Toronto Metropolitan University
2023_Self-reported Human Papillomavirus Vaccination and Vaccine Effectiveness Among Men Who Have Sex With Men A quantitative bias analysis.pdf (479.38 kB)

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

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journal contribution
posted on 2024-04-03, 20:30 authored by Catharine Chambers, Shelley L. Deeks, Rinku Sutradhar, Joseph Cox, Alexandra De Pokomandy, Troy Grennan, Trevor HartTrevor Hart, Gilles Lambert, David M. Moore, Daniel Grace, Ramandip Grewal, Jody Jollimore, Nathan J. Lachowsky, Ashley Mah, Rosane Nisenbaum, Gina Ogilvie, Chantal Sauvageau, Darrell H.S. Tan, Anna Yeung, Ann N. Burchell


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.


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.


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.


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