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1.
Suzanne E. Powell Susan Hariri Martin Steinau Heidi M. Bauer Nancy M. Bennett Karen C. Bloch Linda M. Niccolai Sean Schafer Elizabeth R. Unger Lauri E. Markowitz 《Vaccine》2012
Background
Vaccination against human papillomavirus (HPV) types 16 and 18 is recommended for girls aged 11 or 12 years with catch-up vaccination through age 26 in the U.S. Cervical intraepithelial neoplasia (CIN) grade 2 or 3 and adenocarcinoma in situ (CIN2+) are used to monitor HPV vaccine impact on cervical disease. This report describes vaccination status in women diagnosed with CIN2+ and examines HPV vaccine impact on HPV 16/18-related CIN2+.Methods
As part of a vaccine impact monitoring project (HPV-IMPACT), females 18–31 years with CIN2+ were reported from pathology laboratories in CA, CT, NY, OR, TN from 2008 to 2011. One diagnostic block was selected for HPV DNA typing with Roche Linear Array. Demographic, abnormal Papanicolaou (Pap) test dates and vaccine status information were collected. The abnormal Pap test immediately preceding the CIN2+ diagnosis was defined as the ‘trigger Pap’.Results
Among 5083 CIN2+ cases reported to date, 3855 had vaccination history investigated; 1900 had vaccine history documented (vaccinated, with trigger Pap dates, or unvaccinated). Among women who initiated vaccination >24 months before their trigger Pap, there was a significantly lower proportion of CIN2+ lesions due to 16/18 compared to women who were not vaccinated (aPR = .67, 95% CI: .48–.94). Among the 1900 with known vaccination status, 20% initiated vaccination on/after their trigger screening. Women aged 21–23 years were more likely to initiate vaccination on/after the trigger Pap compared to 24–26 year olds (29.0% vs. 19.6%, p = .001), as were non-Hispanic blacks compared to non-Hispanic whites (27.3% vs. 19.0%, p = .001) and publicly compared to privately insured women (38.1% vs. 17.4%, p < .0001).Conclusion
We found a significant reduction in HPV 16/18-related lesions in women with CIN2+ who initiated vaccination at least 24 months prior to their trigger Pap. These preliminary results suggest early impact of the HPV vaccine on vaccine-type disease, but further evaluation is warranted. 相似文献2.
Emma T. Callegari Sepehr N. Tabrizi Jan Pyman Marion Saville Alyssa M. Cornall Julia M.L. Brotherton Suzanne M. Garland 《Vaccine》2014
Objectives
This study aimed to determine human papillomavirus (HPV) genotypes present in biopsy sections from young women of vaccine eligible age living in Victoria, Australia, with confirmed cervical intraepithelial neoplasia grade 3 (CIN3) or adenocarcinoma in situ (AIS) using laser capture microdissection (LCM).Methods
Histologically confirmed CIN3 or AIS positive biopsies from vaccine eligible women (born after 30th June 1981, n = 169), between May 2011 and March 2013, were identified. CIN3 or AIS lesions were isolated from biopsy material using LCM, and the HPV genotypes present in whole tissue sections (WTS) as well as LCM-isolated lesion tissue were determined by a sensitive reverse hybridisation assay; RHA kit HPV SPF10-LiPA25, version 1 (Labo Bio-medical Products, Rijswijk, The Netherlands).Results
One hundred and sixty-eight cases were shown to be HPV positive (99%), of which 20 (12%) had more than one HPV genotype detected using WTS-PCR. Evaluation by LCM of individual biopsies with mixed infections showed 18 cases (90%) had only one HPV genotype associated with each CIN3 lesion. HPV 16 was the most common HPV type, found in 95/168 cases (57%).Conclusion
LCM-PCR allowed us to confirm the presence of a single HPV genotype associated with each biologically separate CIN3 lesion, supporting the theory that only one virus type causes each independent CIN lesion. LCM will provide an important tool in assessing vaccine effectiveness in HPV vaccine programs. 相似文献3.
