Effectiveness of quadrivalent human papillomavirus vaccination against high-grade cervical lesions by age and doses: a population-based cohort study

IF 13.6 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Europe Pub Date : 2025-02-01 DOI:10.1016/j.lanepe.2024.101178

Shiqiang Wu , Alexander Ploner , Ana Martina Astorga Alsina , Yunyang Deng , Lina Ask Schollin , Jiayao Lei

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引用次数: 0

Abstract

Background

One or two-dose schedule for human papillomavirus (HPV) vaccination has been recommended by the World Health Organization and used in many vaccination programs. We aimed to comprehensively evaluate the effectiveness of quadrivalent HPV vaccine against high-grade cervical lesions by age at vaccination and number of doses received.

Methods

This cohort study included 2,200,495 females aged 10–35 years old who were residents of Sweden between 2006 and 2022, with 584,676 (26.6%) receiving at least one dose of quadrivalent HPV vaccine. We used Poisson regression models to estimate the incidence rate ratios (IRR) comparing the incidence rate of high-grade cervical lesions in relation to age at vaccination and doses.

Findings

In girls initiating vaccination before age 15, we observed IRRs of 0.42 (95% CI 0.33–0.52) after one-dose, 0.54 (0.47–0.63) after two-dose, and 0.50 (0.47–0.53) after three-dose. The IRRs were 0.60 (95% CI 0.52–0.70), 0.55 (0.49–0.62), and 0.54 (0.52–0.56) after one, two or three doses for girls who initiated vaccination age 15–17. For women who initiated vaccination after age 20, higher doses may be needed to achieve a statistically significant risk reduction.

Interpretation

Receiving one or two doses of HPV vaccines prior to age 17, especially for those initiating before age 15, has comparable effectiveness against high-grade cervical lesions with those who received three doses.

Funding

Swedish Research Council, Swedish Research Council for Health, Working Life and Welfare, and Karolinska Institutet.

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来源期刊

Lancet Regional Health-Europe Multiple-

CiteScore

19.90

自引率

1.40%

发文量

260

审稿时长

9 weeks

期刊介绍： The Lancet Regional Health – Europe, a gold open access journal, is part of The Lancet's global effort to promote healthcare quality and accessibility worldwide. It focuses on advancing clinical practice and health policy in the European region to enhance health outcomes. The journal publishes high-quality original research advocating changes in clinical practice and health policy. It also includes reviews, commentaries, and opinion pieces on regional health topics, such as infection and disease prevention, healthy aging, and reducing health disparities.