Wednesday, November 23, 2016

Two shots of HPV vaccine as good as three

Scimex: In a study published online by JAMA, Ole-Erik Iversen, M.D., Ph.D., of the University of Bergen, Norway, and colleagues examined whether human papillomavirus (HPV) type-specific antibody responses would be noninferior (not worse than) among girls and boys ages 9 to 14 years after receiving 2 doses of the 9-valent HPV vaccine compared with adolescent girls and young women ages 16 to 26 years who received the standard 3 doses.

For this study, conducted at 52 ambulatory care sites in 15 countries, five groups were enrolled:(1) girls ages 9 to 14 years to receive 2 doses 6 months apart (n = 301); (2) boys ages 9 to 14 years to receive 2 doses 6 months apart (n = 301); (3) girls and boys ages 9 to 14 years to receive 2 doses 12 months apart (n = 301); (4) girls ages 9 to 14 years to receive 3 doses over 6 months (n = 301); and (5) a control group of adolescent girls and young women ages 16 to 26 years to receive 3 doses over 6 months (n = 314).
Of the 1,518 participants (753 girls [average age, 11.4 years]; 451 boys [average age, 11.5 years]; and 314 adolescent girls and young women [average age, 21 years]), 1,474 completed the study and data from 1,377 were analyzed. At 4 weeks after the last dose, the researchers found that HPV antibody responses in girls and boys given 2 doses were noninferior to HPV antibody responses in adolescent girls and young women given 3 doses.
“Diseases related to the human papillomavirus impose a substantial health care burden on both the developing and developed world,” the authors write. “In many countries, HPV vaccination rates remain suboptimal. Using an effective 2-dose regimen entailing fewer visits could improve adherence to HPV vaccination programs. Co-administration of the 9-valent HPV vaccine with diphtheria, tetanus, pertussis, polio, and meningococcal vaccines could also be completed at the same visit, which has been demonstrated in clinical studies. Based on health economics modeling, use of a 2-dose vaccination schedule could potentially reduce the total costs of HPV vaccination.”
“Further research is needed to assess persistence of antibody responses and effects on clinical outcomes.”