Overcoming barriers to HPV vaccination: Non-inferiority of antibody response to human papillomavirus 16/18 vaccine in adolescents vaccinated with a two-dose vs. a three-dose schedule at 21 months

Lazcano‐Ponce, Eduardo; Stanley, Margaret; Muñóz, Núbia; Torres, Leticia; Cruz-Valdéz, Aurelio; Salmerón, Jorge; Rojas, Rosalba; Herrero, Rolando; Hernández-Ávila, Mauricio

doi:10.1016/j.vaccine.2013.11.059

Cited by 78 publications

(68 citation statements)

References 22 publications

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“…7 The relevance of the third dose can be assessed after 5 y based on the accumulated evidence by that time. If at all needed, the delayed administration of the third dose will have a booster effect that may possibly last longer.…”

Section: Discussionmentioning

confidence: 99%

“…3 Such potent and consistently high immune response in younger girls lead to the hypothesis that less than 3 doses of the vaccine might offer enough protection in girls aged below 15 y A number of randomized and non-randomized studies demonstrated that the antibody response elicited by 2 doses administered at least 6 months apart in adolescent girls was non-inferior to that elicited by 3 doses of the HPV vaccine. [4][5][6][7] The earliest evidence on the protective effect against infection of less than 3 doses of the vaccine was put forward by the posthoc analysis of the results of some of the phase III efficacy trials of the bivalent vaccine (2vHPV) in which some of the girls/ women received single or 2 doses by default. 8 The results also provided the early but exciting indication that even single dose of the vaccine might be effective.…”

Section: Introductionmentioning

confidence: 99%

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Less than 3 doses of the HPV vaccine – Review of efficacy against virological and disease end points

Basu

Bhatla

Ngoma

et al. 2016

Human Vaccines & Immunotherapeutics

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World Health Organization (WHO) recommended 2 doses of the Human Papillomavirus (HPV) vaccine for girls below 15 y on the basis of the immune-bridging studies demonstrating non-inferior immune response of 2 doses in the adolescent girls compared to 3 doses in the young adult women in whom the efficacy against disease is established. The biological nature of the antigens (virus-like particles) constituting the HPV vaccine is responsible for the vigorous antibody response that may make the third dose redundant. The protection offered by 2 doses has been demonstrated in non-randomized clinical trials to be comparable to that offered by 3 doses against incident and persistent infections of vaccine targeted HPV types. However, results emerging from the ecological and nested case-control studies embedded in the population based screening programs of different countries indicate reduced efficacy of 2 doses against virological and disease end points. Some recent studies observed the protective effect of single dose of the vaccine against incident and persistent infections of the vaccine targeted HPV types to be similar to 3 doses in spite of immunological inferiority. The sample size, duration of follow-ups and number of events were limited in these studies. Longer follow ups of the less than 3 doses cohorts in the ongoing studies as well as appropriately designed and ethically justifiable randomized studies are needed to establish the protection offered by the alternative schedules at least beyond 10 y of vaccination.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Less than 3 doses of the HPV vaccine – Review of efficacy against virological and disease end points

Basu

Bhatla

Ngoma

et al. 2016

Human Vaccines & Immunotherapeutics

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“…37 Accounting for those who do not complete the vaccine series would necessitate assumptions regarding vaccine efficacy and duration of protection for those who receive only one or 2 doses. [38][39][40] More complex models are better suited than ours for examining issues related to vaccine protection with less than 3 doses. 41 Instead, we used the simplifying assumption of 100% series completion not only to facilitate the use of our simplified model but also to allow for an easier interpretation of our results regarding the cost-effectiveness of 9vHPV compared with 4vHPV.…”

Section: Vaccine Characteristicsmentioning

confidence: 99%

The impact and cost-effectiveness of nonavalent HPV vaccination in the United States: Estimates from a simplified transmission model

Chesson

Markowitz

Hariri

et al. 2016

Human Vaccines & Immunotherapeutics

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Introduction: The objective of this study was to assess the incremental costs and benefits of the 9-valent HPV vaccine (9vHPV) compared with the quadrivalent HPV vaccine (4vHPV). Like 4vHPV, 9vHPV protects against HPV types 6, 11, 16, and 18. 9vHPV also protects against 5 additional HPV types 31, 33, 45, 52, and 58. Methods: We adapted a previously published model of the impact and cost-effectiveness of 4vHPV to include the 5 additional HPV types in 9vHPV. The vaccine strategies we examined were (1) 4vHPV for males and females; (2) 9vHPV for females and 4vHPV for males; and (3) 9vHPV for males and females. In the base case, 9vHPV cost $13 more per dose than 4vHPV, based on available vaccine price information. Results: Providing 9vHPV to females compared with 4vHPV for females (assuming 4vHPV for males in both scenarios) was cost-saving regardless of whether or not cross-protection for 4vHPV was assumed. The cost per quality-adjusted life year (QALY) gained by 9vHPV for both sexes (compared with 4vHPV for both sexes) was < $0 (cost-saving) when assuming no cross-protection for 4vHPV and $8,600 when assuming cross-protection for 4vHPV. Conclusions: Compared with a vaccination program of 4vHPV for both sexes, a vaccination program of 9vHPV for both sexes can improve health outcomes and can be cost-saving.

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“…Girls who received only two vaccine doses within a short period of time were then separated from those who received the two vaccines at least 6 months apart, and the latter group was considered sufficiently vaccinated based on recent data suggesting protective antibody levels against vaccine HPV B1 61 54 54 0 1 0 0 53 53 B2 87 79 79 2 3 0 1 74 75 B3 183 118 119 1 1 3 6 108 114 B4 223 127 127 0 3 4 3 117 120 B6 123 59 59 1 1 3 7 47 54 B7 166 70 70 1 5 1 2 61 63 B8 181 136 136 0 1 4 0 131 131 B9 155 99 95 3 0 3 40 48 88 Subtotal 1 179 742 739 8 15 18 59 639 types in similar recipients. [7,8] The insufficiently vaccinated rate (IVR) was calculated using the number of girls who received only one dose, or two doses <6 months apart.…”

Section: Definitionsmentioning

confidence: 99%

The Vaccine and Cervical Cancer Screen (VACCS) project: Linking cervical cancer screening to HPV vaccination in the South-West District of Tshwane, Gauteng, South Africa

et al. 2015

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Overcoming barriers to HPV vaccination: Non-inferiority of antibody response to human papillomavirus 16/18 vaccine in adolescents vaccinated with a two-dose vs. a three-dose schedule at 21 months

Cited by 78 publications

References 22 publications

Less than 3 doses of the HPV vaccine – Review of efficacy against virological and disease end points

Less than 3 doses of the HPV vaccine – Review of efficacy against virological and disease end points

The impact and cost-effectiveness of nonavalent HPV vaccination in the United States: Estimates from a simplified transmission model

The Vaccine and Cervical Cancer Screen (VACCS) project: Linking cervical cancer screening to HPV vaccination in the South-West District of Tshwane, Gauteng, South Africa

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