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- Title
Human Papillomavirus Vaccination of Boys and Extended Catch-up Vaccination: Effects on the Resilience of Programs.
- Authors
Elfström, K. Miriam; Lazzarato, Fulvio; Franceschi, Silvia; Dillner, Joakim; Baussano, Iacopo
- Abstract
<bold>Background: </bold>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.<bold>Methods: </bold>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.<bold>Results: </bold>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.<bold>Conclusions: </bold>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.
- Subjects
SWEDEN; HUMAN papillomavirus vaccines; BOYS' health; HEALTH programs; TRANSMISSION of papillomavirus diseases; EPIDEMIOLOGICAL models; PUBLIC health
- Publication
Journal of Infectious Diseases, 2016, Vol 213, Issue 2, p199
- ISSN
0022-1899
- Publication type
journal article
- DOI
10.1093/infdis/jiv368