Global Impact and Cost-Effectiveness of One-Dose Versus Two-Dose Human Papillomavirus Vaccination Schedules: A Comparative Modelling Analysis

Prem, Kiesha; Choi, Yoon Hong; Bénard, Élodie; Burger, Emily A.; Hadley, Liza; Laprise, Jean-François; Regan, Catherine; Drolet, Mélanie; Sy, Stephen; Abbas, Kaja; Kim, Jane J.; Brisson, Marc; Jit, Mark

doi:10.2139/ssrn.3779876

Cited by 7 publications

(7 citation statements)

References 37 publications

(59 reference statements)

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“…Even with a pessimistic assumption that the efficacy of one dose is lower than two/three doses, adopting a one-dose schedule would free up vaccine doses to allow more rapid scale-up of vaccination, and generate the greatest cost savings and health gains with constrained supply in China. Our results about the one-dose schedule are generally consistent with previous modelling studies, 29 , 30 , 32 , 33 , 34 which suggest promising health benefits (in terms of improving both impact and efficiency) and favourable cost-effectiveness of one-dose strategies. However, few studies have explicitly incorporated supply constraints when comparing the impact of adopting a one-dose schedule with other strategies.…”

Section: Discussionsupporting

confidence: 90%

Optimal allocation strategies for HPV vaccination introduction and expansion in China accommodated to different supply and dose schedule scenarios: a modelling study

You¹,

Zhao²,

Hu³

et al. 2023

eClinicalMedicine

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Section: Discussionsupporting

confidence: 90%

Optimal allocation strategies for HPV vaccination introduction and expansion in China accommodated to different supply and dose schedule scenarios: a modelling study

You¹,

Zhao²,

Hu³

et al. 2023

eClinicalMedicine

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“…Among the preponderant factors are the establishment of consistent herd immunity, protecting the population from infection by a major cause of malignant neoplasms, reducing deaths linked to HPV infection, budget relief through cost reduction and greater ease of administration. (36)(37) As for the vaccine efficacy found in the scheme with just one dose of bivalent vaccine, an efficacy finding of 82.1% was observed, a value minimally lower than the value observed with the two-dose scheme of bivalent vaccine. The same is observed years after application of the vaccine when there is stable immunity against HPV, which strengthens the evidence that just one dose would be sufficient for adequate protection 26 .…”

Section: Discussionmentioning

confidence: 81%

Avaliação da eficácia e durabilidade da Vacina Anti-HPV nos diferentes esquemas vacinais: Uma revisão sistemática

Sampaio,

Vilela,

Barros

et al. 2024

Rev. Cont. Saúde

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O HPV é o agente etiológico do câncer de colo de útero. É a segunda principal neoplasia entre as mulheres, quando considerados os países menos desenvolvidos e de baixa renda. Apesar do desenvolvimento de três imunizantes eficazes na prevenção de infecções e de lesões HPV-relacionadas, nem sempre se observa o cumprimento completo do esquema vacinal. Acredita-se que o número de doses seja um fator preponderante para a baixa adesão. Nesse intuito, o objetivo do estudo foi verificar se o esquema reduzido de doses tem uma eficácia e durabilidade comparáveis ao esquema ampliado. Trata-se de uma revisão sistemática da literatura cuja estratégia de pesquisa bibliográfica incluiu consulta às bases de pesquisa PubMed e SciELO no primeiro semestre de 2022. Os critérios de inclusão foram: Estudos clínicos randomizados publicados em língua inglesa, portuguesa ou espanhola; Publicações dos últimos cinco anos; Publicações nas quais a intervenção é a aplicação da vacina na população adolescente ou adulta; Publicações que avaliam diferentes esquemas vacinais e Publicações com desfecho relacionado à eficácia e durabilidade dos esquemas vacinais. Os critérios foram avaliados por dois revisores independentes e o risco de viés das publicações foi analisado pelo checklist CONSORT. Foram reunidos 54 artigos, dos quais 12 foram elegíveis. Os resultados deste estudo demonstraram que os esquemas reduzidos de uma ou duas doses possuem imunogenicidade, eficácia e durabilidade da proteção anti-HPV satisfatórias, sem prejuízos em relação a esquemas de três doses. Portanto, esquemas reduzidos, se tornam uma estratégia de imunização , principalmente no que tange aos países em desenvolvimento, que teriam seus programas de vacinação fortalecidos e a cobertura vacinal ampliada.