Objective
The study aims were to assess the influence of provider recommendations on parental vaccine perceptions and identify the most potent parent vaccine perceptions for HPV vaccine series initiation considering provider recommendation strength.Methods
We administered a questionnaire and assessed HPV vaccine claims among a stratified-random sample of parents of 9–17 year old girls enrolled in Florida's Medicaid and the Children's Health Insurance Program. Using multivariate analyses, we evaluated the associations between: (1) parent vaccine perceptions and provider recommendation strength, and (2) parent vaccine perceptions and HPV vaccine series initiation (≥1 vaccine claim or positive parental report) controlling for provider recommendation strength.Results
The majority of the 2422 participating parents agreed that the HPV vaccine was safe (61%), would not make girls more likely to have sex (69%), and prevented cervical cancer (71%). About half (44%) reported receiving a strong provider recommendation. Compared to parents without recommendations, parents with strong recommendations had 2 to 7 times higher odds of agreeing that: vaccines are safe, the HPV vaccine is safe, not concerned about side effects, and the vaccine prevents cervical cancer. Even when considering provider recommendation strength, HPV vaccine series initiation was more likely among girls of parents who agreed rather than disagreed that the HPV vaccine was safe [odds ratio (OR) = 5.8, 95% confidence interval (CI) = 3.1, 11.1], does not cause sex (OR = 2.0, 95% CI = 1.2, 3.4), prevents cervical cancer (OR = 2.0, 95% CI = 1.0, 3.4), and prevents HPV infections (OR = 1.8, 95% CI = 1.0, 3.0).Conclusions
Parent concerns about HPV vaccine are similar to their concerns about other vaccines. Providers should focus HPV vaccine discussions with parents on vaccine safety and illness prevention. 相似文献4.
Background
Human papillomavirus (HPV) infection and associated cervical disease are common among all women, regardless of sexual identity, yet limited research has examined HPV vaccination among lesbian and bisexual women.Methods
A national sample of lesbian and bisexual women ages 18–26 (n = 543) completed our online survey during Fall 2013. We used multivariable logistic regression to identify correlates of HPV vaccine initiation (receipt of at least 1 dose) and completion (receipt of all 3 recommended doses among initiators).Results
Overall, 45% of respondents had initiated HPV vaccine and 70% of initiators reported completing the series. HPV vaccine initiation was higher among respondents who were students, had received a healthcare provider's recommendation, perceived greater positive social vaccination norms, or anticipated greater regret if they did not get vaccinated and later got HPV. Initiation was lower among those who perceived greater HPV vaccine harms or greater barriers to getting the vaccine (all p < .05). HPV vaccine completion was higher among initiators who had a college degree while it was lower among those who perceived a greater likelihood of acquiring HPV or who anticipated greater regret if they got the vaccine and fainted (all p < .05). Among HPV vaccine initiators who had not yet completed the series, about half (47%) intended to get the remaining doses.Conclusions
Many lesbian and bisexual women are not getting vaccinated against HPV. Healthcare provider recommendations and women's health beliefs may be important leverage points for increasing vaccination among this population. 相似文献5.
Noella W. Whelan Audrey Steenbeek Ruth Martin-Misener Jeffrey Scott Bruce Smith Holly D’Angelo-Scott 《Vaccine》2014
Background
Nova Scotia has the highest rate of cervical cancer in Canada, and most of these cases are attributed to the Human Papillomavirus (HPV). In 2007, Gardasil® was approved and implemented in a successful school-based HPV immunization program. Little is known, however, which strategies (if any) used within a school-based program help to improve vaccine uptake.Methods
A retrospective, exploratory correlation study was conducted to examine the relationship between school-based strategies and uptake of HPV vaccine. Data was analyzed through Logistic regression, using PASW Statistics 17 (formerly SPSS 17).Results
HPV vaccine initiation was significantly associated with Public Health Nurses providing reminder calls for: consent return (p = 0.017) and missed school clinic (p = 0.004); HPV education to teachers (p < 0.001), and a thank-you note to teachers (p < 0.001). Completion of the HPV series was associated with vaccine consents being returned to the students’ teacher (p = 0.003), and a Public Health Nurse being assigned to a school (p = 0.025).Conclusions
These findings can be used to help guide school-based immunization programs for optimal uptake of the HPV vaccine among the student population. 相似文献6.
