Australian national surveillance of juvenile onset recurrent respiratory papillomatosis: Declining incidence post quadrivalent HPV vaccination

Abstract

Introduction To estimate and monitor national incidence of Juvenile onset Recurrent Respiratory Papillomatosis (JoRRP) in Australia following the extensive quadrivalent HPV vaccine catch up program (females aged 12-26 years in 2007-2009, which included women of child bearing age) and to assess demographics and risk factors of incident cases. Methods The Australian Paediatric Surveillance Unit (APSU) undertakes surveillance of rare paediatric diseases by contacting practitioners monthly to report cases. We utilised this well established methodology to undertake prospective population based surveillance of JoRRP by enrolment in APSU of paediatric ENT surgeons, designing a JoRRP case reporting form, and offering clinicians HPV typing of incident cases. Surveillance commenced Oct 2011 and we report here findings for the five-year period to end 2016. Results Using Australian Bureau of Statistics population estimates for children 0-15 years, the average annual incidence rate over the period was 0.12 per 1 00 000. The largest number of cases was reported in the first year, with a decreasing frequency each year thereafter. The rate declined from 0.3 per 1 00 000 in 2012 to 0.04 per 1 00 000 in 2016. Among incident cases, no mothers had been vaccinated prior to pregnancy, 20% had a past history of genital warts, 60% of cases were male, and 60% were first born. The majority were born by vaginal delivery. Four incident cases were genotyped; all were positive for HPV6 (n=1) or HPV11 (n=3). Conclusion To our knowledge this is the first report internationally documenting a decline in JoRRP incidence in a population of children following the introduction of a quadrivalent HPV vaccination program.L6249973262018-11-22 <br />