title: Surveillance of effects of HPV vaccination in Belgium.
abstract: BACKGROUND
  Early effects of HPV (human papillomavirus) vaccination are reflected by changes observable in young women attending cervical cancer screening.
  
  
  METHODS
  The SEHIB study included HPV geno-typing of ∼6000 continuous and 650 pathological cervical cell specimen as well as biopsies, collected from women in Belgium in 2010-2014. Data were linked to vaccination status.
  
  
  RESULTS
  HPV vaccination offered protection among women aged <30years against infection with HPV16 (vaccine effectiveness [VE]=67%, 95% CI: 48-79%), HPV18 (VE=93%, 95% CI: 52-99%), and high-risk HPV (VE=16%, 95% CI: 2-29%). Vaccination protected also against cytological lesions. Vaccination protected against histologically confirmed lesions: significantly lower absolute risks of CIN1+ (risk difference [RD]=-1.6%, 95% CI: -2.6% to -0.7%) and CIN3+ associated with HPV16/18 (RD=-0.3%, 95% CI -0.6% to -0.1%). Vaccine effectiveness decreased with age. Protection against HPV16 and 18 infection was significant in all age groups, however no protection was observed against cytological lesions associated with these types in age-group 25-29.
  
  
  CONCLUSIONS
  The SEHIB study demonstrates the effectiveness of HPV vaccination in Belgian young women in particular in age group 18-19. Declining effectiveness with increasing age may be explained by higher tendency of women already exposed to infection to get the vaccine.
authors.affiliation: Unit of Cancer Epidemiology/Belgian Cancer Centre, Scientific Institute of Public Health, J. Wytsmanstreet 14, B1050 Brussels, Belgium. Electronic address: marc.arbyn@wiv-isp.be.
authors.forename: Marc
authors.initials: M
authors.lastname: Arbyn
authors.affiliation: International Centre for Reproductive Health (ICRH), Ghent University, Ghent, Belgium; Algemeen Medisch Labo, Sonic Healtcare, Antwerp, Belgium; AMBIOR, Laboratory for Cell Biology & Histology, University of Antwerp, Antwerp, Belgium.
authors.forename: Davy Vanden
authors.initials: DV
authors.lastname: Broeck
authors.affiliation: Algemeen Medisch Labo, Sonic Healtcare, Antwerp, Belgium; AMBIOR, Laboratory for Cell Biology & Histology, University of Antwerp, Antwerp, Belgium.
authors.forename: Ina
authors.initials: I
authors.lastname: Benoy
authors.affiliation: Algemeen Medisch Labo, Sonic Healtcare, Antwerp, Belgium; AMBIOR, Laboratory for Cell Biology & Histology, University of Antwerp, Antwerp, Belgium.
authors.forename: Johannes
authors.initials: J
authors.lastname: Bogers
authors.affiliation: Algemeen Medisch Labo, Sonic Healtcare, Antwerp, Belgium.
authors.forename: Christophe
authors.initials: C
authors.lastname: Depuydt
authors.affiliation: N. Goormachtigh Institute for Pathology, Ghent University, Ghent, Belgium.
authors.forename: Marleen
authors.initials: M
authors.lastname: Praet
authors.affiliation: Department of Gynaecology & Oncology, UZ Brussel, Free University of Brussels, Brussels, Belgium.
authors.forename: Philippe De
authors.initials: PD
authors.lastname: Sutter
authors.affiliation: Department of Pathology, VUB, Brussels, Belgium.
authors.forename: Anne
authors.initials: A
authors.lastname: Hoorens
authors.affiliation: Department of Pathology, UZ Leuven, Leuven, Belgium.
authors.forename: Esther
authors.initials: E
authors.lastname: Hauben
authors.affiliation: Department of Gynaecology and Obstetrics, UZ Leuven, Leuven, Belgium.
authors.forename: Willy
authors.initials: W
authors.lastname: Poppe
authors.affiliation: Department of Microbiology and Immunology, Rega Institute, KU Leuven, Leuven, Belgium.
authors.forename: Marc
authors.initials: M
authors.lastname: Van Ranst
authors.affiliation: Department of Pathology, ULg, Liège, Belgium.
authors.forename: Philippe
authors.initials: P
authors.lastname: Delvenne
authors.affiliation: Department of Pathology, ULg, Liège, Belgium.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Gofflot
authors.affiliation: Institut de Pathologie et de Génétique, Charlerloi, Belgium.
authors.forename: Michel
authors.initials: M
authors.lastname: Pétein
authors.affiliation: Centrum voor Medische Analyse, Herentals, Belgium.
authors.forename: Frans
authors.initials: F
authors.lastname: Engelen
authors.affiliation: Pathological Anatomy, AZ Groeninge, Kortrijk, Belgium.
authors.forename: Alain
authors.initials: A
authors.lastname: Vanneste
authors.affiliation: Pathology Mariaziekenhuis Noord Limburg, Overpelt, Belgium.
authors.forename: Lode Op De
authors.initials: LO
authors.lastname: Beeck
authors.affiliation: Vaccine & Infectious Disease Institute (VAXINFECTIO), Antwerp University, Antwerp, Belgium.
authors.forename: Pierre Van
authors.initials: PV
authors.lastname: Damme
authors.affiliation: International Centre for Reproductive Health (ICRH), Ghent University, Ghent, Belgium; Reproductive Health and Research, World Health Organization, Geneva, Switzerland; Department of Gynaecology and Obstetrics, Ghent University, Ghent, Belgium.
authors.forename: Marleen
authors.initials: M
authors.lastname: Temmerman
authors.affiliation: Department of Gynaecology and Obstetrics, Ghent University, Ghent, Belgium.
authors.forename: Steven
authors.initials: S
authors.lastname: Weyers
mesh_terms: D000293:Adolescent; D000328:Adult; D001530:Belgium / Q000453:epidemiology; D001706:Biopsy; D005260:Female; D052162:Human papillomavirus 16 / Q000302:isolation & purification; D052161:Human papillomavirus 18 / Q000302:isolation & purification; D006801:Humans; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000821:virology; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000473:pathology; D014611:Vaccination; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines
keywords: Cervical cancer; HPV; HPV vaccination; Human papillomavirus; Screening; Surveillance