Ashlesha Patel Lisa Stern Zoe Unger Elie Debevec Alicia Roston Rita Hanover Johanna Morfesis 《Vaccine》2014
Objectives
To evaluate whether automated reminders increase on-time completion of the three-dose human papillomavirus (HPV) vaccine series.Methods
Ten reproductive health centers enrolled 365 women aged 19–26 to receive dose one of the HPV vaccine. Health centers were matched and randomized so that participants received either routine follow-up (control) or automated reminder messages for vaccine doses two and three (intervention). Intervention participants selected their preferred method of reminders – text, e-mail, phone, private Facebook message, or standard mail. We compared vaccine completion rates between groups over a period of 32 weeks.Results
The reminder system did not increase completion rates, which overall were low at 17.2% in the intervention group and 18.9% in the control group (p = 0.881). Exploratory analyses revealed that participants who completed the series on-time were more likely to be older (OR = 1.15, 95% CI 1.01–1.31), report having completed a four-year college degree or more (age-adjusted OR = 2.51, 95% CI 1.29–4.90), and report three or more lifetime sexual partners (age-adjusted OR = 3.45, 95% CI 1.20–9.92).Conclusions
The study intervention did not increase HPV vaccine series completion. Despite great public health interest in HPV vaccine completion and reminder technologies, completion rates remain low. 相似文献7.
D. Scott LaMontagne Emmanuel Mugisha Yuanji Pan Edward Kumakech Aloysius Ssemaganda Troy J. Kemp Jane Cover Ligia A. Pinto Mahboobeh Safaeian 《Vaccine》2014
Background
Investigations of vaccine efficacy and immunogenicity for adult females receiving fewer than three doses of human papillomavirus (HPV) vaccine have suggested protection against infection and precancerous lesions. We investigated the immunogenicity of bivalent HPV vaccines among adolescent girls from Uganda who received one, two, or three vaccine doses.Methods
Young girls vaccinated through a government program in Uganda were invited to participate. HPV16- and HPV18-specific antibodies were measured at ≥24 months after the last vaccine dose using an enzyme linked immunoassay in girls who received one (n = 36), two (n = 145), or three (n = 195) doses.Results
Nearly all subjects (99%) were HPV16 and HPV18 seropositive at the time of blood-draw. Geometric mean antibody levels (GMTs) were: HPV161-dose = 230 EU/mL, HPV162-dose = 808 EU/mL, and HPV163-dose = 1607 EU/mL; HPV181-dose = 87 EU/mL, HPV182-dose = 270 EU/mL, and HPV183-dose = 296 EU/mL. The GMT ratio for 2:3 doses was 0.50 (HPV16) and 0.68 (HPV18) and did not meet the non-inferiority criteria (i.e., lower bound of 97.5% confidence interval of the GMT ratio greater than 0.50). The GMT ratio for 1:3 doses for HPV16 and HPV18 was inferior, but absolute GMTs for one dose were higher than adult women who received one dose (HPV16 = 124 EU/mL, HPV18 = 69 EU/mL) where efficacy has been demonstrated.Conclusions
Even though immunogenicity with less than three doses did not meet a priori non-inferiority thresholds, antibody levels measured ≥24 months after last dose were similar to those of adult women who have been followed for more than eight years for efficacy. 相似文献8.
