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ORIGINAL RESEARCH article

Front. Cell. Infect. Microbiol.
Sec. Virus and Host
Volume 14 - 2024 | doi: 10.3389/fcimb.2024.1451308
This article is part of the Research Topic Papillomaviruses, immunity, and tumour development View all 8 articles

Immunogenicity and safety of the fourth dose of quadrivalent human papillomavirus (HPV) vaccine in immunosuppressed women who did not seroconvert after three doses

Provisionally accepted
Lívia Zignago Moreira Dos Santos Lívia Zignago Moreira Dos Santos 1,2*Camila Cristina Martini Rodrigues Camila Cristina Martini Rodrigues 1Karina Takesaki Miyaji Karina Takesaki Miyaji 1Vanessa Infante Vanessa Infante 1Camila de Melo Picone Camila de Melo Picone 1Amanda Nazareth Lara Amanda Nazareth Lara 1Hanna Kann Hanna Kann 3Carina Eklund Carina Eklund 3Joakim Dillner Joakim Dillner 3Philippe Mayaud Philippe Mayaud 4Ana Marli Christovam Sartori Ana Marli Christovam Sartori 1,2
  • 1 Departamento de Infectologia e Medicina Tropical, Faculdade de Medicina da Universidade de Sao Paulo (FMUSP), São Paulo, Rio Grande do Sul, Brazil
  • 2 Centro de Referencia para Imunobiologicos Especiais, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), São Paulo, Brazil
  • 3 Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden
  • 4 Faculty of Infectious & Tropical Diseases, London School of Hygiene and Tropical Medicine and Hygiene (LSHTM), London, United Kingdom

The final, formatted version of the article will be published soon.

    Introduction: Immunocompromised persons have high risk of persistent human papillomavirus (HPV) infection and HPV-related diseases, and lower immune response to vaccines. This study evaluated the immunogenicity and safety of administering a fourth dose of quadrivalent (4v)HPV vaccine in immunosuppressed women who did not seroconvert after three doses. Methods: An openlabel, not-controlled trial included immunosuppressed women (solid organ transplant patients and women receiving treatment for SLE) who did not seroconvert to at least one of the four HPV vaccine types after three 4vHPV vaccine doses. All participants received a fourth 4vHPV vaccine dose (median 27 months after third dose). Immunogenicity was evaluated a month after the fourth dose, by measuring seroconversion rates and antibody geometric mean concentration (GMC). Results: Twenty-three women were included. Among women who did not seroconvert for each vaccine type after three doses, 2/10 seroconverted to HPV6, 3/10 to HPV11, 3/10 to HPV16 and 6/18 to HPV18, after the fourth 4vHPV dose. There was an increase in antibody GMC for HPV 6, 16, 18, with highest increase for HPV16 (from 6.02 to 44.63 International Units). There was no increase of anti-HPV-11. Within seven days after vaccination, only three of the 23 vaccinees reported any adverse event, none of which were classified as serious. Conclusions: Although safe, the fourth 4vHPV vaccine dose led to seroconversion in only few immunosuppressed women who had not seroconverted after three doses.

    Keywords: Immunogenicity, vaccine, Human papillomavirus (HPV), kidney transplantation, liver transplantation, Heart Transplantation, Lung Transplantation, systemic lupus erythematosus (SLE)

    Received: 19 Jun 2024; Accepted: 25 Nov 2024.

    Copyright: © 2024 Moreira Dos Santos, Rodrigues, Miyaji, Infante, Picone, Lara, Kann, Eklund, Dillner, Mayaud and Sartori. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Lívia Zignago Moreira Dos Santos, Departamento de Infectologia e Medicina Tropical, Faculdade de Medicina da Universidade de Sao Paulo (FMUSP), São Paulo, Rio Grande do Sul, Brazil

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.