HPV and Cytology Testing in Women Undergoing 9-Valent HPV Opportunistic Vaccination: A Single-Cohort Follow Up Study

Abstract

Background: This study evaluates the possible effect of 9-valent (9vHPV) vaccination on the results of HPV and cytological tests in a cohort of adult women. Methods: This study is a retrospective, single-cohort, monocentric study. Sexually active women aged 14–70 years, who underwent 9vHPV vaccination, were enrolled. Dose administration dates, side effects and data on Pap smears and HPV tests performed before and after the first vaccine dose were collected. Subjects were considered “unexposed” to the vaccine for all time intervals before the first dose administration, and “exposed” to the first, second and third vaccine doses in all time intervals following each specific dose. Results: A total of 512 women underwent the first 9vHPV dose administration and were enrolled in the study. Median age at vaccination was 30.5 (14–70). Log-rank tests and Cox regression analyses showed a highly statistically significant (p < 0.0001) difference in the time to negativization after the exposure to the third vaccine dose in the 207 women starting with a Pap+ smear (HR (95% C.I.), 2.66 (1.83–3.86)) and in the 198 women starting with an HPV HR+ test (HR (95% C.I.), 7.80 (4.83–12.60)). Conclusions: 9vHPV vaccination may play a role in shortening the clearance time of HPV HR+ or Pap positivity in sexually active adult women.

Human papillomavirus (HPV) vaccination: a call for action in Italy

“…Similarly, HPV16/18 clearance rates at 12 months were 48.8% and 49.8% in the HPV vaccine and control groups, respectively 14. However, we have to point out that limited (retrospective) evidence highlighted that vaccination might have a role in shortening the clearance time of HPV 15. Further prospective investigations would clarify this topic.…”

“…Several studies have evaluated the efficacy of HPV vaccines in reducing the prevalence of HPV, HPV-related disease, and HPV-related cancers 14–23. HPV vaccines serve as a prophylactic treatment, not influencing the outcomes of ongoing lesions, but preventing new lesions.…”

“…Patients who have ever had a life-threatening allergic reaction to any component of the HPV vaccine or a previous dose of the HPV vaccine should not receive HPV vaccines. Having severe allergies (including an allergy to yeast) is not an absolute contraindication to having the vaccine 11 14–21. Ongoing monitoring will ensure the safety of HPV vaccination.…”

Low-Grade Cervical Intraepithelial Neoplasia (CIN1) Evolution: Analysis of Opportunistic Preventive Vaccination Role

“…The trial conducted by De Vincenzo et Al. suggests that anti-HPV vaccination could have a promising role in reducing the time required to eliminate HR-HPV or Pap test positivity in adult women, with a significant reduction in time of negativization compared to subjects who were not vaccinated [ 25 ].…”

HPV Opportunistic Vaccination: A Literature Review and a Single-Center Experience in Northern Italy through the COVID-19 Pandemic

“…The increased prevalence of Pap negative tests after the completion of the vaccination cycle, 62% of the total vaccinated with three doses, supports the theory that the vaccine would help in the negativization of HPV lesions [ 20 ]. A recent Italian article showed a high statistically significant difference ( p < 0.0001) of the cytological negativization time after exposure to the third dose of vaccine in women who started HPV vaccination with an abnormal Pap test and also in women who started HPV vaccination with an hrHPV+ test, concluding that 9vHPV vaccination can play a positive role in shortening the clearance time of hrHPV+ or Pap smear positivity in sexually active adult women [ 21 ].…”