The impact of the national HPV vaccination program in England using the bivalent HPV vaccine: Surveillance of type-specifc HPV in young females, 2010-2016

Background. The national human papillomavirus (HPV) immunization program was introduced in England in September 2008 using the bivalent vaccine. Methods. We collected residual vulva-vaginal swab specimens from 16 to 24-year-old women attending for chlamydia screening between 2010 and 2016 and tested for HPV DNA. We compared changes in type-specifc (vaccine and nonvaccine) HPV prevalence over time and association with vaccination coverage. For women with known vaccination status, vaccine effectiveness was estimated. Results. HPV DNA testing was completed for 15 459 specimens. Prevalence of HPV16/18 decreased between 2010/2011 and 2016 from 8.2% to 1.6% in 16-18 year olds and from 14.0% to 1.6% in 19-21 year olds. Declines were also seen for HPV31/33/45 (6.5% to 0.6% for 16-18 year olds and 8.6% to 2.6% for 19-21 year olds). Vaccine effectiveness for HPV16/18 was 82.0% (95% confdence interval [CI], 60.6%-91.8%) and for HPV31/33/45 was 48.7% (95% CI, 20.8%-66.8%). Prevalence of HPV16/18 was compared to fndings in 2007-2008 (prevaccination) and to predictions from Public Health England's mathematical model. Discussion. Eight years afer the introduction of a national HPV vaccination program, substantial declines have occurred in HPV16/18 and HPV31/33/45. Te prevalence of other high-risk HPV types has not changed.