Changes in HPV Seroprevalence from an Unvaccinated toward a Girls-Only Vaccinated Population in the Netherlands

Abstract

Background: In the Netherlands, bivalent human papillomavirus (HPV) vaccination was included in the National Immunization Program for 12-year-old girls in 2010 (vaccination coverage, 45%–60%). We examined possible changes in HPV seroprevalence in the HPV-unvaccinated Dutch population aged 0–89 years, comparing prevaccination data with data of approximately 6 years after implementation of national vaccination. Methods: Serum samples of men and women were used from two cross-sectional population-based serosurveillance studies performed before (2006–07, n ¼ 6,384) and after (2016–17, n ¼ 5,645) implementation of HPV vaccination in the Netherlands. Seven high-risk HPV-specific antibodies (HPV16, 18, 31, 33, 45, 52, and 58) were tested in a virus-like particle-based multiplex immunoassay. Results: Type-specific HPV seroprevalence increased in women between 2006–07 and 2016–17. Also, a higher seroprevalence for at least one type in women >15 years was found in 2016–17 (31.7%) compared with 2006–07 (25.2%). In men, overall HPV seroprevalence remained similar; however, a lower seroprevalence was found for HPV16 in 2016–17 (7.5%) compared with 2006–07 (10.6%). Conclusions: Our results indicate an increase in high-risk HPV types in women and a rather stable exposure in men. No clear effects of the strategy of girls-only vaccination were observed in men, probably because of the short time after introduction combined with suboptimal coverage. Impact: No herd immunity has been observed yet in a population with suboptimal HPV vaccination coverage.