University of Oulu

Gray, P, Kann, H, Pimenoff, VN, et al. Long‐term follow‐up of human papillomavirus type replacement among young pregnant Finnish females before and after a community‐randomised HPV vaccination trial with moderate coverage. Int. J. Cancer. 2020; 147: 3511– 3522.

Long‐term follow‐up of human papillomavirus type replacement among young pregnant Finnish females before and after a community‐randomised HPV vaccination trial with moderate coverage

Saved in:
Author: Gray, Penelope1; Kann, Hanna2; Pimenoff, Ville N.2,3;
Organizations: 1Faculty of Social Sciences, Tampere University, Tampere, Finland
2Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
3Finnish Cancer Centre‐Mid Finland (FICAN‐Mid), Tampere, Finland
4Research and Development, Tampere University Hospital, Tampere, Finland
5Faculty of Medicine, University of Oulu, Oulu, Finland
6European Science Infrastructure Services, Oulu, Finland
7Department of Infectious Disease Control and Vaccination, Inst. for Health & Welfare, Helsinki, Finland
8Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.2 MB)
Persistent link:
Language: English
Published: John Wiley & Sons, 2020
Publish Date: 2021-01-20


Large scale human papillomavirus (HPV) vaccination against the most oncogenic high‐risk human papillomavirus (HPV) types 16/18 is rapidly reducing their incidence. However, attempts at assessing if this leads to an increase of nonvaccine targeted HPV types have been hampered by several limitations, such as the inability to differentiate secular trends. We performed a population‐based serological survey of unvaccinated young women over 12 years. The women were under 23‐years‐old, residents from 33 communities which participated in a community‐randomised trial (CRT) with approximately 50% vaccination coverage. Serum samples were retrieved pre‐CRT and post‐CRT implementation. Seropositivity to 17 HPV types was assessed. HPV seroprevalence ratios (PR) comparing the postvaccination to prevaccination era were estimated by trial arm. This was also assessed among the sexual risk‐taking core group, where type replacement may occur more rapidly. In total, 8022 serum samples from the population‐based Finnish Maternity Cohort were retrieved. HPV types 16/18 showed decreased seroprevalence among the unvaccinated in communities only after gender‐neutral vaccination (PR16/18A = 0.8, 95% CI 0.7‐0.9). HPV6/11 and HPV73 were decreased after gender‐neutral vaccination (PR6/11A = 0.8, 95% CI 0.7‐0.9, PR73A = 0.7, 95% CI 0.6‐0.9, respectively) and girls‐only vaccination (PR6/11B = 0.8, 95% CI 0.7‐0.9, PR73B = 0.9, 95% CI 0.8‐1.0). HPV68 alone was increased but only after girls‐only vaccination (PR68B = 1.3, 95% CI 1.0‐1.7, PRcore68B = 2.8, 95% CI 1.2‐6.3). A large‐scale, long‐term follow‐up found no type replacement in the communities with the strongest reduction of vaccine HPV types. Limited evidence for an increase in HPV68 was restricted to girls‐only vaccinated communities and may have been due to secular trends ( number: NCT00534638).

see all

Series: International journal of cancer
ISSN: 0020-7136
ISSN-E: 1097-0215
ISSN-L: 0020-7136
Volume: 147
Issue: 12
Pages: 3511 - 3522
DOI: 10.1002/ijc.33169
Type of Publication: A1 Journal article – refereed
Field of Science: 3122 Cancers
Funding: Funding information: Cancerfonden, Grant/Award Numbers: CAN 2015/399, CAN 2017/459; City of Tampere Science Fund; Karolinska Institutet, Grant/Award Numbers: 2‐3698/2017, 2019‐01523; Stiftelsen för Strategisk Forskning, Grant/Award Number: RB13‐0011; Syöpäjärjestöt.
Copyright information: © 2020 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.