Upscaling human papillomavirus vaccination in high-income countries: impact assessment based on transmission model

Infectious Agents and Cancer

Silvia Franceschi⁴  Guglielmo Ronco²  Fulvio Lazzarato¹  Joakim Dillner³  Iacopo Baussano⁴ 

[1] Department of Medical Sciences, Unit of Cancer Epidemiology, University of Turin, Via Santena 7, 10126 Turin, Italy;Centre for Cancer Prevention, Via San Francesco da Paola 31, 10123 Turin, Italy;Karolinska Institutet, Nobels väg 12A, 17177 Stockholm, Sweden;International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon cedex 08, France

关键词: Mathematical model;    High-income;    Vaccination;    Human papillomavirus;   

Others  :  801168
DOI  :  10.1186/1750-9378-9-4

 received in 2013-09-26, accepted in 2014-01-03,  发布年份 2014

【 摘 要 】

Background

The decrease in human papillomavirus (HPV) vaccine prices may allow upscale already started vaccination programmes but the advantages of different options are unclear.

Methods

Using a mathematical model of HPV16 and 18 transmission and data on vaccination coverage from Italy, we compared 3 options to upscale an already started programme targeting 11-year old girls (coverage 65%): a) coverage improvement (from 65% to 90%); b) addition of 11-year-old boys (coverage 65%); or c) 1-year catch-up of older girls (coverage 50%).

Results

The reduction of cervical HPV16/18 infection as compared to no vaccination (i.e. effectiveness against HPV16/18) increased from 76% to 98% with coverage improvement in girls and to 90% with the addition of boys. With higher coverage in girls, HPV16/18 infection cumulative probability by age 35 decreased from 25% to 8% with a 38% increase in vaccine number. The addition of boys decreased the cumulative probability to 18% with a 100% increase in the number of vaccinees. For any coverage in girls, the number of vaccinees to prevent 1 woman from being infected by HPV16/18 by age 35 was 1.5, whereas it was 2.7 for the addition of boys. Catch-up of older girls only moved forward the vaccination effectiveness by 2–5 years.

Conclusions

Increasing vaccination coverage among girls is the most effective option for decreasing HPV16/18. If not achievable, vaccinating boys is justifiable if vaccine cost has at least halved, because this option would almost double the number of vaccinees.

【 授权许可】

   
2014 Baussano et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

Figure 4.

