The impact of 10 years of human papillomavirus (HPV) vaccination in Australia: what additional disease burden will a nonavalent vaccine prevent?

Eurosurveillance - Tập 23 Số 41 - 2018
Cyra Patel1, Julia Brotherton2,3, Alexis Pillsbury1, Sanjay Jayasinghe4,1, Basil Donovan5,6, Kristine Macartney4,1, Helen Marshall7,8
1National Centre for Immunisation Research and Surveillance, Westmead, Australia
2School of Population and Global Health, University of Melbourne, Parkville, Australia
3VCS Population Health, VCS Foundation, East Melbourne, Australia
4Discipline of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
5Sydney Sexual Health Centre, Sydney Hospital, Sydney, Australia
6The Kirby Institute, University of New South Wales, Sydney, Australia
7Robinson Research Institute and Adelaide Medical School, University of Adelaide, North Adelaide, Australia
8Vaccinology and Immunology Research Trials Unit, Women’s and Children’s Hospital, North Adelaide, Australia

Tóm tắt

Background: A National human papilloma virus (HPV) Vaccination Programme for the prevention of HPV infection and associated disease using the quadrivalent HPV vaccine (4vHPV) has been funded and implemented in Australia since 2007, initially for girls only and extended to boys in 2013, with uptake rates among the highest observed worldwide. Aim: We report on the impact of this national programme on HPV prevalence and associated disease burden and estimate the potential impact of adopting a nonavalent HPV (9vHPV) vaccine. Methods: We performed a non-systematic literature review of studies measuring the burden of HPV-associated disease and infection in Australia before and after introduction of HPV vaccination. We also included key national reports with estimates of HPV-related disease burden. Results: Substantial declines in high-grade cervical disease and genital warts among vaccine-eligible women have been observed. Reductions in genital warts incidence and HPV prevalence among heterosexual men of similar age were observed before introduction of the male vaccination programme, indicating a substantial herd effect. 9vHPV vaccine is expected to prevent up to 90% of cervical and 96% of anal cancers. Of an estimated 1,544 HPV-associated cancers in 2012, 1,242 would have been preventable by the 4vHPV vaccine and an additional 187 anogenital cancers by the 9vHPV vaccine. Conclusions: Vaccination using 4vHPV vaccine has had a large demonstrable impact on HPV-related disease in Australia. A switch to 9vHPV could further reduce the HPV-associated cancer burden. With continued high coverage among both males and females, elimination of vaccine-type HPV disease seems achievable in Australia.

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Tập 23 Số 41

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