Post-vaccination HPV seroprevalence among female sexual health clinic attenders in England

David Mesher*, Sara L. Thomas, Ezra Linley, Claire Edmundson, Marta Checchi, Tim Waterboer, Noemi Bender, Martin Müller, Simon Beddows, Ray Borrow, Kate Soldan

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

Background: The National HPV Immunisation Programme was introduced in England in September 2008 using the HPV16/18 bivalent vaccine. We conducted serological surveillance to explore vaccination coverage levels. We also conducted a case-control study to investigate a hypothesised cross-protective effect of the HPV16/18 vaccine against genital warts.

Methods: Residual serum specimens from 16 to 20 year-old women attending six specialist sexual health services (SSHS) between 2011 and 2015 in England were tested for antibodies against HPV16 and HPV18 using a virus-like particle (VLP)-based multiplex serology assay. Patients were classified as having vaccine-induced seropositivity if they were seropositive for both HPV types and either had high antibody levels for at least one HPV type, or moderately high levels for both HPV types. Differences in vaccine-induced seropositivity by patient characteristics were investigated using logistic regression. Vaccine-induced seropositivity was then compared for patients with genital warts (cases) and matched patients without (controls).

Results: Of 3,973 serum specimens collected, 3,870 (97.4%) had a valid result. The proportion of women with vaccine-induced seropositivity decreased with age (from 78.1% in 16-year-olds to 52.6% in 20-year-olds). Vaccine-induced seropositivity was lower among women born outside the UK, from more deprived areas and with a history of chlamydia diagnosis. A difference in uptake by ethnic group was also seen but this was largely confounded by differences in deprivation and country of birth. Among 537 cases and 1,515 controls, there was little evidence of a protective effect of the bivalent HPV vaccine against genital warts (adjusted odds ratio 0.93; 95% CI: 0.74–1.18).

Discussion: Vaccine-induced seropositivity in this high-risk population was in line with vaccination coverage in the general population although was lower in some at-risk sub-groups. This study does not provide evidence to support a cross-protective effect of the HPV16/18 vaccine against genital warts.

Original languageEnglish
Pages (from-to)4210-4218
Number of pages9
JournalVaccine
Volume39
Issue number30
Early online date12 Jun 2021
DOIs
Publication statusPublished - 5 Jul 2021

Bibliographical note

Funding Information: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: RB and EL perform contact research on behalf of Public Health England for GSK, Pfizer and Sanofi Pasteur. TW serves on advisory boards for Merck Sharp & Dohme (MSD). The Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Service has provided GSK with post-marketing surveillance reports on HPV infections; a cost recovery charge is made for these reports. All other authors have no further conflict of interests.
This work was supported by Public Health England.

Open Access: No Open Access licence

Publisher copyright: Crown Copyright © 2021 Published by Elsevier Ltd. All rights reserved.

Citation: David Mesher, Sara L. Thomas, Ezra Linley, Claire Edmundson, Marta Checchi, Tim Waterboer, Noemi Bender, Martin Müller, Simon Beddows, Ray Borrow, Kate Soldan, Post-vaccination HPV seroprevalence among female sexual health clinic attenders in England, Vaccine, Volume 39, Issue 30, 2021, Pages 4210-4218, ISSN 0264-410X,

DOI: https://doi.org/10.1016/j.vaccine.2021.05.018.

Keywords

  • Genital warts
  • HPV
  • Serology
  • Seroprevalence
  • Vaccination

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