Expected impact of a quadrivalent HPV vaccine in France

• Published in: Journal de gynécologie, obstétrique et biologie de la reproduction Vol. 38; no. 5; pp. 389 - 395
• Main Authors: Riethmuller, D, Prétet, J-L, Denis, F, Aubin, F, Pradat, P, Clavel, C, Dachez, R, Gondry, J, Carcopino, X, Mougin, C
• Format: Journal Article
• Language: French
• Published: France Elsevier Masson 01-09-2009
• Subjects: Adolescent; Cancer; Cervical Intraepithelial Neoplasia; Cervical Intraepithelial Neoplasia - epidemiology; Cervical Intraepithelial Neoplasia - prevention & control; Cervical Intraepithelial Neoplasia - virology; Condylomata Acuminata; Condylomata Acuminata - epidemiology; Condylomata Acuminata - prevention & control; Condylomata Acuminata - virology; Female; France; France - epidemiology; Humans; Life Sciences; Markov Chains; Models, Theoretical; Papillomavirus Infections; Papillomavirus Infections - epidemiology; Papillomavirus Infections - prevention & control; Papillomavirus Vaccines; Papillomavirus Vaccines - administration & dosage; Uterine Cervical Neoplasms; Uterine Cervical Neoplasms - epidemiology; Uterine Cervical Neoplasms - prevention & control; Uterine Cervical Neoplasms - virology; France
• ISSN: 0368-2315
• DOI: 10.1016/j.jgyn.2009.04.008

To assess the expected impact in France of a quadrivalent HPV 6/11/16/18 vaccine on the occurrence of genital HPV-induced lesions in women.
A Markov model based on a quadrivalent vaccination of 14-year-old girls as recommended in France was performed to assess the number of subjects needed to vaccinate to prevent an HPV-related event during their lifetime and the expected annual number of cases which could be prevented by vaccination. This model was based on prevalence data reported in four large French studies (EDiTH I-IV) reporting an HPV 6/11/16/18 prevalence of 82% (95% CI: 78.5-85.1) in cervical cancer (CC), 64% (95% CI: 59.7-68.1) in CIN2/3, 34% (95% CI: 28.9-38.1) in low-grade squamous intraepithelial lesions (LSIL) and 83% (95% CI 77.6-87.8) in female external acuminata condylomata (EAC) cases.
Using a theoretical vaccine efficacy of 100%, 130 young women need to be vaccinated to prevent a case of CC, 17 for a case of CIN2/3 and 13 for a case of EAC. Immunization of 80% of 14-year-old girls could prevent 2495 CC (72%), 17,985 CIN2/3 (54%), 8004 CIN1 (27%), and 22,531 EAC female cases (65%) in France annually.
A good adhesion to the preferentially recommended HPV quadrivalent vaccination would thus substantially reduce the burden of female genital lesions in France.