Cost-effectiveness of female human papillomavirus vaccination in 179 countries: a PRIME modelling study

Jit, Mark; Brisson, Marc; Portnoy, Allison; Hutubessy, Raymond

doi:10.1016/s2214-109x(14)70237-2

Cited by 212 publications

(211 citation statements)

References 19 publications

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“…Only a few countries in Asian regions, including Nepal, and Malaysia, provide HPV vaccines as national policies (57). This might be caused by several issues, such as lack of Asian-contextspecific evidence on the efficacy of HPV vaccination, socioeconomic barriers, and most importantly, scarce national budgets which hamper implementation of HPV vaccination in most of Asian countries (58)(59)(60).…”

Section: Discussionmentioning

confidence: 99%

Immunogenicity and safety of human papillomavirus (HPV) vaccination in Asian populations from six countries: a meta-analysis

Setiawan

Luttjeboer

Pouwels

et al. 2017

Jpn. J. Clin. Oncol.

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Cervical cancer is a serious public-health problem in Asian countries. Since human papillomavirus (HPV) infection is the main risk factor for cervical cancer, HPV vaccination is considered a promising strategy to prevent cervical cancer. However, comprehensive immunogenicity and safety information for Asian populations is lacking. We searched four electronic databases including PubMed, EMBASE, Cochrane Library, and clinicaltrials.gov. We reviewed selected manuscripts and extracted the pooled relative risk (RR) from immunogenicity and safety information on HPV vaccination among women in Asian countries. We identified two quadrivalentvaccine studies and eight bivalent-vaccine studies conducted in Asian countries. Analysis across these studies suggested that the HPV vaccines significantly enhanced HPV16-and HPV18-specific antibody among both uninfected (RR 85.69; 95% confidence interval (CI) 31.51-233.04 and 62.77; 95% CI 37.4-105.51) and infected individuals (RR 8.60; 95% CI 6.95-10.64 and RR 8.13; 95% CI 5.96-11.11). Furthermore, HPV vaccination among Asian populations has a favorable safety profile, with only slightly higher risks of local (RR: 1.89; 95% CI 1.65-2.17) and systemic (RR: 1.33; 95% CI 1.18-1.50) adverse events in vaccinated individuals compared with controls. For Asian populations, HPV vaccines enhance the level of HPV16-and HPV18-specific antibodies for both uninfected and infected individuals. Also, the risk of adverse events related to vaccination are acceptable. More data are needed to establish vaccine efficacy with regard to prevention of HPV infection and further outcomes including cervical intraepithelial neoplasia (CIN) and cervical cancer.

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Section: Discussionmentioning

confidence: 99%

Immunogenicity and safety of human papillomavirus (HPV) vaccination in Asian populations from six countries: a meta-analysis

Setiawan

Luttjeboer

Pouwels

et al. 2017

Jpn. J. Clin. Oncol.

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“…74 Studies in cervical cancer project that given established trends and efficacy, significant decreases in incidence and mortality from cervical cancer would be observed by 2050. 75 Given the higher median age of diagnosis of oropharyngeal cancer compared to cervical cancer (58 vs. 48 years), 76 reduction in incidence and mortality rates for oropharyngeal cancer would not likely be observed until at least 2060. 3 In addition to assumptions regarding vaccine efficacy and vaccine uptake, this projection also assumes sustained vaccine protection and no contribution of the second peak of oral HPV infection seen in older populations.…”

Section: What Do We Know About Hpv Vaccines In Hnscc?mentioning

confidence: 99%

“…85 Even if vaccine efficacy against oral infection or vaccine uptake in men is minimal, herd immunity is likely to play a role in decreasing the overall prevalence of HPV in the general population, though these effects are difficult to estimate. 75 In this changing landscape, there are new challenges in evaluating vaccine efficacy. Placebo-controlled trials can no longer be ethically performed, however, observed changes in current OPC incidence trends can provide indirect evidence for the potential impact of HPV vaccines in OPC.…”

Section: ) Conclusion – What Does the Landscape Look Like Ahead?mentioning

confidence: 99%

The potential impact of prophylactic human papillomavirus vaccination on oropharyngeal cancer

