title: Reduction in human papillomavirus (HPV) prevalence among young women following HPV vaccine introduction in the United States, National Health and Nutrition Examination Surveys, 2003-2010.
abstract: BACKGROUND
  Human papillomavirus (HPV) vaccination was introduced into the routine immunization schedule in the United States in late 2006 for females aged 11 or 12 years, with catch-up vaccination recommended for those aged 13-26 years. In 2010, 3-dose vaccine coverage was only 32% among 13-17 year-olds. Reduction in the prevalence of HPV types targeted by the quadrivalent vaccine (HPV-6, -11, -16, and -18) will be one of the first measures of vaccine impact.
  
  
  METHODS
  We analyzed HPV prevalence data from the vaccine era (2007-2010) and the prevaccine era (2003-2006) that were collected during National Health and Nutrition Examination Surveys. HPV prevalence was determined by the Linear Array HPV Assay in cervicovaginal swab samples from females aged 14-59 years; 4150 provided samples in 2003-2006, and 4253 provided samples in 2007-2010.
  
  
  RESULTS
  Among females aged 14-19 years, the vaccine-type HPV prevalence (HPV-6, -11, -16, or -18) decreased from 11.5% (95% confidence interval [CI], 9.2-14.4) in 2003-2006 to 5.1% (95% CI, 3.8-6.6) in 2007-2010, a decline of 56% (95% CI, 38-69). Among other age groups, the prevalence did not differ significantly between the 2 time periods (P > .05). The vaccine effectiveness of at least 1 dose was 82% (95% CI, 53-93).
  
  
  CONCLUSIONS
  Within 4 years of vaccine introduction, the vaccine-type HPV prevalence decreased among females aged 14-19 years despite low vaccine uptake. The estimated vaccine effectiveness was high.
authors.affiliation: National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention , Atlanta, GA, USA. lem2@cdc.gov
authors.forename: Lauri E
authors.initials: LE
authors.lastname: Markowitz
authors.forename: Susan
authors.initials: S
authors.lastname: Hariri
authors.forename: Carol
authors.initials: C
authors.lastname: Lin
authors.forename: Eileen F
authors.initials: EF
authors.lastname: Dunne
authors.forename: Martin
authors.initials: M
authors.lastname: Steinau
authors.forename: Geraldine
authors.initials: G
authors.lastname: McQuillan
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Unger
mesh_terms: D000293:Adolescent; D000328:Adult; D002584:Cervix Uteri / Q000821:virology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques; D009749:Nutrition Surveys; D027383:Papillomaviridae / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D015995:Prevalence; D014481:United States / Q000453:epidemiology; D014621:Vagina / Q000821:virology; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines
keywords: HPV vaccine; human papillomavirus; prevalence; vaccine effectiveness; vaccine impact