Pediatr Infect Dis J. 2018 Apr;37(4):e93-e102. doi: 10.1097/INF.0000000000001871.
The burden of cervical cancer caused by human papillomavirus (HPV) is high in Latin America. The suboptimal HPV vaccination coverage in adolescents could be improved by pediatric immunization. HPV vaccination has not yet been reported in girls <9 years of age.
This ongoing phase III, controlled, randomized, single-blind, multicenter study conducted in Colombia, Mexico and Panama (NCT01627561) evaluated the safety and immunogenicity of AS04-HPV-16/18 vaccine in 4-6-year-old girls. Healthy girls (randomized 1:1) received either 2 doses of AS04-HPV-16/18 vaccine (HPV group, N=74) or 1 dose of each measles-mumps-rubella and diphtheria-tetanus-acellular-pertussis vaccines (control group, N=74) 6 months apart. We report the safety and serum anti-HPV-16 and anti-HPV-18 antibodies (measured by enzyme-linked immunosorbent assay) up to 6 months postvaccination, that is, month (M) 12.
Injection site pain was the most frequently reported solicited local symptom in HPV vaccinees. The incidence of other solicited and unsolicited symptoms after each vaccination was similar between the HPV and control group. Until M12, 1 girl in the HPV group and 2 in the control group reported serious adverse events; all serious adverse events were assessed as unrelated to study vaccines. No potential immune-mediated diseases were identified. All girls seroconverted for both antigens after 2 doses of AS04-HPV-16/18. In initially seronegative girls, anti-HPV-16 geometric mean concentrations were 20080.0 enzyme-linked immunosorbent assay units (EU)/mL at M7 and 3246.5 EU/mL at M12; anti-HPV-18 geometric mean concentrations were 10621.8 EU/mL at M7 and 1216.6 EU/mL at M12.
Two-dose vaccination with AS04-HPV-16/18 was well tolerated and induced adequate antibody responses in 4-6-year-old girls.
在拉丁美洲,人乳头瘤病毒(HPV)导致的宫颈癌负担很高。通过儿科免疫接种可以提高青少年 HPV 疫苗接种的覆盖率。尚未报道在 9 岁以下女孩中接种 HPV 疫苗。
本研究为正在进行的 III 期、对照、随机、单盲、多中心研究,在哥伦比亚、墨西哥和巴拿马进行(NCT01627561),评估了 AS04-HPV-16/18 疫苗在 4-6 岁女孩中的安全性和免疫原性。健康女孩(随机 1:1)接受 2 剂 AS04-HPV-16/18 疫苗(HPV 组,N=74)或各 1 剂麻疹-腮腺炎-风疹和白喉-破伤风-无细胞百日咳疫苗(对照组,N=74),间隔 6 个月。我们报告了接种后 6 个月(即接种后第 12 个月)的安全性和血清抗 HPV-16 和抗 HPV-18 抗体(通过酶联免疫吸附试验测量)。
接种部位疼痛是 HPV 疫苗接种者最常报告的局部症状。HPV 疫苗组和对照组每次接种后的其他局部和全身症状发生率相似。到 M12 时,HPV 组有 1 名女孩和对照组有 2 名女孩报告了严重不良事件;所有严重不良事件均被评估为与研究疫苗无关。未发现潜在的免疫介导性疾病。所有女孩在接受 2 剂 AS04-HPV-16/18 后均对两种抗原产生血清学转换。在最初血清学阴性的女孩中,抗 HPV-16 的几何平均浓度分别为接种后第 7 个月的 20080.0 酶联免疫吸附试验单位(EU)/mL 和接种后第 12 个月的 3246.5 EU/mL;抗 HPV-18 的几何平均浓度分别为接种后第 7 个月的 10621.8 EU/mL 和接种后第 12 个月的 1216.6 EU/mL。
4-6 岁女孩接种 2 剂 AS04-HPV-16/18 疫苗具有良好的耐受性,并诱导了足够的抗体应答。