Evidence map›Paper›PMID 31319173›Full record

ArticlePapillomavirus research (Amsterdam, Netherlands)2019

Is one dose of human papillomavirus vaccine as effective as three?: A national cohort analysis.

Julia Ml Brotherton, Alison Budd, Christopher Rompotis, Natasha Bartlett, Michael J Malloy, Rachael L Andersen, Kim Ar Coulter, Peter W Couvee, Nerida Steel, Gail H Ward and 1 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Papillomavirus research (Amsterdam, Netherlands), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
49citing papers in PubMed, 4 pooled it
11.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

49 citing papers in PubMed, 4 syntheses or guidelines pooled it, 118 citations in OpenAlex.

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  6. HPV Vaccine Intent among Adult Women Receiving Care at Community Health Centers.Journal of cancer education : the official journal of the American Association for Cancer Education · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 8 institutions in 1 country.

Julia Ml BrothertonNational HPV Vaccination Program Register, VCS Population Health, VCS Foundation, East Melbourne, Victoria, Australia; Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia. Electronic address: jbrother@vcs.org.au.
Alison BuddScreening Analysis and Monitoring Unit, Australian Institute of Health and Welfare, Canberra, Australia. Electronic address: Alison.budd@aihw.gov.au.
Christopher RompotisScreening Analysis and Monitoring Unit, Australian Institute of Health and Welfare, Canberra, Australia. Electronic address: christopher.rompotis@aihw.gov.au.
Natasha BartlettScreening Analysis and Monitoring Unit, Australian Institute of Health and Welfare, Canberra, Australia. Electronic address: Natasha.Bartlett@aihw.gov.au.
Michael J MalloyNational HPV Vaccination Program Register, VCS Population Health, VCS Foundation, East Melbourne, Victoria, Australia; Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia. Electronic address: mmalloy@vcs.org.au.
Rachael L AndersenScreening and Preventive Health Services, Department of Health and Human Services, Melbourne, Victoria, Australia. Electronic address: Rachael.Andersen@dhhs.vic.gov.au.
Kim Ar CoulterCancer Screening Services, Department of Health, Northern Territory Government, Casuarina, Northern Territory, Australia. Electronic address: Kim.Coulter@nt.gov.au.
Peter W CouveeACT Cervical Screening Program, Population, Health Protection and Prevention, ACT Health, Canberra, Australian Capital Territory, Australia. Electronic address: Peter.Couvee@act.gov.au.
Nerida SteelWA Cervical Cancer Prevention Program, Women and Newborn Health Service, North Metropolitan Health Service, Western Australia, Australia; Institute for Health, University of Notre Dame Australia, Fremantle, Western Australia, Australia. Electronic address: Nerida.Steel@health.wa.gov.au.
Gail H WardPopulation Screening and Cancer Prevention, Tasmanian Health Service, Hobart, Tasmania, Australia. Electronic address: gail.ward@ths.tas.gov.au.
Marion SavilleVCS Foundation, Carlton, Victoria, Australia; Department of Obstetrics and Gynaecology, University of Melbourne, Victoria, Australia. Electronic address: msaville@vcs.org.au.
Australian Institute of Health and Welfare · AUMyer Foundation · AUACT GovernmentDepartment of Health and Human Services · AUGovernment of the Northern Territory · AUThe University of Notre Dame Australia · AUUniversity of Melbourne · AUUniversity of Tasmania · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimProphylactic human papillomavirus (HPV) vaccines are highly effective at preventing pre-cancerous cervical lesions when given in a three-dose schedule. Some post-hoc trial data suggest that one dose prevents HPV infection. If one dose could prevent pre-cancerous cervical lesions, then global cervical cancer prevention would be greatly facilitated. We assessed the effectiveness of quadrivalent HPV vaccine by number of doses against cervical intraepithelial neoplasia (CIN) 2 or 3/adenocarcinoma-in-situ (AIS)/cancer in Australia up to seven years post vaccination.

methodsWe linked registry data from all 8 jurisdictional cervical screening registers, with the national HPV vaccination register, death index and cancer registers for all Australian women aged 15 or under when eligible for vaccine who screened between April 2007 (when vaccination commenced) and 31 December 2014. We performed Cox proportional hazard regression, adjusted a priori for age, socioeconomic status, and area of residence, to estimate hazard ratios of histologically confirmed CIN2/CIN3/AIS/cancer.

resultsWe included 250,648 women: 48,845 (19·5%) unvaccinated, 174,995 (69·8%) had received three doses, 18,190 (7·3%) two doses and 8,618 (3·4%) one dose. The adjusted hazard ratio was significantly lower for all dose groups compared to unvaccinated women (1 dose 0·65 (95%CI 0·52-0·81), 2 doses 0·61 (0·52-0·72) and 3 doses 0·59 (0·54-0·65).) With adjustment for age at vaccination amongst the vaccinated group, the adjusted hazard ratios for one dose and two dose recipients were comparable to three dose recipients (one dose 1.01 (95%CI 0.81-1.26), two doses 1.00 (0.85-1.17).) Multiple sensitivity analyses, including use of different dose assignment methods, produced consistent findings. Comparison with a historical cohort of age matched women showed that the result was not due to herd protection alone.

conclusionsOne dose had comparable effectiveness as two or three doses in preventing high-grade disease in a high coverage setting. These findings support the hypothesis that one dose vaccination may be a viable strategy when working towards the global elimination of cervical cancer.

Indexed as

AdolescentAdultAlphapapillomavirusAustraliaFemaleHumansMiddle AgedOutcome Assessment, Health CarePapillomavirus InfectionsPapillomavirus VaccinesProportional Hazards ModelsPublic Health SurveillanceUterine Cervical DysplasiaVaccinationYoung AdultPapillomavirus VaccinesAustraliaCervical intraepithelial neoplasiaEffectivenessHuman papillomavirusVaccination

Identifiers

PMID31319173
PMCPMC6658930
OpenAlexW2958262815

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.