Effectiveness of 'catch-up' human papillomavirus vaccination to prevent cervical neoplasia in immunosuppressed and non-immunosuppressed women

Michael J Silverberg; Wendy A Leyden; Jennifer O Lam; Chun R Chao; Steven E Gregorich; Megan J Huchko; Shalini Kulasingam; Miriam Kuppermann; Karen K Smith-McCune; George F Sawaya

doi:10.1016/j.vaccine.2020.05.004

Effectiveness of 'catch-up' human papillomavirus vaccination to prevent cervical neoplasia in immunosuppressed and non-immunosuppressed women

Vaccine. 2020 Jun 15;38(29):4520-4523. doi: 10.1016/j.vaccine.2020.05.004. Epub 2020 May 20.

Authors

Affiliations

¹ Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA. Electronic address: Michael.J.Silverberg@kp.org.
² Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
³ Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.
⁴ Department of Medicine, University of California at San Francisco, San Francisco, CA, USA.
⁵ Department of Obstetrics, Gynecology & Reproductive Sciences, University of California at San Francisco, San Francisco, CA, USA; Department of Obstetrics and Gynecology, Global Health Institute, Duke University, Durham, NC, USA.
⁶ Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
⁷ Department of Obstetrics, Gynecology & Reproductive Sciences, University of California at San Francisco, San Francisco, CA, USA; Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CA, USA.
⁸ Department of Obstetrics, Gynecology & Reproductive Sciences, University of California at San Francisco, San Francisco, CA, USA.

Abstract

It is unknown whether the HPV vaccine is effective in immunocompromised women during catch-up ages. We performed a case-control study of 4,357 women with incident CIN2+ (cases) and 5:1 age-matched, incidence-density selected controls (N = 21,773) enrolled in an integrated health care system from 2006 to 2014. Vaccine effectiveness was estimated from multivariable conditional logistic regression models, with results stratified by immunosuppression history, defined as prior HIV infection, solid organ transplant history, or recently prescribed immunosuppressive medications. HPV vaccination resulted in a 19% reduction in CIN2+ rates for women without an immunosuppression history but a nonsignificant 4% reduction for women with an immunosuppression history. Further research is needed to evaluate whether catch-up HPV vaccine effectiveness varies by immunosuppression status, especially given the recent approval of the HPV vaccine for adults up to 45 years of age.

Keywords: HIV; Human papillomavirus; Immunosuppression; Vaccination.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Adult
Alphapapillomavirus*
Case-Control Studies
Female
HIV Infections*
Humans
Papillomavirus Infections* / epidemiology
Papillomavirus Infections* / prevention & control
Papillomavirus Vaccines*
Uterine Cervical Neoplasms* / prevention & control
Vaccination

Substances

Papillomavirus Vaccines

Abstract

Publication types

MeSH terms

Substances

Grants and funding