Elyse Olshen Kharbanda Emily ParkerJames D. Nordin Brita HedblomSharon J. Rolnick 《Preventive medicine》2013
Objectives
To describe human papillomavirus (HPV) vaccine coverage among adult privately insured women including variation in coverage by race/ethnicity.Methods
This cross-sectional, observational study included women 18–26 years of age with continuous enrollment in a U.S. Midwestern health insurance plan and at least one visit to a plan affiliated practice. Vaccination data came from insurance claims and the electronic medical record. Primary outcomes were: receipt of at least 1 HPV vaccine (HPV1) and completion of the 3-dose HPV vaccine series (HPV3). Coverage was described for the entire cohort and stratified by race/ethnicity. For a subset of women, automated data was compared to personal recall.Results
As of June 2010, among 2546 privately insured women 18–26 years, 72.7% had received their first HPV vaccine and 57.9% completed the 3-dose series. Compared to white women, African American and Asian women had significantly lower coverage for HPV1 and HPV3. There was 94.5% (95% CI: 88.5–100%) agreement between personal recall and claims/EMR for receiving HPV1.Conclusions
In this cohort of privately insured women, a majority received HPV1 and more than half completed the 3-dose vaccine series. Marked disparities in receipt of HPV vaccine by race/ethnicity were observed. 相似文献9.
Walter W. Williams Peng-Jun Lu Mona Saraiya David Yankey Christina Dorell Juan L. Rodriguez Deanna Kepka Lauri E. Markowitz 《Vaccine》2013
Background
Human papillomavirus (HPV) vaccination is recommended to protect against HPV-related diseases.Objective
To estimate HPV vaccine coverage and assess factors associated with vaccine awareness, initiation and receipt of 3 doses among women age 18–30 years.Methods
Data from the 2010 National Health Interview Survey were analyzed to assess associations of HPV vaccination among women age 18–26 (n = 1866) and 27–30 years (n = 1028) with previous HPV exposure, cervical cancer screening and selected demographic, health care and behavioral characteristics using bivariate analysis and multivariable logistic regression.Results
Overall, 23.2% of women age 18–26 and 6.7% of women age 27–30 years reported receiving at least 1 dose of HPV vaccine. In multivariable analyses among women age 18–26 years, not being married, having a regular physician, seeing a physician or obstetrician/gynecologist in the past year, influenza vaccination in the past year, and receipt of other recommended vaccines were associated with HPV vaccination. One-third of unvaccinated women age 18–26 years (n = 490) were interested in receiving HPV vaccine. Among women who were not interested in receiving HPV vaccine (n = 920), the main reasons reported included: not needing the vaccine (41.3%); concerns about safety of the vaccine (12.5%); not knowing enough about the vaccine (11.9%); not being sexually active (8.2%); a doctor not recommending the vaccine (7.6%); and already having HPV (2.7%). Among women with health insurance, 10 or more physician contacts within the past year and no contraindications, 74.5% reported not receiving HPV vaccine.Conclusions
HPV vaccination coverage among women age 18–26 years remains low. Opportunities to vaccinate are missed. Healthcare providers can play an important role in educating young women about HPV and encouraging vaccination. Successful public health and educational interventions will need to address physician attitudes and practice patterns and other factors that influence vaccination behaviors. 相似文献10.
Objectives
The study aims to determine HPV vaccine uptake (≥1 dose) amongst adolescent girls in Hong Kong and to explore the reasons for non-acceptance of the vaccine.Study design
A total of 1832 secondary school girls (15.5 ± 2.0 years) were randomly surveyed. Their HPV vaccine uptake was estimated, and their reasons for non-vaccination summarised.Results
A total of 131 (7.2%, 95% CI: 6.0–8.4%) adolescent girls had received the HPV vaccine (≥1 dose). Vaccine uptake was positively associated with a higher maternal education level and locally born status. Amongst the non-vaccinated girls, 20.6% had never heard of or knew little about the vaccine, 20.2% ‘did not know where to receive’, and 17.8% were concerned about the cost.Conclusions
The HPV vaccine uptake amongst adolescent girls in Hong Kong is very low. A school-based education and service programme is needed to improve uptake and prevent disparities in the Chinese population. 相似文献11.
