Massachusetts General Hospital
Division of Infectious Diseases, Department of Medicine, Harvard Medical School
Dr. Ruanne Barnabas is the Chief of the Division of Infectious Diseases at Massachusetts General Hospital (MGH) and a South African physician-scientist. Over the last 15 years, her research has focused on interventions for HIV and STI treatment and prevention. She is particularly interested in novel approaches that increase access to services. She led the Delivery Optimization for Antiretroviral therapy (DO ART) Study that evaluated the efficacy and cost-effectiveness of decentralized, community-based ART. Also, she leads work to increase access to HIV care, including testing lottery incentives and home delivery. She is the Principal Investigator of the KEN SHE Study to assess the impact of single-dose human papillomavirus (HPV) vaccination in Kenya. Recently, her work has extended to COVID-19 prevention within households. Her work aims to identify effective and scalable HIV, HPV, and infectious disease treatment and prevention strategies to increase access across diverse communities and promote equity in health. She serves as an advisor to the World Health Organization and UNAIDS. She was honored as a Fellow of the Infectious Diseases Society of America in 2020. Dr. Barnabas graduated from the University of Cape Town, South Africa, where she received her medical degree. She received her research doctorate in medicine and clinical epidemiology from the University of Oxford, where she was a Rhodes Scholar. She completed her Infectious Diseases fellowship at the University of Washington.

Presenter of 3 Presentations

STATE OF THE SCIENCE ON HPV VACCINATION

Session Type
Public Health
Date
Mon, Apr 17, 2023
Session Time
02:00 PM - 03:30 PM
Room
Ballroom C
Presentation Type
ONSITE
Lecture Time
02:00 PM - 02:18 PM

ONE DOSE HPV VACCINATION OVERVIEW AND A FOCUS ON THE KENSHE DATA

Session Type
Plenary Session
Date
Wed, Apr 19, 2023
Session Time
11:00 AM - 12:30 PM
Room
Ballroom C
Presentation Type
ONSITE
Lecture Time
11:00 AM - 11:00 AM

A RANDOMIZED TRIAL OF SINGLE-DOSE HPV VACCINATION EFFICACY AMONG YOUNG WOMEN: FINAL EFFICACY RESULTS

Session Type
Public Health
Date
Fri, Apr 21, 2023
Session Time
02:15 PM - 03:45 PM
Room
206
Presentation Type
ONSITE
Lecture Time
03:35 PM - 03:45 PM

Abstract

Introduction

Single-dose HPV 16/18 vaccination efficacy (VE) of 97.5% at month 18 is comparable to multi-dose regimens at months 24-36. Data on single-dose durability over several years are needed.

Methods

We conducted a randomized, multicenter, double-blind, controlled, cross-over trial to estimate the efficacy of single-dose HPV vaccination at three study sites in Kenya. Healthy, 15- to 20-year-old women were randomly assigned (1:1:1) to single-dose bivalent (HPV 16/18), nonavalent (HPV 16/18/31/33/45/52/58/6/11), or control (meningococcal) vaccination. The modified intent-to-treat (mITT) HPV 16/18 and HPV 16/18/31/33/45/52/58 cohorts included HPV naïve participants (i.e., participants who tested negative for vaccine type-specific HPV DNA at enrollment and month three and HPV antibody negative at enrollment). During follow-up, clinicians collected cervical swabs every six months, which were tested for HPV DNA for endpoints. The outcome was incident persistent vaccine type-specific HPV infection. We analyzed VE up to the cross-over study visit at month 36.

Results

Between December 2018 and November 2019, we recruited and randomly assigned 2,275 participants to receive bivalent (n=760), nonavalent (n=758), or control (n=757) vaccine. From enrollment to January 2023, 2,061/2,275 (90.7%) randomized participants provided at least five swabs for HPV DNA testing before cross-over vaccination. The median follow-up up to cross-over was 35 months. Seventy-five incident persistent infections were detected in the HPV 16/18 mITT cohort: two in the bivalent group, one in the nonavalent group, and 72 in the control group; nonavalent VE was 98.8% (95%CI 91.3-99.8%, p=<0.0001); bivalent VE was 97.5% (95%CI 90.0-99.4%, p=<0.0001). Eighty-nine persistent infections were detected in the HPV 16/18/31/33/45/52/58 mITT cohort: five in the nonavalent group and 84 in the control group; nonavalent VE was 95.5% (95%CI 89.0-98.2%, p<0.0001). The rate of SAEs was 7.8-9.5% by group; none were vaccine-related.

Conclusions

In a randomized trial among young women with HPV exposure, single-dose HPV vaccination was highly efficacious (>95%) over three years.

Hide