Date of Award

January 2014

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Linda Niccolai

Abstract

Background: HPV vaccines have demonstrated high efficacy in clinical trials against cervical lesions and infections by HPV vaccine types 16 and 18. Together these two types are responsible for approximately 70% of cervical cancer. Data on HPV vaccine effectiveness in general populations is limited.

Methods: Surveillance data monitoring high-grade cervical lesions in Connecticut was used. Medical records were reviewed and patients were interviewed to ascertain HPV vaccine history. Patients' biopsy specimens were typed to determine the presence of vaccine or non-vaccine type HPV. Odds ratios were determined using logistic regression, adjusting for age at diagnosis, grade of cervical lesion, race/ethnicity, and insurance type.

Results: From 2008-2012, 788 women with known vaccine status and typed biopsy specimens were analyzed. 8.9% of women received at least one vaccine dose. Adjusted vaccine effectiveness for at least one dose was estimated to be 53%. Vaccine type HPV was strongly associated with higher grade cervical lesions, but other statistically significant associations were not found.

Conclusions: The data suggests that HPV vaccination provides protection against vaccine type high-grade cervical lesions in women. Although these results are promising, more long term data and greater sample sizes are required to better estimate vaccine effectiveness.

Comments

This is an Open Access Thesis.

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