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Original article Effect of the human papillomavirus vaccine on the risk of genital warts: a nationwide cohort study of South Korean adolescent girls
Jaeyoung Cho1orcid , Eun Mi Kim1orcid , Jihye Kim1orcid , Ju-Young Shin2orcid , Eui Hyeok Kim3orcid , Jong Heon Park1orcid , Seunghyun Lewis Kwon4orcid , Geun-Yong Kwon5orcid , Soon-Ae Shin6orcid , Jaiyong Kim1orcid
Epidemiol Health 2024;e2024040
DOI: https://doi.org/10.4178/epih.e2024040 [Accepted]
Published online: March 18, 2024
1Department of Big Data Strategy, National Health Insurance Services, Wonju, Korea
2School of Pharmacy, Sungkyunkwan University, Suwon, Korea
3Department of Obstetrics & Gynecology, CHA Ilsan Medical Center, Goyang, Korea
4Division of Immunization, Bureau of Healthcare Safety and Immunization, Korea Disease Control and Prevention Agency, Cheongju, Korea
5Division of Immunization Planning, Bureau of Healthcare Safety and Immunization, Korea Disease Control and Prevention Agency, Cheongju, Korea
6Health Insurance Research Institute, National Health Insurance Services, Wonju, Korea
Corresponding author:  Soon-Ae Shin,
Email: dockjy2@gmail.com
Jaiyong Kim,
Email: dockjy2@gmail.com
Received: 2 November 2023   • Revised: 6 February 2024   • Accepted: 4 March 2024
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OBJECTIVES
The purpose of this study was to assess the effectiveness of human papillomavirus (HPV) vaccination administered to adolescent girls through South Korea’s National Immunization Program.
METHODS
This retrospective cohort study included individuals who were 12 to 13 years old, whether vaccinated or unvaccinated, between July 2016 and December 2017. The incidence of genital warts (GWs) was monitored through 2021. Time-stratified hazard ratios (HRs) were estimated, adjusting for birth year, socioeconomic status, and the level of urbanization of the region, and were presented with 95% confidence intervals (CIs). Data were sourced from the Immunization Registry Integration System, linked with the National Health Information Database.
RESULTS
The study included 332,062 adolescent girls, with an average follow-up period of approximately 4.6 years. Except for the first year, the HRs for the vaccinated group were lower than those for the unvaccinated group. The HRs for specific cutoff years were as follows: year 2, 0.62 (95% CI, 0.31 to 1.13); year 3, 0.58 (95% CI, 0.35 to 0.96); and year 4 and beyond, 0.39 (95% CI, 0.28 to 0.52).
CONCLUSIONS
Our findings indicate that HPV vaccination was associated with a reduction in the risk of GWs among adolescent girls. Notably, this reduction became significant as the incidence of GWs increased with age.


Epidemiol Health : Epidemiology and Health