Guo

Eisele

Fakhry

2016

Cancer

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Oropharyngeal cancer (OPC) is significantly increasing in incidence in the United States. Given that these epidemiologic trends are driven by HPV, the potential impact of prophylactic HPV vaccines on the prevention of OPC is of interest. To date, the primary evidence supporting the approval of current prophylactic HPV vaccines are large phase III clinical trials focused on prevention of genital disease (cervical and anal cancer, as well as genital warts). These trials reported 89-98% vaccine efficacy for prevention of both premalignant lesions and persistent genital infection. However, these trials were designed before the etiologic relationship between HPV and oropharyngeal cancer was established. There are differences in the epidemiology of oral and genital HPV infection, such as differences in age and gender distributions, which suggest that the vaccine efficacy shown in genital cancers may not be directly translatable to the oropharynx. Evaluation of vaccine efficacy is challenging in the oropharynx because no premalignant lesions analogous to cervical intraepithelial neoplasia (CIN) in cervical cancer has been identified. In order to truly investigate the efficacy of these vaccines in the oropharynx, additional clinical trials with feasible endpoints are needed.

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“…Lastly, while the financial cost has been the major prohibitive factor to add the vaccine on the national vaccination program [31], more evidence has shown that the vaccine is cost effective compared to the cost of HPV and anogenital cancer treatments and damage to the quality of life [32,33]. In Thailand, the series of HPV vaccines cost between US$ 180 and US$ 340, while the gross national income per capita was approximately US$ 3,900 [33]. Relieving financial burdens of vaccination is necessary.…”

mentioning

confidence: 99%

Human papillomavirus (HPV) vaccination and factors related to intention to obtain the vaccine among young college women in Thailand

Ratanasiripong

Sriumporn

Kathalae

et al. 2018

JHR

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Purpose Most cervical cancers are caused by genital human papillomavirus (HPV). However, it can be prevented if females receive an HPV vaccine. Nevertheless, there is limited evidence of HPV vaccination and predictors of intention to obtain the vaccine among young women in Thailand. The paper aims to discuss this issue. Design/methodology/approach This cross-sectional study examined HPV vaccination and factors influencing intention to vaccinate among a convenient sample of college women in Thailand. The data collection was conducted via a self-administered “HPV and HPV vaccine-related knowledge, attitudes, and behaviors” questionnaire. Findings Out of 1,030 participants, 309 (30.0 percent) were aware of HPV and the HPV vaccine. Out of these, 257 participants reported that they had not obtained the vaccine and 18 participants were unsure if they had already obtained the vaccine or not. Only 34 participants confirmed that they had received the vaccine. Among those who were aware of HPV and the HPV vaccine, 56.4 percent of them did not know that most HPV-infected persons do not show any signs or symptoms, and 53.3 percent thought that the vaccine provided protection against other sexually transmitted infections as well. Most had positive attitudes toward vaccination and subjective norms. Among the participants who had not received the vaccine, the intention to obtain the vaccine was predicted by age, knowledge, attitudes toward vaccination, and subjective norms. The reasons for not being vaccinated included the cost of the vaccine, lack of knowledge, and perception of themselves being at low risk. Originality/value This study found low HPV vaccination among college women. However, those who had not received the vaccine intended to obtain the vaccine at some point in the future. An HPV vaccination campaign may be well tailored in order to increase the intention to obtain the vaccine which, in turn, may increase the HPV vaccination. Vaccination cost sharing should be discussed among Thai policy makers in order to alleviate the financial burden for women.

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Cost-effectiveness of female human papillomavirus vaccination in 179 countries: a PRIME modelling study

Abstract: WHO.

Cited by 212 publications

References 19 publications

Immunogenicity and safety of human papillomavirus (HPV) vaccination in Asian populations from six countries: a meta-analysis

Immunogenicity and safety of human papillomavirus (HPV) vaccination in Asian populations from six countries: a meta-analysis

The potential impact of prophylactic human papillomavirus vaccination on oropharyngeal cancer

Human papillomavirus (HPV) vaccination and factors related to intention to obtain the vaccine among young college women in Thailand

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