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Estimating effectiveness of HPV vaccination against HPV infection from post-vaccination data in the absence of baseline data

机译：基线数据缺失估算HPV疫苗接种HPV感染的有效性

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BackgroundHPV vaccination programs have been introduced in large parts of the world, but monitoring of effectiveness is not routinely performed. Many countries introduced vaccination programs without establishing the baseline of HPV prevalences. We developed and validated methods to estimate protective effectiveness (PE) of vaccination from the post-vaccination data alone using references, which are invariant under HPV vaccination.MethodsType-specific HPV prevalence data for 15–39?year-old women were collected from the pre- and post-vaccination era in a region in southern Sweden. In a region in middle Sweden, where no baseline data had been collected, only post-vaccination data was collected. The age-specific baseline prevalence of vaccine HPV types (vtHPV, HPV 6, 11, 16, 18) were reconstructed as Beta distributions from post-vaccination data by applying the reference odds ratios between the target HPV type and non-vaccine-type HPV (nvtHPV) prevalences. Older non-vaccinated age cohorts and the southern Sweden region were used as the references. The methods for baseline reconstructions were validated by computing the Bhattacharyya coefficient (BC), a measure for divergence, between reconstructed and actual observed prevalences for vaccine HPV types in Southern Sweden, and in addition, for non-vaccine types in both regions. The PE estimates among 18–21?year-old women were validated by comparing the PE estimates that were based on the reconstructed baseline prevalences against the PE estimates based on the actual baseline prevalences.ResultsIn Southern Sweden the PEs against vtHPV were 52.2% (95% CI: 44.9–58.5) using the reconstructed baseline and 49.6% (43.2–55.5) using the actual baseline, with high BC 82.7% between the reconstructed and actual baseline. In the middle Sweden region where baseline data was missing, the PE was estimated at 40.5% (31.6–48.5).ConclusionsProtective effectiveness of HPV vaccination can be estimated from post-vaccination data alone via reconstructing the baseline using non-vaccine HPV type data.
机译：BackgroundHPV疫苗接种计划已在世界范围内引入，但不常规地进行有效性的监测。许多国家介绍了疫苗接种计划而不建立HPV患病率的基线。我们开发和验证了使用在HPV疫苗接种疫苗下不变的疫苗接种数据的疫苗接种疫苗接种的保护效果（PE）的方法。特异性特异性HPV患病率数据为15-39岁？从中收集岁月的妇女瑞典南部的一个地区的疫苗接种时代。在瑞典中间的一个地区，在没有收集基线数据的情况下，只收集了疫苗接种后数据。通过在靶HPV型和非疫苗型HPV之间施加参考ODDS比率，将疫苗HPV类型（VTHPV，HPV 6,11,11,18,118）重建为β分布的年龄特异性基线患病率作为疫苗接种数据。 （NVTHPV）普遍存在。较旧的非接种式年龄群组和瑞典南部地区用作参考。通过计算BHATTACHARYA系数（BC），验证基线重建的方法，该方法是在瑞典南部疫苗HPV类型的重建和实际观察到的患者之间进行分歧，另外，对于两个地区的非疫苗类型。 18-21之间的体育估计是通过比较基于基于实际基线普遍存在的重建基线普遍存在的PE估算的体育估算来验证岁月的估计。瑞典南部南部的PE为52.2％（95 ％CI：44.9-58.5）使用重建的基线和49.6％（43.2-55.5）使用实际基线，在重建和实际基线之间具有高BC 82.7％。在缺少基线数据的中间地区，PE估计为40.5％（31.6-48.5）。可以通过使用非疫苗HPV型数据重建基线来估计HPV疫苗接种的支持性效果。

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