Objective
To examine the association between attending a well-woman clinic in the prior 2 years and obtaining the human papillomavirus (HPV) vaccine for their 9–17-year-old child.Methods
Women (n = 1256) who attended reproductive health clinics during September 2011 to February 2013 and had ≥1 children 9–17 years of age were asked to complete a self-administered questionnaire containing questions on demographic characteristics, prior well-woman visits, HPV awareness, and HPV vaccine intent and uptake among their adolescent children.Results
Nearly 78% of women reported having undergone a well-woman visit during the past 2 years. Bivariate analysis showed that the HPV vaccine initiation (23.9% vs. 14.0%, P = .004) and completion (13.6% vs. 6.7%, P = .011) among 9–17 daughters differed between mothers who did or did not have a well-woman visit during the past 2 years. However, intent to vaccinate them (47.2% vs. 53.3%, P = .173) did not differ between these two groups. With regard to 9–17 year old sons, vaccine initiation (10.1% vs. 9.6%, P = .871), completion (4.6% vs. 2.4%, P = .273) and intent to vaccinate (47.3% vs. 52.1%, P = .311) did not differ between these two groups. Multivariable logistic regression analyses confirmed the findings of these bivariate analyses after adjusting for confounder variables.Conclusion
The well-woman visit may be a missed opportunity for physicians to educate their patients about the benefits of HPV vaccination for their adolescent children in general and sons in particular. Intervention studies are warranted to assess the benefits of using this setting to improve HPV vaccine uptake in the US. 相似文献12.
Stephen I. Pelton Derek Weycker Jerome O. Klein David Strutton Vincent Ciuryla Gerry Oster 《Vaccine》2010
Background
Immunogenicity studies suggest antibody responses from a 7-valent pneumococcal conjugate vaccine (PCV7) regimen consisting of 2 doses in the primary series are less immunogenic, for at least several vaccine serotypes, compared with a regimen consisting of 3 doses; evidence of effectiveness for prevention of invasive pneumococcal disease for both regimens is available but comparative data are lacking for prevention of lower respiratory tract diseases (LRTD).Methods
We compared rates of LRTD between children who were born in 2002 and received 2 versus 3 PCV7 doses in the primary series, both before and after receipt of the booster dose, using a retrospective matched-cohort design and health insurance claims data. Two-dose and 3-dose children were matched (1:1) using propensity scoring. Cumulative rates of hospital admissions and outpatient visits for LRTD were tallied during the post-primary/pre-booster period and the post-booster period (to age 3 years), respectively.Results
During the post-primary/pre-booster period, 3-dose children (n = 3293) had 7.8 (95% CI: 0.8 to 14.8) fewer LRTD-related hospital admissions (per 1000 children) and 57 (95% CI: −6 to 128) fewer LRTD-related outpatient visits (per 1000 children) than matched 2-dose subjects (n = 3293). During the post-booster period, the numbers of LRTD-related hospital admissions and outpatient visits did not differ significantly between 3-dose and 2-dose children.Conclusions
Our findings suggest that a 2-dose PCV7 primary series, while conferring savings from reduced vaccine costs in comparison with a 3-dose primary series, also may confer less protection against LRTD in the first year of life, at least during the period soon after the vaccine is introduced. 相似文献13.
Mostafa K. El-Awady Ashraf A. Tabll Hassan Yousif Yasmin El-Abd Mohamed Reda Samy B. Khalil Abdel Rahman El-Zayadi Maysa H. Shaker Noha G. Bader El Din 《Vaccine》2010
Introduction
The highest estimated prevalence of HCV infection has been reported in Egypt, nearly 12% mostly type 4. Currently, a commercial vaccine to protect this high risk population as well as global HCV infected patients is not available.Objectives
In the present study, we aim at: (1) examining the viral binding capacities of purified monospecific polyclonal murine antibodies raised against genetically conserved viral protein sequences, i.e. synthetic peptides derived from those sequences located within envelope proteins and (2) assessment of immunogenic properties and safety parameters of those peptides individually and in a vaccine format in mice.Methods
Purified IgG Abs from immunized mice were used in immunocapture RT-PCR experiments to test viral neutralization by Abs raised against each of 4 peptides termed p35 (E1), p36 (E2), p37 (E2) and p38 (E2). Swiss mice were immunized with each of the 3 peptides (p35, p37 and p38) which generated neutralizing antibodies in immunocapture experiments. Antibody responses to corresponding peptides were determined using different routes of administration, different adjuvants, different doses and at different time points post-injection. To explore the dose range for future pharmacological studies, three doses namely 50 ng, 10 μg and 50 μg/25 gm mouse body weight were tested for biochemical and histopathological changes in several organs.Results
Murine Abs against p35, p37 and p38 but not p36 showed HCV neutralization in immunocapture experiments. Subcutaneous injection of peptides elicited higher responses than i.m. and i.p. Immunization with Multiple Antigenic Peptide (MAP) form or coupled to Al PO4 elicited the highest Ab responses. Peptide doses of 50 ng/25 gm body weight or less were effective and safe, however dose assessment still requires further study. Histopathological changes were observed in animals that received doses ∼1000 times higher than the potential therapeutic dose.Conclusion
Exploration of humoral immunogenicity, neutralization capacity and safety suggested that the peptides presented herein are candidate vaccine components for further preclinical assessment. 相似文献14.
