학술논문
The value of including boys in an HPV vaccination programme: a cost-effectiveness analysis in a low-resource setting.
Document Type
Journal Article
Author
Source
Subject
*VACCINATION
*PAPILLOMAVIRUSES
*COST effectiveness
*COST analysis
*ONCOGENIC DNA viruses
*PREVENTION of communicable diseases
*IMMUNIZATION
*ECONOMICS
*HEALTH policy
*PAPILLOMAVIRUS disease diagnosis
*CERVICAL intraepithelial neoplasia
*MEDICAL screening
*PAPILLOMAVIRUS diseases
*RESEARCH funding
*QUALITY-adjusted life years
CERVIX uteri tumors
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Language
ISSN
0007-0920
Abstract
We assessed the cost-effectiveness of including boys vs girls alone in a pre-adolescent vaccination programme against human papillomavirus (HPV) types 16 and 18 in Brazil. Using demographic, epidemiological, and cancer data from Brazil, we developed a dynamic transmission model of HPV infection between males and females. Model-projected reductions in HPV incidence under different vaccination scenarios were applied to a stochastic model of cervical carcinogenesis to project lifetime costs and benefits. We assumed vaccination prevented HPV-16 and -18 infections in individuals not previously infected, and protection was lifelong. Coverage was varied from 0-90% in both genders, and cost per-vaccinated individual was varied from IUSD 25 to 400. At 90% coverage, vaccinating girls alone reduced cancer risk by 63%; including boys at this coverage level provided only 4% further cancer reduction. At a cost per-vaccinated individual of USD 50, vaccinating girls alone was