Immunogenicity and safety of human papillomavirus (HPV) vaccination in Asian populations from six countries: a meta-analysis

Abstract

Cervical cancer is a serious public-health problem in Asian countries. Since human papillomavirus (HPV) infection is the main risk factor for cervical cancer, HPV vaccination is considered a promising strategy to prevent cervical cancer. However, comprehensive immunogenicity and safety information for Asian populations is lacking. We searched four electronic databases including PubMed, EMBASE, Cochrane Library, and clinicaltrials.gov. We reviewed selected manuscripts and extracted the pooled relative risk (RR) from immunogenicity and safety information on HPV vaccination among women in Asian countries. We identified two quadrivalentvaccine studies and eight bivalent-vaccine studies conducted in Asian countries. Analysis across these studies suggested that the HPV vaccines significantly enhanced HPV16-and HPV18-specific antibody among both uninfected (RR 85.69; 95% confidence interval (CI) 31.51-233.04 and 62.77; 95% CI 37.4-105.51) and infected individuals (RR 8.60; 95% CI 6.95-10.64 and RR 8.13; 95% CI 5.96-11.11). Furthermore, HPV vaccination among Asian populations has a favorable safety profile, with only slightly higher risks of local (RR: 1.89; 95% CI 1.65-2.17) and systemic (RR: 1.33; 95% CI 1.18-1.50) adverse events in vaccinated individuals compared with controls. For Asian populations, HPV vaccines enhance the level of HPV16-and HPV18-specific antibodies for both uninfected and infected individuals. Also, the risk of adverse events related to vaccination are acceptable. More data are needed to establish vaccine efficacy with regard to prevention of HPV infection and further outcomes including cervical intraepithelial neoplasia (CIN) and cervical cancer.

Efficacy, Immunogenicity, and Safety of a 9-Valent Human Papillomavirus Vaccine: Subgroup Analysis of Participants From Asian Countries

“…Real-world experience in the 10 years following introduction of qHPV and bivalent HPV vaccines has demonstrated that vaccination prevents HPV infections and HPV-related disease and supports the favorable safety profile of HPV vaccines [ 9 , 33 , 34 ]. A recent meta-analysis found that HPV vaccines were highly immunogenic and well tolerated in Asian populations, consistent with international HPV vaccination studies [ 35 ].…”

Peak neutralizing and cross-neutralizing antibody levels to human papillomavirus types 6/16/18/31/33/45/52/58 induced by bivalent and quadrivalent HPV vaccines

“…Despite of that, differences in bivalent and quadrivalent vaccine immunogenicity among adolescent women from geographically different regions, including Finland and India, were not reported by previous clinical trials. 9,[13][14][15][16] Secondly, given that the endpoint titers for many of bivalent/Finnish recipients were not accessed, as they reached values >180,000, the reported higher HPV16/18 antibody levels induced in the bivalent/Finnish recipients are under-estimations of the true difference in antibody response. Nevertheless, our conservative estimations oversee the need to investigate the cross-neutralizing properties of the two vaccines in further details.…”

Advances in Designing and Developing Vaccines, Drugs and Therapeutic Approaches to Counter Human Papilloma Virus

“…Lyophilized HPV pseudovirions have been delivered to murine models using microneedles ( 27 ). Studies exploring PubMed, EMBASE, Cochrane Library, and clinicaltrials.gov databases for published reports on immunogenicity and safety of bivalent and quadrivalent vaccines, specifically in Asian populations, have suggested strategies for developing vaccines that elicit enhanced HPV-16- and HPV-18- specific antibody levels ( 28 ). In light of the serious consequences of HPV-associated cancers and warts, HPV vaccination should be included in the standard childhood vaccination regimen ( 29 ).…”