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J Infect Dis. 2016 Jan 15;213(2):199-205. doi: 10.1093/infdis/jiv368. Epub 2015 Jul 3.

Human Papillomavirus Vaccination of Boys and Extended Catch-up Vaccination: Effects on the Resilience of Programs.

Author information

1
Department of Medical Epidemiology and Biostatistics.
2
Department of Translational Medicine, University of Piemonte Orientale Avogadro, Novara Unit of Cancer Epidemiology, Department of Medical Sciences, University of Turin, Italy International Agency for Research on Cancer, Lyon, France.
3
International Agency for Research on Cancer, Lyon, France.
4
Department of Medical Epidemiology and Biostatistics Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.

Abstract

BACKGROUND:

Decreasing human papillomavirus (HPV) vaccine prices makes scaling up of vaccination programs attractive for countries that initially targeted 1 or a few birth cohorts of girls and/or achieved low coverage. This article aims to compare the impact of alternative HPV vaccination strategies, using data from Sweden, a high-income country that has experienced vaccine price changes.

METHODS:

Using an HPV transmission model, we compared the existing vaccination program to alternatives, accounting for a 1-time catch-up vaccination of 22-26-year-old women, with or without routine vaccination of school-age boys, and for a 1-time catch-up vaccination of males aged 13-26 years. We also assessed the resilience of vaccination alternatives to coverage reduction.

RESULTS:

On the basis of an HPV16/18 prevalence of 12% before the HPV vaccine era, extended catch-up vaccination for females and males yielded relative reductions in the HPV prevalence of 49.4% and 55.6%, respectively, during the first 10 years after the start of each vaccination strategy, whereas the existing program yielded a relative reduction of 38.6% during the same period. The increased prevalence reduction due to catch-up vaccination continued for about 30 years. As compared to female-only routine and extended catch-up vaccination, routine vaccination of males with or without catch-up was, respectively, 12.6-fold and 7.2-fold more resilient to coverage reduction.

CONCLUSIONS:

Vaccination strategies based on catch-up vaccination of females and males are effective for accelerating HPV prevalence reduction. Inclusion of routine male vaccination improves the resilience of vaccination programs.

KEYWORDS:

catch-up; coverage reduction; gender neutral; human papillomavirus vaccination; resilience

PMID:
26142436
DOI:
10.1093/infdis/jiv368
[Indexed for MEDLINE]

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