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Delayed HPV Vaccination and Infection Risk
J Infect Dis; ePub 2016 Oct 12; Schlecht, et al
Among adolescents immunized for human papillomavirus (HPV) at ≥15 years, longer time-to-complete the 3-dose schedule was positively associated with increased risk of anogenital HPV6/11/16/18 infections, as well as incidence of associated cervical cytological abnormalities. This according to a recent longitudinal study of 1,139 sexually-active, inner-city adolescent women receiving the 3-dose quadrivalent (4vHPV) vaccine. Researchers found:
- Vaccinated women had significantly lower incidence rate ratios of cervical HPV6/11/16/18 and related types HPV31 and 45, as well an anal HPV6/11/16/18, compared to vaccine naïve women at enrollment.
- Higher risks of cervical HPV6/11/16/18 infection (HR, 2.9), along with associated cytological abnormalities (HR, 4.5), were observed among women immunized at ≥15 years who took ≥12 months to complete the 3-dose regimen.
Citation:
Schlecht NF, Diaz A, Shankar V, et al. Risk of delayed HPV vaccination in inner-city adolescent women. [Published online ahead of print October 12, 2016]. J Infect Dis. doi:10.1093/infdis/jiw486.
HPV vaccine is recommended for routine vaccination at age 11 or 12 years.1 ACIP also recommends vaccination for females aged 13 through 26 years and males aged 13 through 21 years not vaccinated previously. Vaccination is also recommended through age 26 years for men who have sex with men and for immunocompromised persons (including those with HIV infection) if not vaccinated previously.1 A recent study showed that 19% of 15-year-old females, 32% of 16-year-old females, and 55% of 18-year-old females have had sex.2 The current article supports the importance of vaccination during early adolescence when rates of sexual activity are low in order to protect against acquisition of HPV during middle and late adolescence, when the rate of sexual activity rises dramatically. —Neil Skolnik, MD