Self-reported Human Papillomavirus Vaccination and Vaccine Effectiveness Among Men Who Have Sex with Men: A Quantitative Bias Analysis

Epidemiology. 2023 Mar 1;34(2):225-229. doi: 10.1097/EDE.0000000000001580. Epub 2023 Jan 31.

Abstract

Background: Self-report of human papillomavirus (HPV) vaccination has ~80-90% sensitivity and ~75-85% specificity. We measured the effect of nondifferential exposure misclassification associated with self-reported vaccination on vaccine effectiveness (VE) estimates.

Methods: Between 2017-2019, we recruited sexually active gay, bisexual, and other men who have sex with men aged 16-30 years in Canada. VE was derived as 1-prevalence ratio × 100% for prevalent anal HPV infection comparing vaccinated (≥1 dose) to unvaccinated men using a multivariable modified Poisson regression. We conducted a multidimensional and probabilistic quantitative bias analysis to correct VE estimates.

Results: Bias-corrected VE estimates were relatively stable across sensitivity values but differed from the uncorrected estimate at lower values of specificity. The median adjusted VE was 27% (2.5-97.5th simulation interval = -5-49%) in the uncorrected analysis, increasing to 39% (2.5-97.5th simulation interval = 2-65%) in the bias-corrected analysis.

Conclusion: A large proportion of participants erroneously reporting HPV vaccination would be required to meaningfully change VE estimates.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Homosexuality, Male
  • Human Papillomavirus Viruses
  • Humans
  • Male
  • Papillomavirus Infections* / epidemiology
  • Papillomavirus Infections* / prevention & control
  • Papillomavirus Vaccines* / therapeutic use
  • Self Report
  • Sexual and Gender Minorities*
  • Vaccination
  • Vaccine Efficacy

Substances

  • Papillomavirus Vaccines