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--- Sexual Activity-Related Outcomes after HPV Vaccination of 11- to 12-Year-Olds

Tuesday, 13th of November 2012

• SEXUAL ACTIVITY–RELATED OUTCOMES AFTER HUMAN PAPILLOMAVIRUS VACCINATION OF 11- TO 12-YEAR-OLDS

1. 1.   Robert A. Bednarczyk, PhD^a,^b,
2. 2.   Robert Davis, MD, MPH^a,
3. 3.   Kevin Ault, MD^c,
4. 4.   Walter Orenstein, MD^c,^d, and
5. 5.   Saad B. Omer, MBBS, PhD, MPH^a,^b,^c,^d

+ Author Affiliations

1. 1.    ^aCenter for Health Research-Southeast, Kaiser Permanente, Atlanta, Georgia; and
2. 2.    ^bRollins School of Public Health,
3. 3.    ^cSchool of Medicine, and
4. 4.    ^dEmory Vaccine Center, Emory University, Atlanta, Georgia

 

From Pediatrics

 

Abstract below; full text is athttp://pediatrics.aappublications.org/content/early/2012/10/10/peds.2012-1516.long

OBJECTIVE: Previous surveys on hypothesized sexual activity changes after human papillomavirus (HPV) vaccination may be subject to self-response biases. To date, no studies measured clinical markers of sexual activity after HPV vaccination. This study evaluated sexual activity–related clinical outcomes after adolescent vaccination.

METHODS: We conducted a retrospective cohort study utilizing longitudinal electronic data from a large managed care organization. Girls enrolled in the managed care organization, aged 11 through 12 years between July 2006 and December 2007, were classified by adolescent vaccine (HPV; tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis, adsorbed; quadrivalent meningococcal conjugate) receipt. Outcomes (pregnancy/sexually transmitted infection testing or diagnosis; contraceptive counseling) were assessed through December 31, 2010, providing up to 3 years of follow-up. Incidence rate ratios comparing vaccination categories were estimated with multivariate Poisson regression, adjusting for health care–seeking behavior and demographic characteristics.

RESULTS: The cohort included 1398 girls (493 HPV vaccine–exposed; 905 HPV vaccine–unexposed). Risk of the composite outcome (any pregnancy/sexually transmitted infection testing or diagnosis or contraceptive counseling) was not significantly elevated in HPV vaccine–exposed girls relative to HPV vaccine–unexposed girls (adjusted incidence rate ratio: 1.29, 95% confidence interval [CI]: 0.92 to1.80; incidence rate difference: 1.6/100 person-years; 95% CI: −0.03 to 3.24). Incidence rate difference for Chlamydia infection (0.06/100 person-years [95% CI: −0.30 to 0.18]) and pregnancy diagnoses (0.07/100 person-years [95% CI: −0.20 to 0.35]), indicating little clinically meaningful absolute risk differences.

CONCLUSIONS: HPV vaccination in the recommended ages was not associated with increased sexual activity–related outcome rates.