In Germany data on the epidemiology of HPV infections and especially on the impact of HPV vaccination are rare. WOLVES (Wolfsburg HPV epidemiology study) 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.
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.
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).
Although vaccination rates were relatively low an impact of HPV vaccination is visible.