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HPV vaccine and STIs

Children's Hospital (Vancouver, B.C.). Vaccine Evaluation Center; Centre for Health Evaluation & Outcome Sciences; Children's Hospital (Vancouver, B.C.). Research Institute; BC Centre for Disease Control; Women's Hospital (Vancouver, B.C.)

Background: Current human papillomavirus (HPV) vaccine coverage in the United States (in 2019, 66-70%), remains below the Healthy People 2020 coverage goal of 80%. HPV Vaccine misinformation, including parental concerns of sexual risk-compensation influence vaccine uptake. We examined the association between HPV vaccination and sexually transmitted infection (STI) outcomes. Methods: Of the 20,146 participants from 2013-2014 and 2015-2016 cycles of the National Health and Nutrition Examination Survey, 1050 women aged 18-35 with a history of sexual activity had complete case data. Roa-Scott Chi-squared and F-tests assessed survey-weighted socio-demographic differences between vaccinated and unvaccinated participants. Weighted logistic regression assessed crude and adjusted associations between self-reported HPV vaccination (none vs. ≥1dose) and lab-confirmed STIs (trichomonas and chlamydia) and vaccine-type HPV (6/11/16/18). As a sensitivity analysis, we conducted weighted-propensity score (PS) models and inverse probability weighting by vaccination status. PS and logistic regression were estimated through survey-weighted logistic regression on variables including race, education, income, marital status, US citizenship, cycle year and age. Results: Overall, 325 (31.8%) of young women with a history of sexual activity were HPV vaccinated, of which 22 (6.1%) received the vaccine at the routine-recommended ages of 11-12, 65.7% were vaccinated after their self-reported sexual debut, 3.8% had a lab-confirmed STI and 3.5% had vaccine-type HPV. There was no association between HPV vaccination and any STIs (adjusted odds ratio [aOR] 0.67, 95%CI:0.38-1.20), and vaccinated participants had 59% reduced odds of vaccine-type HPV (vs. unvaccinated; aOR 0.41, 95%CI:0.20-0.83). Results from the PS sensitivity analysis were similar to the main findings. Conclusion: Among young women who reported a history of sexual activity, HPV vaccination status was protective against vaccine-type HPV and not associated with lab-based STI outcomes. Although findings may be susceptible to reporting bias, results indicating low vaccine uptake at routine-recommended ages requires additional efforts promoting HPV vaccination before sexual-debut.

Article; Postprint

eng

Vancouver : University of British Columbia Library

10.14288/1.0448744

Medicine, Faculty of; Pediatrics, Department of; Population and Public Health (SPPH), School of

10.1016/j.vaccine.2020.10.033

Faculty; Researcher; Postdoctoral

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