title: Is vaccine type seropositivity a marker for human papillomavirus vaccination? National Health and Nutrition Examination Survey, 2003-2010.
abstract: OBJECTIVE
  Since 2006, human papillomavirus (HPV) vaccination has been routinely recommended for adolescent females in the USA. The quadrivalent vaccine induces long-term seropositivity to HPV 6/11/16, which may be useful as a marker for HPV vaccine coverage.
  
  
  METHODS
  We evaluated vaccine type seropositivity (i.e., seropositivity to HPV 6/11/16 with or without HPV18) among females aged 14-59 years participating in the 2003-2010 National Health and Nutrition Examination Survey (cross-sectional, nationally representative surveys). We compared pre-vaccine era (2003-2006) to vaccine era (2007-2010) seropositivity and assessed agreement between vaccine era seropositivity and reported vaccination by kappa statistic.
  
  
  RESULTS
  Seropositivity was 1.0% among 2151 females in the pre-vaccine era and 22.1% among 1420 females in the vaccine era (p < 0.001); 23.1% of vaccine era females reported receipt of one or more HPV vaccine dose. Seropositivity and reported vaccination had high agreement (kappa = 0.79; 95% confidence interval 0.74-0.84). Among seropositive females, 14.5% reported no vaccination.
  
  
  CONCLUSIONS
  The increase in vaccine era seropositivity likely reflects vaccination uptake. Our study suggests seropositivity to HPV 6/11/16 may be a useful marker for vaccination coverage in adolescent and young adult females. Discordance between seropositivity and reported vaccination may be explained by inaccurate reporting and/or natural exposure to HPV.
authors.affiliation: Division of Sexually Transmitted Disease Prevention, National Center for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Disease, and Tuberculosis Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, USA. Electronic address: xfq7@cdc.gov.
authors.forename: Emiko Y
authors.initials: EY
authors.lastname: Petrosky
authors.affiliation: Division of Sexually Transmitted Disease Prevention, National Center for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Disease, and Tuberculosis Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Hariri
authors.affiliation: Division of Sexually Transmitted Disease Prevention, National Center for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Disease, and Tuberculosis Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, USA.
authors.forename: Lauri E
authors.initials: LE
authors.lastname: Markowitz
authors.affiliation: Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Gitika
authors.initials: G
authors.lastname: Panicker
authors.affiliation: Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Unger
authors.affiliation: Division of Sexually Transmitted Disease Prevention, National Center for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Disease, and Tuberculosis Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, USA.
authors.forename: Eileen F
authors.initials: EF
authors.lastname: Dunne
mesh_terms: D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000276:immunology*; D030361:Papillomavirus Infections / Q000517:prevention & control; D053918:Papillomavirus Vaccines / Q000276:immunology*; D014611:Vaccination; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D015415:Biomarkers; D053918:Papillomavirus Vaccines
keywords: Human papillomavirus vaccine; National Health and Nutrition Examination Survey; Seropositivity