ArticlemedRxiv : the preprint server for health sciences2025
The effect of bivalent HPV vaccination against invasive cervical cancer and CIN3+ in the Netherlands: a national linkage study.
Article in medRxiv : the preprint server for health sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The protective effect of HPV vaccination against cervical cancer has been demonstrated in registry linkage studies. The start age of screening in those studies was lower than 25 years. We estimated the vaccine effectiveness of bivalent HPV16/18 vaccination against invasive cervical cancer and cervical intraepithelial neoplasia grade 3 (CIN3+) in the Netherlands where routine screening starts at age 30 years. Methods: We linked the vaccination status of women born in year 1993 who were eligible for HPV vaccination at age 16 years with histopathological results recorded in the nationwide pathology databank (Palga). Cumulative risks of invasive cervical cancer and CIN3+ were estimated for fully vaccinated (3 doses or 2 doses ≥150 days apart), partially vaccinated, and unvaccinated women. Vaccine effectiveness estimates were adjusted for differences in screening participation between the vaccine groups. Findings: A total of 103,059 women were included, of whom 47,130 were fully vaccinated, 5,098 were partially vaccinated, and 50,831 were unvaccinated. Five (0·011%) cancers were observed in fully vaccinated, two (0·039%) in partially vaccinated, and 42 (0·083%) in unvaccinated women. The vaccine effectiveness in fully vaccinated women was 91·5% (95% CI 78·9, 96·6) against cancer and 81·2% (95% CI 78·4, 83·7) against CIN3+. The vaccine effectiveness in partially vaccinated women was 48·1% (95% CI -56·8, 82·8) against cancer and 58·4% (95% CI 45·3, 68·3) against CIN3+. Interpretation: The high effectiveness of bivalent HPV vaccination against cervical cancer and CIN3+ and the low cancer incidence supports a screening start age of 30 years in vaccinated women. Research in context:
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