Impact of partial bivalent HPV vaccination on vaccine-type infection: a population-based analysis

Background: Data on the effectiveness of 1 dose of HPV vaccine are lacking, particularly in population-based settings. Data from a national HPV immunisation catch-up programme of 14-18 year old girls were used to assess the effectiveness of < 3 doses of the bivalent vaccine on vaccine-type and cross reactive-type HPV infection. Methods: Cervical samples from women attending for their first cervical smear which had been genotyped for HPV as part of a longitudinal HPV surveillance programme were linked to immunisation records to establish the number of vaccine doses (0,1,2,3) administered. Vaccine effectiveness (VE) adjusted for deprivation and age at first dose, was assessed for prevalent HPV 16/18 and HPV 31/33/45 infection.Results: VE for prevalent HPV 16/18 infection associated with 1, 2 and 3 doses was 48.2% (95% CI 16.8-68.9), 54.8% (95% CI 30.7-70.8) and 72.8% (95% CI 62.8-80.3). Equivalent VE for prevalent HPV 31/33/45 infection was -1.62% (95% CI -85.1 – 45.3), 48.3 % (95% CI 7.6 -71.8) and 55.2 % (95% CI 32.6-70.2).Conclusion: Consistent with recent aggregated trial data, we demonstrate the potential effectiveness of even one dose of HPV vaccine on vaccine type infection. Given that these women were immunised as part of a catch-up campaign, the VE observed in this study is likely to be an underestimate of what will occur in girls vaccinated at younger ages. Further population-based studies which look at the clinical efficacy of one dose schedules arewarranted.