Objectives
This cross-sectional study, guided by Ajzen's Theory of Planned Behavior, aimed to identify factors that influence the decision to obtain an HPV vaccine among college women and to examine the relationships among these factors.Methods
An electronic self-administered survey was utilized to collect data. An email invitation was sent to 3074 college women attending a large, public university in southern California, aged between 18 and 26 years. The email directed the recipient to click on a link to a web-based survey if she wanted to participate in the study.Results
Participants in this study were college women (n = 384; 175 HPV non-vaccinees and 209 HPV vaccinees). Women in this study knew that a Pap test is still needed after HPV vaccination and that the HPV vaccine does not protect against other Sexually Transmitted Infections. Both non-vaccinees and vaccinees had positive attitudes about mandating HPV vaccine. Knowledge and attitudes toward the vaccine were not directly linked to the outcome predictors – intention to obtain the vaccine and vaccine uptake. Attitude about receiving HPV vaccine, subjective norms (complying with the expectations of others), and perceived behavioral control were correlated with the outcome predictors. Subjective norms consistently predicted intention to obtain HPV vaccine and vaccine uptake.Conclusions
A proposal to mandate the HPV vaccine among young girls/women was acceptable to this population. Vaccination promotion strategies to increase the vaccine uptake rate among the catch-up group (aged 13–26) should include attention to college women's subjective norms. Health care provider's recommendation and encouragement from significant others (i.e., mother and peers) are critical in order for the college women to obtain the vaccine. 相似文献15.
Ismar A. Rivera-Olivero Berenice del Nogal Mariana Fuentes Rossana Cortez Debby Bogaert Peter W.M. Hermans Jacobus H de Waard 《Vaccine》2014
Background and aims
We evaluated the immunogenicity of the 7-valent pneumococcal conjugate vaccine (PCV7), and its impact on pneumococcal carriage in Venezuelan children at high risk for invasive pneumococcal disease (IPD).Methods
82 children (age 2–59 months) with sickle cell anemia (n = 22), chronic heart disease (n = 19), HIV infection (n = 12), immune-suppressive therapy (n = 11) and other IPD-predisposing conditions (n = 18) were vaccinated with PCV7 according to CDC-recommended age-related immunization schedules. Blood samples were taken to determine the concentration of IgG antibody, and nasopharyngeal swabs were obtained to isolate Streptococcus pneumoniae, before the first vaccine dose and 1 month after completion of the vaccination schedule.Results
Pneumococcal carriage prior to the first immunization was 27% (n = 22), with the most frequently carried serotypes being vaccine serotypes 6B (22%) and 14 (13%). One month after completion of the vaccination scheme pneumococcal carriage was 22% (n = 17), dominated by non-vaccine serotypes 19A (24%) and 7F (12%). Before immunization, 65% of the subjects had IgG antibody titers >0.35 μg/mL for five serotypes tested. Post-vaccination, 100% of the subjects showed titers >1.0 μg/mL for all PCV7 serotypes with geometric mean concentrations (GMC) ranging from 1.75 μg/mL (serotype 23F) to 17.16 μg/mL (serotype 14). Children previously colonized with serotype 6B had a significantly lower GMC to this serotype following immunization than children not carrying 6B prior to the first PCV dose (p < 0.05).Conclusions
PCV7 is highly immunogenic in Venezuelan children at high-risk for IPD. Vaccination was associated with an immediate shift in nasopharyngeal carriage toward non-PCV7 serotypes. Finally, we observed serotype-specific hyporesponsiveness to immunization after natural carriage with the same serotype in high-risk children. 相似文献16.
