These findings highlight the importance of accounting for herd protection induced by early childhood HA vaccination. They also support the very recent Advisory Committee for Immunization Practices recommendations for universal HA immunization of 1-year-olds.
We developed a dynamic compartmental model to assess the impact of HPV Universal Mass
Vaccination (UMV) with Cervarix™, which offers protection against
HPV16/18 and cross-protection against other cancer-causing types, using up-to-date
efficacy data. Analyses were performed in the UK because of the large amount of high
quality epidemiological data available. For each HPV type/group of types considered, the
model was calibrated to 14 epidemiological datasets (prevalence of HPV infection, cervical
intraepithelial neoplasia (CIN): CIN1, CIN2, CIN3 pre-screening and cervical cancer (CC)
incidence over 10 y post-screening). Impacts of cross-protection, female catch-up
vaccination, and additional male vaccination on oncogenic infections, high-grade CIN
(CIN2+) and CC were evaluated. Our results show that female UMV with 80%
coverage and cross-protection against high-risk types resulted in 81% CIN2+
and 88% CC reductions vs. 57% and 75%, respectively, without
cross-protection. Vaccinating 40% of males and 80% of females was equivalent
to 90% female-only coverage regarding CIN2+ (87% and 87%,
respectively) and CC (93% and 94%, respectively) reductions. Female-only
coverage of 80% substantially reduced male HPV16 and 18 infection due to herd
protection (74% and 89%, respectively). Increasing female coverage to
90% reduced HPV16 and HPV18 infections in males relatively similarly to 80%
female combined with 40% male coverage. Model outcomes strengthen previous
conclusions about the significant added value of Cervarix™
cross-protection for CC prevention, the primary HPV vaccination public health priority.
Regarding female CC prevention and male HPV16/18 infection, small increases in female
coverage induce similar benefits to those achieved by additionally vaccinating men with
40% coverage.
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