Epidemiologic Impact of HPV Vaccination

HPV 疫苗的流行病学影响

基本信息

批准号：
10451708
负责人：
JESSICA A KAHN
金额：
$ 63.76万
依托单位：
CINCINNATI CHILDRENS HOSP MED CTR
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-01-18 至 2024-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10451708
关键词：
15 year old Address Adherence Age Anogenital cancer Area Automobile Driving Behavior Behavioral Mechanisms Biological Cervical Cancer Screening Clinic Clinical Clinical Trials Communities Cost Effectiveness Analysis Counseling Data Data Set Death Rate Diagnostic Dose Effectiveness Enrollment Epidemiological trend Epidemiology Genotype Goals Healthy People 2020 Human Papilloma Virus Vaccination Human Papilloma Virus Vaccine Human Papilloma Virus-Related Malignant Neoplasm Human Papillomavirus Human papilloma virus infection Human papillomavirus 16 Individual Infection Infrastructure Investigation Longitudinal trends Malignant Neoplasms Malignant neoplasm of cervix uteri Marketing Methodology Methods Morbidity - disease rate Morphologic artifacts Outcome Policies Population Heterogeneity Prevalence Public Health Publications Recommendation Reporting Research Risk Risk Reduction Schedule Screening for cancer Seminal Sentinel Surveillance Signal Transduction Time Vaccinated Vaccination Vaccine Clinical Trial Vaccines Woman Work base clinical practice community setting cross immunity detection assay disparity reduction ethnic diversity experience health communication high risk population human female inclusion criteria innovation male malignant oropharynx neoplasm men mortality non-compliance novel policy recommendation prevent prophylactic racial diversity recruit screening program surveillance study trend unvaccinated vaccine effectiveness virology young man young woman

项目摘要

Project Summary Introduction of prophylactic human papillomavirus (HPV) vaccines has the potential to dramatically decrease morbidity and mortality from anogenital and oropharyngeal cancers. However, data from vaccine clinical trials cannot predict vaccine effectiveness in “real-world” community settings, and introduction of a 9-valent (in addition to a 2- and 4-valent) vaccine in 2015 and reduced dosing schedules (from 3 to 2 doses) in 2016 could further modify vaccine effectiveness. The impact of vaccine introduction can be efficiently and accurately evaluated by HPV surveillance studies that assess vaccine effectiveness, herd protection, cross-protection (decrease in HPV types genetically related to vaccine types), and type replacement (increase in non-vaccine- type HPV due to a reduction in vaccine types). We previously conducted 4 HPV surveillance studies in women (2006-2017) and 2 in men (2013-2017). Among women, we found evidence for vaccine effectiveness (but lower effectiveness with 1 vs. 3 doses), herd protection, and cross-protection; no evidence for type- replacement; and an unexpected increase in non-vaccine-type HPV in unvaccinated women. Among men, we found preliminary evidence for vaccine effectiveness and herd protection. Continued investigation through the proposed renewal is essential to achieve the following objectives: 1) assess the effects of 9-valent vaccine introduction and reduced dosing schedules on effectiveness, 2) elucidate long-term trends in herd protection, 3) identify signals of diminished cross-protection or emerging type-replacement, and 4) determine mechanisms for increases in non-vaccine-type HPV in unvaccinated women. The specific aims are to: 1) determine long- term trends in 4-valent - and emerging trends in 9-valent - HPV prevalence among vaccinated women (2006- 2023) and men (2013-2023) to assess HPV vaccine effectiveness, and among unvaccinated women and men to assess herd protection; 2) assess the differential impact of the number of vaccine doses received on vaccine-type HPV, by age; 3) determine trends in non-vaccine-type HPV prevalence among vaccinated women and men, to examine for persistent cross-protection and emerging type replacement; and 3) explore biological and behavioral mechanisms for the increase in non-vaccine-type HPV in unvaccinated women. Our approach will be to enroll 1,600 women and men in two additional surveillance studies, to characterize the impact of vaccine introduction across a total of 6 time periods in women (2006-2023, N=2,400) and 4 in men (2013- 2023, N=1,600). The proposed research is innovative because the resulting data could shift current research and clinical practice paradigms in the areas of vaccination and virology, and the research plan utilizes novel concepts, approaches and new methodologies to explore mechanisms driving HPV trends. The proposed research is significant because the data will provide key evidence for: 1) vaccination and cervical cancer screening programs; 2) public health communications and risk-reduction counseling; and 3) cost-effectiveness analysis and policy decisions: these will help to reduce disparities and mortality due to HPV-related cancers.