【 参考文献 】

• [1]Salisbury DM: Male vaccination against human papillomavirus. Lancet Infect Dis 2012, 12:582-583.
• [2]Donovan B, Franklin N, Guy R, Grulich AE, Regan DG, Ali H, Wand H, Fairley CK: Quadrivalent human papillomavirus vaccination and trends in genital warts in Australia: analysis of national sentinel surveillance data. Lancet Infect Dis 2011, 11:39-44.
• [3]Centers for Disease Control and Prevention (CDC): Recommendations on the use of quadrivalent human papillomavirus vaccine in males--Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep 2011, 60:1705-8.
• [4]Forman D, de Martel C, Lacey CJ, Soerjomataram I, Lortet-Tieulent J, Bruni L, Vignat J, Ferlay J, Bray F, Plummer M, Franceschi S: Global burden of human papillomavirus and related diseases. Vaccine 2012, 30:F12-F23.
• [5]Georgousakis M, Jayasinghe S, Brotherton J, Gilroy N, Chiu C, Macartney K: Population-wide vaccination against human papillomavirus in adolescent boys: Australia as a case study. Lancet Infect Dis 2012, 12:627-634.
• [6]French KM, Barnabas RV, Lehtinen M, Kontula O, Pukkala E, Dillner J, Garnett GP: Strategies for the introduction of human papillomavirus vaccination: modelling the optimum age- and sex-specific pattern of vaccination in Finland. Br J Cancer 2007, 96:514-518.
• [7]Kim JJ, Goldie SJ: Health and economic implications of HPV vaccination in the United States. N Engl J Med 2008, 359:821-832.
• [8]Jit M, Choi YH, Edmunds WJ: Economic evaluation of human papillomavirus vaccination in the United Kingdom. BMJ 2008, 337:a769.
• [9]Bogaards JA, Coupe VM, Meijer CJ, Berkhof J: The clinical benefit and cost-effectiveness of human papillomavirus vaccination for adult women in the Netherlands. Vaccine 2011, 29:8929-8936.
• [10]Chesson HW, Ekwueme DU, Saraiya M, Dunne EF, Markowitz LE: The cost-effectiveness of male HPV vaccination in the United States. Vaccine 2011, 29:8443-8450.
• [11]Elbasha EH, Dasbach EJ: Impact of vaccinating boys and men against HPV in the United States. Vaccine 2010, 28:6858-6867.
• [12]Regan DG, Philp DJ, Hocking JS, Law MG: Modelling the population-level impact of vaccination on the transmission of human papillomavirus type 16 in Australia. Sex Health 2007, 4:147-163.
• [13]Baussano I, Elfstrom KM, Lazzarato F, Gillio-Tos A, De Marco L, Carozzi F, Del Mistro A, Dillner J, Franceschi S, Ronco G: Type-Specific Human Papillomavirus Biological Features: Validated Model-Based Estimates. 8th edition. 2013, e81171.
• [14]Ronco G, Giorgi-Rossi P, Carozzi F, Confortini M, Dalla Palma P, Del Mistro A, Ghiringhello B, Girlando S, Gillio-Tos A, De Marco L, Naldoni C, Pierotti P, Rizzolo R, Schincaglia P, Zorzi M, Zappa M, Segnan N, Cuzick J, New Technologies for Cervical Cancer screening (NTCC) Working Group: Efficacy of human papillomavirus testing for the detection of invasive cervical cancers and cervical intraepithelial neoplasia: a randomised controlled trial. Lancet Oncol 2010, 11:249-257.
• [15]Hoare A, Regan DG, Wilson DP: Sampling and sensitivity analyses tools (SaSAT) for computational modelling. Theor Biol Med Model 2008, 5:4. BioMed Central Full Text
• [16]Vaccarella S, Franceschi S, Snijders PJ, Herrero R, Meijer CJ, Plummer M: Concurrent infection with multiple human papillomavirus types: pooled analysis of the IARC HPV prevalence surveys. Cancer Epidemiol Biomarkers Prev 2010, 19:503-510.
• [17]Carozzi F, Ronco G, Gillio-Tos A, De Marco L, Del Mistro A, Girlando S, Franceschi S, Plummer M, Vaccarella S, New Technologies for Cervical Cancer screening (NTCC) Working Group: Concurrent infections with multiple human papillomavirus (HPV) types in the New Technologies for Cervical Cancer (NTCC) screening study. Eur J Cancer 2012, 48:1633-1637.
• [18]Vaccarella S, Franceschi S, Herrero R, Schiffman M, Rodriguez AC, Hildesheim A, Burk RD, Plummer M: Clustering of multiple human papillomavirus infections in women from a population-based study in Guanacaste, Costa Rica. J Infect Dis 2011, 204:385-390.
