccine viral strains, highlighting the importance of male coverage for herd immunity.

Key Points

  • To compare the real-life protective effectiveness—combining direct vaccine efficacy and indirect herd effects—of gender-neutral versus girls-only HPV vaccination programs in an HPV-vaccine-naïve population.
  • Community-randomized trial (NCT000534638) assigning 33 Finnish communities to gender-neutral HPV16/18 vaccination (Arm A), girls-only HPV vaccination with male HBV vaccination (Arm B), or gender-neutral HBV vaccination (Arm C).
  • Invited 39,420 females and 40,852 males aged 12–15 born between 1992 and 1995, with 11,662 males and 20,513 females receiving three doses (achieving 20–30% male and 50% female coverage).
  • Collected and analyzed 11,396 cervicovaginal samples for HPV DNA from 18.5-year-old women four years post-vaccination (2010–2014) to assess prevalence.
  • Vaccine efficacy against HPV16/18 ranged from 89.2% to 95.2% across birth cohorts, with cross-protective efficacy peaking in the 1994–95 cohort for HPV45 (82.8% in Arm A vs 86.1% in Arm B) and HPV31 (77.6% in Arm A vs 84.6% in Arm B).
  • In unvaccinated females born in 1994–95, herd effects reached 51.0% (95% CI, 8.3–73.8) in Arm A and 47.2% (95% CI, 6.5–70.2) in Arm B for HPV18, and 53.7% (95% CI, 22.1–72.5) in Arm A for HPV31/33, with no significant herd effect for HPV16 or HPV45.
  • Protective effectiveness against HPV16/18 was 58.1% (95% CI, 45.1–69.4) in Arm A versus 55.7% (95% CI, 42.9–66.6) in Arm B, while effectiveness against cross-protected types HPV31/33 was 60.5% (95% CI, 43.6–73.4) in Arm A versus 44.5% (95% CI, 24.9–60.6) in Arm B.

Cite This Study

Söderlund‐Strand et al. (2017) studied this question.

synapsesocial.com/papers/6a7efb8080d715b4559c459fhttps://doi.org/10.1002/ijc.31119
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