Background
The objective of this study was to estimate the number of years after onset of a quadrivalent HPV vaccination program before notable reductions in genital warts and cervical intraepithelial neoplasia (CIN) will occur in teenagers and young adults in the United States.Methods
We applied a previously published model of HPV vaccination in the United States and focused on the timing of reductions in genital warts among both sexes and reductions in CIN 2/3 among females. Using different coverage scenarios, the lowest being consistent with current 3-dose coverage in the United States, we estimated the number of years before reductions of 10%, 25%, and 50% would be observed after onset of an HPV vaccination program for ages 12–26 years.Results
The model suggested female-only HPV vaccination in the intermediate coverage scenario will result in a 10% reduction in genital warts within 2–4 years for females aged 15–19 years and a 10% reduction in CIN 2/3 among females aged 20–29 years within 7–11 years. Coverage had a major impact on when reductions would be observed. For example, in the higher coverage scenario a 25% reduction in CIN2/3 would be observed with 8 years compared with 15 years in the lower coverage scenario.Conclusions
Our model provides estimates of the potential timing and magnitude of the impact of HPV vaccination on genital warts and CIN 2/3 at the population level in the United States. Notable, population-level impacts of HPV vaccination on genital warts and CIN 2/3 can occur within a few years after onset of vaccination, particularly among younger age groups. Our results are generally consistent with early reports of declines in genital warts among youth. 相似文献17.
Prasad S. Kulkarni Amita Sapru Pradeep M. D’costa Anand Pandit Shampur N. Madhusudana Ashwin Belludi Yajaman Somnath Mangrule Bhagwat Gunale Ashish R. Bavdekar 《Vaccine》2013
Background
Rabies is 100% fatal but preventable with modern vaccines and immunoglobulins. There is a huge demand for rabies vaccines in developing countries of Asia and Africa. We have developed a new purified vero cell rabies vaccine (PVRV) and evaluated its safety and immunogenicity in healthy volunteers by intramuscular (IM) and intradermal (ID) routes of vaccination.Methodology
Sixty adults aged between 18 and 50 years were recruited in this actively controlled Phase I clinical study and were randomized to receive three 1 ml or 0.1 ml doses of new PVRV intramuscularly or intradermally on days 0, 7 and 21. The control group received commercially available PVRV (Verorab) by intramuscular route. Adverse events (AEs) were recorded with diary cards till day 28 post-vaccination. Immunogenicity was assessed on day 0, 7, 21 and 42 by rapid fluorescence focus inhibition test (RFFIT).Results
In all, 116 solicited local and systemic events were reported across the three groups. Most were mild and resolved without sequelae. Also the few unsolicited events, deemed unrelated to the study vaccines, caused no problems. No significant changes in the routine laboratory parameters were found. Two doses of a vaccine elicited protective titres (≥0.5 IU/ml) in all subjects, the GMTs varying between 0.57 and 0.69 IU/ml on day 7, 3.07 and 3.97 IU/ml on day 21, and 6.12 and 8.52 IU/ml on day 42 post-vaccination.Conclusions
PVRV was well tolerated and showed good immunogenicity regardless of whether administered intramuscularly or, using a tenth of that volume, intradermally. Further studies with this new vaccine are warranted. 相似文献18.
