Abstract
Background: Oropharyngeal cancer incidence is rapidly rising due to human papillomavirus (HPV) 16 infection. The dearth of data on effectiveness of national girl-only vaccination program in preventing oral HPV infection and the potential herd immunity effect on unvaccinated boys has resulted in considerable controversy regarding the need to vaccinate boys, especially in countries with high vaccination coverage of girls.
Methods: Subjects aged 0-65 years undergoing tonsillectomy for non-malignant indications were recruited in 6 UK hospitals. Oral samples were collected in following order: oral rinse, tongue base and pharyngeal wall brushes, then tonsil tissue (tonsillectomy). Vaccination data was obtained from regional health authorities. All samples were centrally tested for HPV-DNA by PCR amplification. (NCT01330147).
Results: Of 940 subjects, 243 girls and 69 boys were aged 12-24; median age 18.6 years. 189 (78%) girls and no boys received HPV vaccination. Overall, oropharyngeal-HPV16 prevalence in vaccinated girls was significantly lower than unvaccinated girls (0.5% vs 5.6%, p=0.04). In contrast, prevalence of any oropharyngeal-HPV type was similar in vaccinated and unvaccinated girls (19% vs 20%, p=0.76). Oropharyngeal-HPV16 prevalence in (unvaccinated) boys was similar to vaccinated girls (0% vs 0.5%, p>0.99), and lower than unvaccinated girls (0% vs 5.6%, p=0.08).
Conclusions: Our findings indicate that the UK girl-only national vaccination program is associated with significant reductions in oropharyngeal-HPV16 infections in children and young adults. This is also the first data to suggest potential herd immunity from girl-only vaccination against oropharyngeal HPV infection in contemporaneously-aged boys.
Methods: Subjects aged 0-65 years undergoing tonsillectomy for non-malignant indications were recruited in 6 UK hospitals. Oral samples were collected in following order: oral rinse, tongue base and pharyngeal wall brushes, then tonsil tissue (tonsillectomy). Vaccination data was obtained from regional health authorities. All samples were centrally tested for HPV-DNA by PCR amplification. (NCT01330147).
Results: Of 940 subjects, 243 girls and 69 boys were aged 12-24; median age 18.6 years. 189 (78%) girls and no boys received HPV vaccination. Overall, oropharyngeal-HPV16 prevalence in vaccinated girls was significantly lower than unvaccinated girls (0.5% vs 5.6%, p=0.04). In contrast, prevalence of any oropharyngeal-HPV type was similar in vaccinated and unvaccinated girls (19% vs 20%, p=0.76). Oropharyngeal-HPV16 prevalence in (unvaccinated) boys was similar to vaccinated girls (0% vs 0.5%, p>0.99), and lower than unvaccinated girls (0% vs 5.6%, p=0.08).
Conclusions: Our findings indicate that the UK girl-only national vaccination program is associated with significant reductions in oropharyngeal-HPV16 infections in children and young adults. This is also the first data to suggest potential herd immunity from girl-only vaccination against oropharyngeal HPV infection in contemporaneously-aged boys.
| Original language | English |
|---|---|
| Journal | Clinical Infectious Diseases |
| Early online date | 22 Dec 2018 |
| DOIs | |
| Publication status | Published - Dec 2018 |
Keywords
- head and neck cancer
- vaccination
- oropharyngeal cancer
- cancer prevention
- clinical trial
Access to Document
- Hesham_Mehanna_et_al_Human_Papillomavirus_(HPV)_vaccine_effectiveness_Clinical_Infectious_Diseases_2018
Checked for eligibility: 17/12/2018 This is the accepted manuscript for a forthcoming publication in Clinical Infectious Diseases.