WOLVES – impact of HPV vaccination in Wolfsburg, Germany

Objectives: In Germany data on the epidemiology of HPV infections and especially on the impact of HPV vaccination are rare. WOLVES ( Wol fsburg HP V e pidemiology s tudy) is the first population based surveillance study in Germany to measure the impact of HPV vaccination and the burden of HPV related diseases in a two different birth cohorts. Methods: All women born 1993/84 and 1988/89 who were registered in the city of Wolfsburg were invited by letter. Participants filled in a standardized questionnaire and underwent pelvic examination with Pap smear and HPV testing (HC2-LR and HR). HPV genotyping (LiPA) was done in all HC2 positive samples. Women with genital warts (GW) or atypical smears were transferred to colposcopy. Results: 53,6% (n = 148) of the 1993/94 and 18,7% (n = 221) of the 1988/89 target populations were vaccinated until October 2015. The overall HPV prevalence (HC2 HR & LR) was 25,9%. Between the two age groups significant differences were observed (22,4% vs. 26,6%). In the 1988/89 cohort 2,7% (n = 6) were tested positive for HPV 6/11/16/18 in vaccinated women vs. 11,2% (n = 108) in not vaccinated women and 0% vs. 4 (3,1%) in the 1993/94 cohort. In women with initially negative HPV result (n = 848) 182 were tested HPV positive once in 5 year follow up with biopsy proven CIN2+ (0,36%). In HPV positive women (n = 308) the risk for CIN2+ into 5 years was 11,7% (n = 36). Conclusions: Although vaccination rates were relatively low an impact of HPV vaccination is visible.