Changes in genital Human Papillomavirus (HPV) prevalence among urban females a decade after the Malaysian HPV vaccination program.

Abstract

To increase the coverage of HPV vaccination, Malaysia implemented a national school-based vaccination program for all 13-year-old girls in 2010. Two years later, a clinic-based catch-up program was started for 16 to 21-year-old girls. We assessed the prevalence of a range of HPV genotypes, among a sample of urban women within the age groups of 18-24 and 35-45 years in 2019-2020, a decade into the national vaccination program. The HPV prevalence was then compared to that reported in an unvaccinated population in 2013-2015. We sampled a total of 1134 participants, comprising of 277 women aged 18-24 years and 857 women aged 35-45 years, from several urban clinics in the state of Selangor. Participants provided a self-acquired vaginal sample for HPV genotyping. Comprehensive sociodemographic and vaccination history were collected. The HPV vaccination coverage among women in the younger age group increased from 9.3% in 2013-2015 to 75.5% in 2019-2020. The prevalence of vaccine-targeted HPV16/18 decreased 91% (CI: 14.5%-99.0%) among the younger women, from 4.0% in 2013-2015 to 0.4% in 2019-2020. There was also an 87% (CI: 27.5%-97.5%) reduction in HPV6/11/16/18. There was no difference in the prevalence of non-vaccine targeted HPV genotypes among younger women. The HPV prevalence among older women, for both vaccine targeted and non-vaccine targeted genotypes in 2019-2020, did not differ from 2013-2015. The observed decline in prevalence of vaccine-targeted HPV genotype among younger women a decade after the national HPV vaccination program is an early indication of its effectiveness in reducing the burden of cervical cancer.