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“…4,24 The high level of efficacy builds on observational data 11,12 and provides rigorous evidence for single-dose HPV vaccination to prevent persistent HPV infections, which could increase vaccine access and coverage, offering a cost-effective strategy for cervical cancer prevention. 25 Strengths of the study include the randomized, double-blind, controlled design, high retention, measurement of cervical HPV DNA as the outcome, determination of persistent HPV DNA, and the head-to-head comparison of the licensed bivalent and nonavalent HPV vaccines in protection against persistent infection with oncogenic HPV types included in the vaccines. In addition, the trial successfully enrolled persons exposed to HPV infection who were successfully retained in all randomized groups, allowing rapid assessment of single-dose efficacy.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of single-dose HPV vaccination among young African women

Barnabas

Brown

Onono

et al. 2021

Preprint

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Background: Single-dose HPV vaccination, if efficacious, would be tremendously advantageous; simplifying implementation and decreasing costs.Methods: We performed a randomized, multi-center, double-blind, controlled trial of single-dose nonavalent (HPV 16/18/31/33/45/52/58/6/11) or bivalent (HPV 16/18) HPV vaccination compared to meningococcal vaccination among Kenyan women aged 15-20 years. Enrollment and six monthly cervical swabs and a month three vaginal swab were tested for HPV DNA. Enrollment sera were tested for HPV antibodies. The modified intent-to-treat (mITT) cohort comprised participants who tested HPV antibody negative at enrollment and HPV DNA negative at enrollment and month three. The primary outcome was incident persistent vaccine-type HPV infection by month 18.Results: Between December 2018 and June 2021, 2,275 women were randomly assigned and followed; 758 received the nonavalent HPV vaccine, 760 the bivalent HPV vaccine, and 757 the meningococcal vaccine; retention was 98%. Thirty eight incident persistent infections were detected in the HPV 16/18 mITT cohort: one each among participants assigned to the bivalent and nonavalent groups and 36 among those assigned to the meningococcal group; nonavalent Vaccine Efficacy (VE) was 97.5% (95%CI 81.7-99.7%, p=<0.0001), and bivalent VE was 97.5% (95%CI 81.6-99.7%, p=<0.0001). Thirty-three incident persistent infections were detected in the HPV 16/18/31/33/45/52/58 mITT cohort: four in the nonavalent group and 29 in the meningococcal group; nonavalent VE for HPV 16/18/31/33/45/52/58 was 88.9% (95%CI 68.5-96.1%, p<0.0001). The rate of SAEs was 4.5-5.2% by group.Conclusions: Single-dose bivalent and nonavalent HPV vaccines were each highly effective in preventing incident persistent oncogenic HPV infection, similar to multidose regimens.

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Global Impact and Cost-Effectiveness of One-Dose Versus Two-Dose Human Papillomavirus Vaccination Schedules: A Comparative Modelling Analysis

Cited by 7 publications

References 37 publications

Optimal allocation strategies for HPV vaccination introduction and expansion in China accommodated to different supply and dose schedule scenarios: a modelling study

Optimal allocation strategies for HPV vaccination introduction and expansion in China accommodated to different supply and dose schedule scenarios: a modelling study

Avaliação da eficácia e durabilidade da Vacina Anti-HPV nos diferentes esquemas vacinais: Uma revisão sistemática

Efficacy of single-dose HPV vaccination among young African women

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