Talía Malagón Véronique Joumier Marie-Claude Boily Nicolas Van de Velde Mélanie Drolet Marc Brisson 《Vaccine》2013
Background
Differences in sexual behaviour are partly responsible for significant inequalities in human papillomavirus (HPV)-related diseases between sub-populations. Our aim was to illustrate how differential HPV vaccine uptake by sexual behaviour can impact population-level vaccination effectiveness and inequalities in HPV prevalence.Methods
We used a multi-type individual-based transmission-dynamic model of HPV infection. The modelled population is stratified into 4 sexual activity levels (low = L0, high = L3). The model was calibrated to Canadian epidemiological data, including the proportion of sexually active individuals by gender and type-specific HPV prevalence by level of sexual activity. Vaccine uptake by sexual activity level was varied in one-way sensitivity analyses. Uncertainty in model predictions is presented using the median [10-90th percentiles] of simulations.Results
In our pre-vaccination calibrated modelled population, the most sexually active risk groups (L2–L3) account for 43% of prevalent HPV-16/18 infections while only representing 20% of the population. Under base case assumptions (age at vaccination = 12 years, vaccine efficacy = 100%, average duration of protection = 20 years, overall coverage = 50%), vaccinating girls is predicted to reduce HPV-16/18 prevalence by 56% [46–69] at equilibrium (70 years post-vaccination) when uptake is uniform across sexual activity levels, and by 35% [28–40] when uptake is maldistributed (L0: 100%, L1: 55%, L2: 0%, L3: 0%). At uniform 50% vaccination coverage across risk groups, HPV-16/18 prevalence is predicted to be reduced by 62% [52–73], 74% [57–82], 40% [24–60], and 28% [7–54] at equilibrium among women in levels of sexual activity L0, L1, L2 and L3, respectively.Conclusions
A low vaccine uptake in girls at highest risk of future HPV acquisition may substantially limit population effectiveness of vaccination. Vaccination effectiveness is lower in more sexually active groups due to smaller herd effects. Uniform vaccination coverage across sub-populations may not be able to decrease existing inequalities in HPV infection and disease unless coverage is high enough to produce herd effects in higher risk groups. 相似文献19.
James W. Keck Jay D. Wenger Dana L. Bruden Karen M. Rudolph Debby A. Hurlburt Thomas W. Hennessy Michael G. Bruce 《Vaccine》2014
Background
Changes in pneumococcal serotype-specific carriage and invasive pneumococcal disease (IPD) after the introduction of pneumococcal conjugate vaccine (PCV7) could inform serotype epidemiology patterns following the introduction of newer conjugate vaccines.Methods
We used data from statewide IPD surveillance and annual pneumococcal carriage studies in four regions of Alaska to calculate serotype-specific invasiveness ratios (IR; odds ratio of a carried serotype's likelihood to cause invasive disease compared to other serotypes) in children <5 years of age. We describe changes in carriage, disease burden, and invasiveness between two time periods, the pre-PCV7 period (1996–2000) and the late post-PCV7 period (2006–2009).Results
Incidence of IPD decreased from the pre- to post-vaccine period (95.7 vs. 57.2 cases per 100,000 children, P < 0.001), with a 99% reduction in PCV7 disease. Carriage prevalence did not change between the two periods (49% vs. 50%), although PCV7 serotype carriage declined by 97%, and non-vaccine serotypes increased in prevalence. Alaska pre-vaccine IRs corresponded to pooled results from eight pre-vaccine comparator studies (Spearman's rho = 0.44, P = 0.002) and to the Alaska post-vaccine period (Spearman's rho = 0.28, P = 0.029). Relatively invasive serotypes (IR > 1) caused 66% of IPD in both periods, although fewer serotypes with IR > 1 remained in the post-vaccine (n = 9) than the pre-vaccine period (n = 13).Conclusions
After PCV7 introduction, serotype IRs changed little, and four of the most invasive serotypes were nearly eliminated. If PCV13 use leads to a reduction of carriage and IPD for the 13 vaccine serotypes, the overall IPD rate should further decline.Note
The findings and conclusions in this report are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention. 相似文献20.
Amelieke J.H. Cremers Jacques F. Meis Grietje Walraven Christa E. van der Gaast-de Jongh Gerben Ferwerda Peter W.M. Hermans 《Vaccine》2014