• [19]Paavonen J, Naud P, Salmeron J, Wheeler CM, Chow SN, Apter D, Kitchener H, Castellsague X, Teixeira JC, Skinner SR, Hedrick J, Jaisamrarn U, Limson G, Garland S, Szarewski A, Romanowski B, Aoki FY, Schwarz TF, Poppe WA, Bosch FX, Jenkins D, Hardt K, Zahaf T, Descamps D, Struyf F, Lehtinen M, Dubin G, HPV PATRICIA Study Group: Efficacy of human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine against cervical infection and precancer caused by oncogenic HPV types (PATRICIA): final analysis of a double-blind, randomised study in young women. Lancet 2009, 374:301-314.
• [20]Wheeler CM, Kjaer SK, Sigurdsson K, Iversen OE, Hernandez-Avila M, Perez G, Brown DR, Koutsky LA, Tay EH, García P, Ault KA, Garland SM, Leodolter S, Olsson SE, Tang GW, Ferris DG, Paavonen J, Steben M, Bosch FX, Dillner J, Joura EA, Kurman RJ, Majewski S, Muñoz N, Myers ER, Villa LL, Taddeo FJ, Roberts C, Tadesse A, Bryan J: The impact of Quadrivalent Human Papillomavirus (HPV; Types 6, 11, 16, and 18) L1 virus-like particle vaccine on infection and disease due to oncogenic nonvaccine hpv types in sexually active women aged 16–26 years. J Infect Dis 2009, 199:936-944.
• [21]Giuliano AR, Palefsky JM, Goldstone S, Moreira ED Jr, Penny ME, Aranda C, Vardas E, Moi H, Jessen H, Hillman R, Chang YH, Ferris D, Rouleau D, Bryan J, Marshall JB, Vuocolo S, Barr E, Radley D, Haupt RM, Guris D: Efficacy of quadrivalent HPV vaccine against HPV infection and disease in males. N Engl J Med 2011, 364:401-411.
• [22]Giambi C: Tassi di copertura vaccinale per HPV in Italia. IJPH 2011, Vol 8, Num 3(suppl 1):S23-27. http://www.ijph.it/pdf/56/023.pdf webcite
• [23]Dorleans F, Giambi C, Dematte L, Cotter S, Stefanoff P, Mereckiene J, O’Flanagan D, Lopalco PL, D’Ancona F, Levy-Bruhl D, Dorleans F, Giambi C, Dematte L, Cotter S, Stefanoff P, Mereckiene J, O’Flanagan D, Lopalco PL, D’Ancona F, Levy-Bruhl D, VENICE 2 project gatekeepers group: The current state of introduction of human papillomavirus vaccination into national immunisation schedules in Europe: first results of the VENICE2 2010 survey. Euro Surveill 2010., 15(47) Available from: URL: http://www.eurosurveillance.org/ webcite
• [24]Giambi C: Stato di avanzamento della campagna vaccinale per l’HPV: dati di copertura vaccinale al 31/12/2010 eaggiornamento delle decisioni in merito alle strategie vaccinali. Istituto Superiore di Sanità: Reparto di Epidemiologia di Malattie Infettive del CNESPS; http://www.epicentro.iss.it/ webcite
• [25]Garnett GP: Role of herd immunity in determining the effect of vaccines against sexually transmitted disease. J Infect Dis 2005, 191(Suppl 1):S97-106.
• [26]Darden PM, Thompson DM, Roberts JR, Hale JJ, Pope C, Naifeh M, Jacobson RM: Reasons for not vaccinating adolescents: National Immunization Survey of Teens, 2008–2010. Pediatrics 2013, 131:645-651.
• [27]Bonanni P, Pesavento G, Bechini A, Tiscione E, Mannelli F, Benucci C, Nostro AL: Impact of universal vaccination programmes on the epidemiology of hepatitis B: 10 years of experience in Italy. Vaccine 2003, 21:685-691.
• [28]Kane MA: Preventing cancer with vaccines: progress in the global control of cancer. Cancer Prev Res (Phila) 2012, 5:24-29.
• [29]Schiffman M, Castle PE, Jeronimo J, Rodriguez AC, Wacholder S: Human papillomavirus and cervical cancer. Lancet 2007, 370:890-907.
• [30]Michels KB, Zur Hausen H: HPV vaccine for all. Lancet 2009, 374:268-270.
• [31]Giuliano AR, Lee JH, Fulp W, Villa LL, Lazcano E, Papenfuss MR, Abrahamsen M, Salmeron J, Anic GM, Rollison DE, Smith D: Incidence and clearance of genital human papillomavirus infection in men (HIM): a cohort study. Lancet 2011, 377:932-940.
• [32]Kreimer AR, Rodriguez AC, Hildesheim A, Herrero R, Porras C, Schiffman M, González P, Solomon D, Jiménez S, Schiller JT, Lowy DR, Quint W, Sherman ME, Schussler J, Wacholder S, CVT Vaccine Group: Proof-of-principle evaluation of the efficacy of fewer than three doses of a bivalent HPV16/18 vaccine. J Natl Cancer Inst 2011, 103:1444-1451.