After the rollout of the human papillomavirus (HPV) vaccination program in New York City, the rates of vaccine-related HPV types decreased but nonvaccine high-risk HPV types increased among adolescent girls and young women, according to results of a cohort study published in JAMA Network Open.
After approval of the HPV vaccine in 2007, this prospective cohort study was launched at Mount Sinai Adolescent Health Center in New York City to determine HPV infection rates among sexually active adolescent girls and young women (aged 13-21 years) who were vaccinated against HPV. Study participants (N=1453) were assessed for HPV infection every 6 months until 26 years of age.
At baseline, participants had a mean age of 18.2 (standard deviation [SD], 1.4) years, and 58.8% identified as Hispanic and 50.4% as Black.
Cervical vaccine-related HPV types decreased from 9.1% between 2008 and 2010 to 4.7% between 2017 and 2019 (P =.004). The nonvaccine high-risk cervical and anal HPV types increased in frequency from 25.1% to 30.5% (P =.03) during the same time periods, respectively.
Stratified by vaccine timing, participants who were adolescent girls who had been vaccinated before coitarche showed protection from cervical vaccine types at a rate of 19% per year (adjusted odds ratio [aOR], 0.81; 95% CI, 0.67-0.98). However, this population was associated with an 8% per year (aOR, 1.08; 95% CI, 1.07-1.13) increased risk for nonvaccine high-risk HPV, and an 11% per year (aR, 1.11; 95% CI, 1.05-1.17) increased risk for nonvaccine high-risk anal HPV.
Stratified by type, vaccine-related types HPV-31 (aOR, 0.76) and HPV-45 (aOR, 0.77) decreased during the study. In addition, nonvaccine cervical types HPV-68 (aOR, 1.16), HPV-56 (aOR, 1.13), HPV-59 (aOR, 1.09); and anal types HPV-68 (aOR, 1.21), HPV-56 (aOR, 1.16), HPV-39 (aOR, 1.13), and HPV-51 (aOR, 1.12) increased during the study.
This study was limited as it remains unclear whether patterns of overall cervical cancer risk have changed as a result of these trends in high-risk HPV types.
The researchers concluded that real-world evidence suggests that after the rollout of the HPV vaccine program, vaccine-related types have declined and nonvaccine high-risk types have increased among sexually active adolescent girls and young women.
Disclosure: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.
Schlecht NF, Diaz A, Nucci-Sack A, et al. Incidence and types of human papillomavirus infections in adolescent girls and young women immunized with the human papillomavirus vaccine. JAMA Netw Open. 2021;4(8):e2121893. doi:10.1001/jamanetworkopen.2021.21893