This project aims to monitor the impact of HPV vaccine on population health by tracking HGCLs and the HPV types associated with those lesions. These lesions occur in greater numbers and develop over a shorter time frame than cervical cancer, making them an efficient endpoint when examining vaccine effectiveness. In addition, these lesions are important because they can incur substantial morbidity, treatment costs, and psychological stress.
Goals & Objectives
- Monitor HPV vaccine impact on HGCLs also known as cervical intraepithelial neoplasia (CIN) grades 2 and 3 and adenocarcinoma in situ (AIS).
- Monitor HPV vaccine impact on HPV types associated with CIN 2/3 and AIS lesions.
- Improve public health practice through local population-based surveillance of HPV-related cervical cancer precursors.
- Estimate cervical cancer screening rates in Connecticut.
- Statewide passive monitoring of CIN2/3 and AIS diagnoses from pathology laboratories
- Population-based active surveillance for CIN2/3 and AIS in New Haven county
- Enhanced data collection through patient interviews and medical record reviews to determine HPV vaccination status
- Specimen collection to determine HPV type associated with CIN2/3 and AIS diagnoses
- Laboratory and physician surveys
- Estimation of cervical cancer screening in Connecticut
- Analyses of population databases for other HPV indicators such as anogenital warts
Contributions from students at Yale and other universities
- Increasing Human Papillomavirus Vaccine Uptake in Adolescents: A Targeted Intervention Approach. AmberJean Hansen (2016) MPH Capstone. University of New England.
- Trends in HPV 16/18-Associated Cervical Lesions in New Haven County, Connecticut, 2008-2014. Susan Hanagan (2016) MPH Thesis. Yale School of Public Health.
- Sociodemographic Differences in Human Papillomavirus Vaccine Impact: a Systematic Review. Alexandra Montano (2016) MPH Thesis. Yale School of Public Health.
- Spatial Distribution of High Grade Cervical Lesions in Connecticut, 2008-2013. Aref Seno (2015) MPH Thesis. Yale School of Public Health.
- Provider Survey to Identify Pathology Laboratories, 2015. Adam Misiorski (2015) Undergraduate Internship. Southern Connecticut State University.
- HPV Vaccine Effectiveness in New Haven County, Connecticut Women Aged 18-39, 2008-2012. Jennifer Berry (2014) MPH Thesis. Yale School of Public Health.
- HPV Type Distribution in New Haven County, Connecticut Among Women with CIN2+ Diagnoses from 2008-2010. Chelsea Russ (2012) MPH Thesis. Yale School of Public Health.
- The Prevalence of HPV Associated Disease in Women under Age 21: Who will be missed under the new cervical cancer screening guidelines? Amanda Decew (2012) MPH Thesis. Yale School of Public Health.
- HPV Vaccination Histories among High-Risk Women in New Haven County: Disparities and Barriers. Niti Mehta (2011) MPH Thesis. Yale School of Public Health.
- Social Economic Characteristics and Cervical Abnormalities in Connecticut. James Santinelli (2010) MPH Thesis. Yale School of Public Health.
Select List of Publications
1.Niccolai LM, Meek JI, Brackney M, Hadler JL, Sosa LE, Weinberger DM. Declines in human papillomavirus (HPV)-associated high-grade cervical lesions after introduction of HPV vaccines in Connecticut, United States, 2008-2015. Clinical Infectious Diseases 2017;65:884-9.
2.Hariri S, Markowitz LE, Bennett NM, Niccolai LM, Schafer S, Bloch K, Park IU, Scahill MW, Julian P, Abdullah N, Levine D, Whitney E, Unger ER, Steinau M, Bauer HM, Meek J, Hadler J, Sosa L, Powell SE, Johnson ML. Monitoring effect of human papillomavirus vaccines in US population, Emerging Infections Program, 2008–2012. Emerging Infectious Diseases 2015;21:1557–61.
3.Hariri S, Bennett NM, Niccolai LM, Schafer S, Park I, Bloch K, Unger ER, Whitney E, Julian P, Scahill MW, Abdullah N, Levine D, Johnson ML, Steinau M, Markowitz LE.. Reduction in HPV 16/18-associated high grade cervical lesions following HPV vaccine introduction in the United States, 2008–2012. Vaccine 2015;33:1608–13.
4.Niccolai LM, McBride V, Julian PR. Sources of information for assessing human papillomavirus vaccination histories in young women. Vaccine 2014;32:2945-7.
5.Waggaman C, Julian P, Niccolai LM. Interactive effects of individual and neighborhood race and ethnicity on rates of high-grade cervical lesions.Cancer Epidemiology 2014;38:248-52.
6.Niccolai LM, Julian P, Meek J, McBride V, Hadler J, Sosa L. Declining rates of high-grade cervical lesions in young women in Connecticut, 2008-2011.Cancer Epidemiology, Biomarkers & Prevention 2013;22:1446–50.
7.Niccolai LM, Russ C, Julian PJ, Hariri S, Sinard J, Meek JI, McBride V, Markowitz LE, Unger ER, Hadler JL, Sosa LE. Individual and geographic disparities in human papillomavirus types 16/18 in high-grade cervical lesions: Associations with race, ethnicity, and poverty.Cancer 2013;119:3052–8.
Project Contact Person
Monica Brackney, MS
Connecticut Emerging Infections Program
One Church Street, 7th floor
New Haven, CT 06510