Reduction in Human Papillomavirus (HPV) Prevalence Among Young Women Following HPV Vaccine Introduction in the United States, National Health and Nutrition Examination Surveys, 2003–2010

TLDR: Within 4 years of vaccine introduction, the vaccine-type HPV prevalence decreased among females aged 14-19 years despite low vaccine uptake, and the estimated vaccine effectiveness was high.

Abstract: Background. Human papillomavirus (HPV) vaccination was introduced into the routine immunization schedule in the United States in late 2006 for females aged 11 or 12 years with catch-up vaccination recommended for those aged 13-26 years. In 2010 3-dose vaccine coverage was only 32% among 13-17 year-olds. Reduction in the prevalence of HPV types targeted by the quadrivalent vaccine (HPV-6 -11 -16 and -18) will be one of the first measures of vaccine impact. Methods. We analyzed HPV prevalence data from the vaccine era (2007-2010) and the prevaccine era (2003-2006) that were collected during National Health and Nutrition Examination Surveys. HPV prevalence was determined by the Linear Array HPV Assay in cervicovaginal swab samples from females aged 14-59 years; 4150 provided samples in 2003-2006 and 4253 provided samples in 2007-2010. Results. Among females aged 14-19 years the vaccine-type HPV prevalence (HPV-6 -11 -16 or -18) decreased from 11.5% (95% confidence interval [CI] 9.2-14.4) in 2003-2006 to 5.1% (95% CI 3.8-6.6) in 2007-2010 a decline of 56% (95% CI 38-69). Among other age groups the prevalence did not differ significantly between the 2 time periods (P > .05). The vaccine effectiveness of at least 1 dose was 82% (95% CI 53-93). Conclusions. Within 4 years of vaccine introduction the vaccine-type HPV prevalence decreased among females aged 14-19 years despite low vaccine uptake. The estimated vaccine effectiveness was high.