Lengthening dosing schedule of HPV vaccine may provide effective option for expanding use of vaccine
Administration of human papillomavirus (HPV) vaccine doses over a longer period of time to adolescent girls in Vietnam resulted in antibody concentration levels that were comparable to the standard vaccine schedule, according to a study in the April 13 issue of JAMA, a theme issue on infectious disease and immunology.
Kathleen M. Neuzil, M.D., M.P.H., of PATH, Seattle, presented the findings of the study at a JAMA media briefing at the National Press Club in Washington, D.C.
Cervical cancer is an important cause of illness and death among women throughout the world. "Each year, new cases of cervical cancer occur in approximately 529,000 women and 275,000 women die. An estimated 88 percent of deaths due to cervical cancer occur among women residing in developing countries," according to background information in the article. Human papillomaviruses are the primary cause of cervical cancer. "Combined with continued strengthening of simple evidence-based screening and treatment approaches, effective HPV vaccine programs could reduce cervical cancer rates in developing countries to the low levels currently observed in many developed countries. One challenge to broadly implementing HPV vaccination programs in developing countries will be delivering the currently recommended 3 doses of vaccine to adolescents within 6 months (dosing schedules at 0, 2, and 6 months or at 0, 1, and 6 months)," the authors write. Even in settings in which such vaccination schedules are feasible, alternative schedules may have advantages, such as lower cost (the vaccine could be delivered with other health interventions) or increased coverage (it may be easier for girls and their families or for vaccinators).
Dr. Neuzil and colleagues conducted a randomized noninferiority trial (predetermined measured outcome of intervention not worse than that of standard dosing schedule) in northwestern Vietnam to determine the immunogenicity (the ability of the vaccine to stimulate an immune response) and reactogenicity (the capacity of a vaccine to produce adverse reactions) of alternative schedules of quadrivalent HPV vaccine. The study, conducted between October 2007 and January 2010, assessed 4 schedules of an HPV vaccine delivered in 21 schools to 903 adolescent girls (ages 11-13 years at enrollment). Intramuscular injection of 3 doses of quadrivalent HPV vaccine was delivered on a standard dosing schedule (at 0, 2, and 6 months) or one of 3 alternative dosing schedules (at 0, 3, and 9 months; at 0, 6, and 12 months; or at 0,12, and 24 months). Of the 903 girls, 809 (89.6 percent) received all 3 doses of vaccine and had a serum sample available for testing after the final dose of the HPV vaccine.
For all 4 vaccination schedule groups and vaccine types, the HPV geometric mean titers (GMTs; a measure of antibody concentrations) were low at the beginning of the study and increased significantly after receipt of 3 doses of the vaccine. For the intention-to-treat population and compared with the standard schedule group at 0, 2, and 6 months, the alternative schedule groups at 0, 3, and 9 months and 0, 6, and 12 months met noninferiority criteria (as gauged by level of antibody concentrations) for the anti-HPV-16 and anti-HPV-18 (HPV types) responses at 1 month after receipt of the third dose. Compared with the standard schedule group, the alternative schedule group at 0, 12, and 24 months met noninferiority criteria for HPV-18 but not for HPV-16.
The vaccine was generally well tolerated in each dosing schedule group. Pain at the injection site was the most common adverse event. No serious adverse events were found.
"The similarity of the immunogenicity and reactogenicity profiles of the HPV vaccine reported from this predominantly ethnic minority population in a low-resource area of Vietnam and other populations throughout the world is reassuring and supports more widespread introduction of the vaccine. The World Health Organization acknowledges that programmatic constraints must be considered in the decision to commence national HPV immunization programs. The option of delivering HPV vaccine on flexible schedules will allow countries to minimize costs and maximize feasibility according to local vaccination practices," the authors write.
More information: JAMA. 2011;3051424-1431.
Provided by JAMA and Archives Journals
- New HPV vaccine under study Nov 19, 2007 | not rated yet | 0
- Study: Males should be given HPV vaccine Nov 28, 2007 | not rated yet | 0
- Study on government's controversial choice of HPV vaccine Jul 18, 2008 | not rated yet | 0
- One in four California adolescent girls has had HPV vaccine Feb 17, 2009 | not rated yet | 0
- Cervical screenings could be cut to twice in a lifetime with HPV vaccine Nov 10, 2010 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Classical and Quantum Mechanics via Lie algebras
Apr 15, 2011 I'd like to open a discussion thread for version 2 of the draft of my book ''Classical and Quantum Mechanics via Lie algebras'', available online at http://lanl.arxiv.org/abs/0810.1019 , and for the...
- More from Physics Forums - Independent Research
More news stories
(AP)—Government health officials are investigating several health problems reported with potentially contaminated medications made by a Tennessee specialty pharmacy.
Diseases, Conditions, Syndromes 17 hours ago | not rated yet | 0
(HealthDay)—Comorbid conditions often accompany alopecia areata, according to a study published online May 22 in JAMA Dermatology.
Diseases, Conditions, Syndromes 18 hours ago | not rated yet | 0
(HealthDay)—As a world-class golfer, Stacy Lewis' accomplishments are remarkable. But it was a physical challenge in her childhood that defined her ascent to the top of her sport.
Diseases, Conditions, Syndromes 19 hours ago | not rated yet | 0
Saudi Arabia said Friday it would send samples taken from animals possibly infected with a deadly SARS-like virus to the United States for testing in a bid to find the source of disease.
Diseases, Conditions, Syndromes 22 hours ago | not rated yet | 0
The World Health Organization voiced deep concern Thursday over the SARS-like virus that has killed 22 people in less than a year, saying it might potentially spread more widely between humans.
Diseases, Conditions, Syndromes May 24, 2013 | 5 / 5 (1) | 0
Heart failure accelerates the aging process and brings on early andropausal syndrome (AS), according to research presented today at the Heart Failure Congress 2013. AS, also referred to as male 'menopause', was four times ...
1 hour ago | not rated yet | 1
Coenzyme Q10 decreases all cause mortality by half, according to the results of a multicentre randomised double blind trial presented today at Heart Failure 2013 congress. It is the first drug to improve heart failure mortality ...
1 hour ago | not rated yet | 2
(AP)—Department of Justice lawyers have again asked a federal appeals court in New York to delay lifting age restrictions and prescription requirements on an emergency contraceptive popularly known as the morning-after ...
57 minutes ago | not rated yet | 0
Mortality and length of stay are highest in heart failure patients admitted in January, on Friday, and overnight, according to research presented today at the Heart Failure Congress 2013. The analysis of nearly 1 million ...
1 hour ago | not rated yet | 0
(Medical Xpress)—A new study by researchers in the US has shown that an ancient virus can be modified to help in the fight against the simian immunodeficiency virus SIV, which is the equivalent in monkeys ...
22 hours ago | 5 / 5 (3) | 0 |
Two mutations central to the development of infantile myofibromatosis (IM)—a disorder characterized by multiple tumors involving the skin, bone, and soft tissue—may provide new therapeutic targets, according to researchers ...
17 hours ago | 3 / 5 (2) | 0 |