title: No evidence for cross-protection of the HPV-16/18 vaccine against HPV-6/11 positivity in female STI clinic visitors.
abstract: Data from a vaccine trial and from post-vaccine surveillance in the United Kingdom have suggested that the bivalent HPV-16/18 vaccine offers cross-protection against HPV-6/11 and protection against anogenital warts (AGW). We studied the effect of the bivalent vaccine on genital HPV-6/11 positivity and AGW in the Netherlands.
  
  
  
  We included all vaccine-eligible women from the PASSYON study, a biennial cross-sectional study among 16- to 24-year-old sexually transmitted infection (STI) clinic attendants. Vaginal self-swabs were analyzed for type specific HPV and AGW were diagnosed at the STI-clinic. Prevalence of HPV-6 and/or HPV-11 and AGW were compared between self-reported vaccinated and unvaccinated women by log-binomial regression analysis, adjusted for demographics and risk behavior.
  
  
  
  Of the 1198 women included, 56% reported to be vaccinated at least once. Relative to unvaccinated women, the adjusted prevalence ratio (PR) for HPV-6/11 was 1.03 (95% confidence interval [CI] 0.74-1.43) for women vaccinated at least once. The crude PR for AGW was 0.67 (95% CI 0.22-2.07) for women vaccinated at least once. Adjustment did not change these results.
  
  
  
  We observed no cross-protective effect of the bivalent vaccine on genital HPV-6/11 positivity and a non-significant partially protective effect on AGW.
authors.affiliation: Center for Infectious Disease Control, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA Bilthoven, The Netherlands; School of Public Health and Primary Care, Maastricht University Medical Center, P.O. Box 616, 6200 MD Maastricht, The Netherlands. Electronic address: petra.woestenberg@rivm.nl.
authors.forename: Petra J
authors.initials: PJ
authors.lastname: Woestenberg
authors.affiliation: Center for Infectious Disease Control, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA Bilthoven, The Netherlands. Electronic address: audrey.king@rivm.nl.
authors.forename: Audrey J
authors.initials: AJ
authors.lastname: King
authors.affiliation: Center for Infectious Disease Control, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA Bilthoven, The Netherlands; Julius Center, University Medical Center Utrecht, P.O. Box 85500, 3508 GA Utrecht, The Netherlands. Electronic address: marianne.van.der.sande@rivm.nl.
authors.forename: Marianne A B
authors.initials: MA
authors.lastname: van der Sande
authors.affiliation: Center for Infectious Disease Control, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA Bilthoven, The Netherlands; Department of Pathology, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands. Electronic address: robine.donken@rivm.nl.
authors.forename: Robine
authors.initials: R
authors.lastname: Donken
authors.affiliation: Center for Infectious Disease Control, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA Bilthoven, The Netherlands. Electronic address: suzan.leussink@rivm.nl.
authors.forename: Suzan
authors.initials: S
authors.lastname: Leussink
authors.affiliation: Center for Infectious Disease Control, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA Bilthoven, The Netherlands. Electronic address: fiona.van.der.klis@rivm.nl.
authors.forename: Fiona R M
authors.initials: FR
authors.lastname: van der Klis
authors.affiliation: School of Public Health and Primary Care, Maastricht University Medical Center, P.O. Box 616, 6200 MD Maastricht, The Netherlands; Department of Sexual Health, Infectious Diseases and Environment, South Limburg Public Health Service, P.O. Box 2022, 6160 HA Geleen, The Netherlands. Electronic address: christian.hoebe@ggdzl.nl.
authors.forename: Christian J P A
authors.initials: CJ
authors.lastname: Hoebe
authors.affiliation: Center for Infectious Disease Control, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA Bilthoven, The Netherlands. Electronic address: hans.bogaards@rivm.nl.
authors.forename: Johannes A
authors.initials: JA
authors.lastname: Bogaards
authors.affiliation: Center for Infectious Disease Control, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA Bilthoven, The Netherlands. Electronic address: birgit.van.benthem@rivm.nl.
authors.forename: Birgit H B
authors.initials: BH
authors.lastname: van Benthem
mesh_terms: D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities; D003218:Condylomata Acuminata / Q000517:prevention & control* / Q000821:virology; D056738:Cross Protection; D003430:Cross-Sectional Studies; D005260:Female; D052140:Human papillomavirus 11 / Q000276:immunology*; D052162:Human papillomavirus 16 / Q000276:immunology; D052161:Human papillomavirus 18 / Q000276:immunology*; D052163:Human papillomavirus 6 / Q000276:immunology; D006801:Humans; D009426:Netherlands / Q000453:epidemiology; D030361:Papillomavirus Infections / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control* / Q000821:virology; D053918:Papillomavirus Vaccines / Q000276:immunology*; D015995:Prevalence; D012749:Sexually Transmitted Diseases / Q000517:prevention & control; D006113:United Kingdom / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control; D014621:Vagina / Q000821:virology; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines; C510352:human papillomavirus vaccine, L1 type 16, 18
keywords: Condylomata acuminata; Human papillomavirus 11; Human papillomavirus 6; Human papillomavirus vaccine, L1 type 16, 18; Prevention & control; Vaccination; Warts