项目概要预防性人乳头瘤病毒 (HPV) 疫苗的引入有可能大幅减少然而，来自疫苗临床试验的数据显示肛门生殖器癌和口咽癌的发病率和死亡率。无法预测疫苗在“现实世界”社区环境中的有效性，以及引入 9 价疫苗（在 2015 年增加 2 价和 4 价）疫苗，并在 2016 年减少接种计划（从 3 剂减至 2 剂）可以有效、准确地进一步修改疫苗引入的影响。通过 HPV 监测研究进行评估，评估疫苗有效性、群体保护、交叉保护（与疫苗类型遗传相关的 HPV 类型减少）和类型替代（非疫苗类型增加）由于疫苗类型减少，我们之前对女性进行了 4 项 HPV 监测研究。在男性中（2006-2017 年）和 2 例女性中（2013-2017 年），我们发现了疫苗有效性的证据（但 1 剂与 3 剂相比效果较低）、群体保护和交叉保护；没有证据表明替代；以及未接种疫苗的女性中非疫苗型 HPV 的意外增加。通过继续调查找到了疫苗有效性和牛群保护的初步证据。拟议的更新对于实现以下目标至关重要：1）评估九价疫苗的效果介绍和减少剂量方案的有效性，2) 阐明牛群保护的长期趋势， 3) 识别交叉保护减弱或新兴类型替代的信号，以及 4) 确定机制针对未接种疫苗的女性中非疫苗型 HPV 的增加，具体目标是： 1) 确定长期- 接种疫苗的女性中 4 价 HPV 流行率的长期趋势和 9 价 HPV 流行率的新趋势（2006 年至今） 2023 年）和男性（2013-2023 年）评估 HPV 疫苗的有效性，以及未接种疫苗的女性和男性评估群体保护；2) 评估接种疫苗剂量的不同影响疫苗型 HPV，按年龄分类；3) 确定肺炎女性中非疫苗型 HPV 的流行趋势和男性，检查持续性交叉保护和新兴类型替代；3) 探索生物学；未接种疫苗的女性中非疫苗型 HPV 增加的行为机制。将招募 1,600 名女性和男性参加另外两项监测研究，以描述总共 6 个时间段对女性（2006 年至 2023 年，N=2,400）和 4 个时间段的男性（2013 年至 2023 年，N=1,600）。拟议的研究具有创新性，因为所得数据可能会改变当前的研究。疫苗接种和病毒学领域的临床实践范例，该研究计划利用了新颖的方法探索推动 HPV 趋势的机制的概念、途径和新方法。研究意义重大，因为这些数据将为以下方面提供关键证据：1) 疫苗接种和宫颈癌筛查计划；2) 公共卫生沟通和降低风险咨询；以及 3) 成本效益分析和政策决定：这些将有助于减少 HPV 相关癌症造成的差异和死亡率。

项目成果

期刊论文数量（11）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Prevalence of potential sexual abuse in adolescents and young adults and feasibility of an assessment and management plan used in three research projects.

DOI：
10.1002/nur.21850
发表时间：
2018-04
期刊：
Research in nursing & health
影响因子：
2
作者：
Morrow C;Thomas R;Ding L;Kahn JA
通讯作者：
Kahn JA

Epidemiology of Any and Vaccine-Type Anogenital Human Papillomavirus Among 13-26-Year-Old Young Men After HPV Vaccine Introduction.

DOI：
10.1016/j.jadohealth.2018.01.005
发表时间：
2018-07
期刊：
The Journal of adolescent health : official publication of the Society for Adolescent Medicine
影响因子：
0
作者：
Chandler E;Ding L;Gorbach P;Franco EL;Brown DA;Widdice LE;Bernstein DI;Kahn JA
通讯作者：
Kahn JA

Who's Not Protected in the Herd? Factors Associated with Vaccine-Type HPV in Unvaccinated Women.

谁在牛群中不受保护？