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Volume 22, Number 10—October 2016

Population-Level Effects of Human Papillomavirus Vaccination Programs on Infections with Nonvaccine Genotypes

David MesherComments to Author , Kate Soldan, Matti Lehtinen, Simon Beddows, Marc Brisson, Julia M.L. Brotherton, Eric P.F. Chow, Teresa Cummings, Mélanie Drolet, Christopher K. Fairley, Suzanne M. Garland, Jessica A. Kahn, Kimberley Kavanagh, Lauri E. Markowitz, Kevin G. Pollock, Anna Söderlund-Strand, Pam Sonnenberg, Sepehr N. Tabrizi, Clare Tanton, Elizabeth R. Unger, and Sara L. Thomas
Author affiliations: Public Health England, London, UK (D. Mesher, K. Soldan, S. Beddows); London School of Hygiene and Tropical Medicine, London (D. Mesher, S.L. Thomas); University of Tampere, Tampere, Finland (M. Lehtinen); Imperial College London, London (M. Brisson); Centre de recherche du CHU de Québec, Quebec City, Quebec, Canada (M. Brisson, M. Drolet); Université Laval, Quebec (M. Brisson, M Drolet); Victorian Cytology Service, Melbourne, Victoria, Australia (J.M.L. Brotherton); University of Melbourne, Melbourne (J.M.L. Brotherton, S.M. Garland, S.N. Tabrizi); Melbourne Sexual Health Centre, Melbourne (E.P.F. Chow, C.K. Fairley); Monash University, Melbourne (E.P.F. Chow, C.K. Fairley); Indiana University School of Medicine, Indianapolis, Indiana, USA (T. Cummings); Murdoch Childrens Research Institute, Parkville, Victoria, Australia (S.M. Garland, S.N. Tabrizi); The Royal Women’s Hospital, Melbourne (S.M. Garland, S.N. Tabrizi); Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA (J.A. Kahn); University of Cincinnati College of Medicine, Cincinnati (J.A. Kahn); University of Strathclyde, Glasgow, Scotland, UK (K. Kavanagh); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (L. Markowitz, E. Unger); Health Protection Scotland, Glasgow (K.G. Pollock); Division of Clinical Microbiology, Laboratory Medicine, Skåne, Lund, Sweden (A. Söderlund-Strand); University College London, London (P. Sonnenberg, C. Tanton)

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Table 2

Summary prevalence ratios for meta-analysis of changes in nonvaccine high-risk HPV types among girls and women, by age group*

Population age group, y, and HPVtype No. studies† Heterogeneity
Prevalence ratio 
(95% CI)
I2, % p value
HPV types in nonavalent vaccine 8
HPV31 6.4 0.381 0.73 (0.58–0.91)
HPV33 0 0.471 1.04 (0.78–1.38)
HPV45 5.5 0.387 0.96 (0.75–1.23)
HPV52 24.0 0.238 1.34 (1.13–1.59)
HPV58 0 0.727 1.01 (0.80–1.26)
Other high-risk HPV types 8
HPV35 25.1 0.229
HPV39 0 0.984 1.27 (1.05–1.54)
HPV51 43.6 0.088
HPV56 74.3 <0.001
HPV59 66.8 0.004
HPV68 0 0.690 1.26 (0.88–1.81)
Other possibly high-risk HPV types 6
HPV26 0 0.478 1.63 (0.84–3.16)
HPV53 3.6 0.394 1.51 (1.10–2.06)
HPV70 23.6 0.257 1.34 (0.75–2.39)
HPV73 0 0.961 1.36 (1.03–1.80)


HPV types in nonavalent vaccine 8
HPV31 28.8 0.198
HPV33 50.9 0.047
HPV45 64.3 0.007
HPV52 31.0 0.180
HPV58 0 0.806 1.14 (0.99–1.31)
Other high-risk HPV types 8
HPV35 7.9 0.369 1.07 (0.85–1.34)
HPV39 0 0.522 1.13 (1.00–1.28)
HPV51 49.8 0.052
HPV56 82.6 <0.001
HPV59 63.6 0.007
HPV68 35.6 0.145
Other possibly high-risk HPV types 6
HPV26 44.3 0.110
HPV53 30.8 0.204
HPV70 25.1 0.246
HPV73 59.2 0.032
HPV82 38.3 0.151

*HPV, human papillomavirus; –, prevalence ratio not calculated because of heterogeneity of data.
†Number of studies was the same for all HPV types within each category.

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Page created: September 20, 2016
Page updated: September 20, 2016
Page reviewed: September 20, 2016
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