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Measuring vaccine effectiveness against persistent HPV infections: a comparison of different statistical approaches Donken, R.; Hoes, J.; Knol, M. J.; Ogilvie, Gina; Dobson, S.; King, A. J.; Singer, Joel; Woestenberg, P. J.; Bogaards, J. A.; Meijer, C. J. L. M.; de Melker, H. E.

Abstract

Background: Persistent high-risk human papillomavirus (HPV) infection is endorsed by the World Health Organization as an intermediate endpoint for evaluating HPV vaccine effectiveness/efficacy. There are different approaches to estimate the vaccine effectiveness/efficacy against persistent HPV infections. Methods: We performed a systematic literature search in Pubmed to identify statistical approaches that have been used to estimate the vaccine effectiveness/efficacy against persistent HPV infections. We applied these methods to data of a longitudinal observational study to assess their performance and compare the obtained vaccine effectiveness (VE) estimates. Results: Our literature search identified four approaches: the conditional exact test for comparing two independent Poisson rates using a binomial distribution, Generalized Estimating Equations for Poisson regression, Prentice Williams and Peterson total time (PWP-TT) and Cox proportional hazards regression. These approaches differ regarding underlying assumptions and provide different effect measures. However, they provided similar effectiveness estimates against HPV16/18 and HPV31/33/45 persistent infections in a cohort of young women eligible for routine HPV vaccination (range VE 93.7–95.1% and 60.4–67.7%, respectively) and seemed robust to violations of underlying assumptions. Conclusions: As the rate of subsequent infections increased in our observational cohort, we recommend PWP-TT as the optimal approach to estimate the vaccine effectiveness against persistent HPV infections in young women. Confirmation of our findings should be undertaken by applying these methods after longer follow-up in our study, as well as in different populations.

Item Metadata

Title
Measuring vaccine effectiveness against persistent HPV infections: a comparison of different statistical approaches
Creator
Donken, R.; Hoes, J.; Knol, M. J.; Ogilvie, Gina; Dobson, S.; King, A. J.; Singer, Joel; Woestenberg, P. J.; Bogaards, J. A.; Meijer, C. J. L. M.; de Melker, H. E.
Contributor
Children's Hospital (Vancouver, B.C.). Vaccine Evaluation Center
Publisher
BioMed Central
Date Issued
2020-07-08
Description
Background: Persistent high-risk human papillomavirus (HPV) infection is endorsed by the World Health Organization as an intermediate endpoint for evaluating HPV vaccine effectiveness/efficacy. There are different approaches to estimate the vaccine effectiveness/efficacy against persistent HPV infections. Methods: We performed a systematic literature search in Pubmed to identify statistical approaches that have been used to estimate the vaccine effectiveness/efficacy against persistent HPV infections. We applied these methods to data of a longitudinal observational study to assess their performance and compare the obtained vaccine effectiveness (VE) estimates. Results: Our literature search identified four approaches: the conditional exact test for comparing two independent Poisson rates using a binomial distribution, Generalized Estimating Equations for Poisson regression, Prentice Williams and Peterson total time (PWP-TT) and Cox proportional hazards regression. These approaches differ regarding underlying assumptions and provide different effect measures. However, they provided similar effectiveness estimates against HPV16/18 and HPV31/33/45 persistent infections in a cohort of young women eligible for routine HPV vaccination (range VE 93.7–95.1% and 60.4–67.7%, respectively) and seemed robust to violations of underlying assumptions. Conclusions: As the rate of subsequent infections increased in our observational cohort, we recommend PWP-TT as the optimal approach to estimate the vaccine effectiveness against persistent HPV infections in young women. Confirmation of our findings should be undertaken by applying these methods after longer follow-up in our study, as well as in different populations.
Subject
Human papillomavirus; HPV; Persistent infection; HPV vaccination; Follow-up
Genre
Article
Type
Text
Language
eng
Date Available
2020-07-13
Provider
Vancouver : University of British Columbia Library
Rights
Attribution 4.0 International (CC BY 4.0)
DOI
10.14288/1.0392353
URI
http://hdl.handle.net/2429/75141
Affiliation
Medicine, Faculty of; Other UBC; Non UBC; Population and Public Health (SPPH), School of
Citation
BMC Infectious Diseases. 2020 Jul 08;20(1):482
Publisher DOI
10.1186/s12879-020-05083-7
Peer Review Status
Reviewed
Scholarly Level
Faculty
Copyright Holder
The Author(s)
Rights URI
http://creativecommons.org/licenses/by/4.0/
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Attribution 4.0 International (CC BY 4.0)