Vaccinating women previously exposed to human papillomavirus: a cost-effectiveness analysis of the bivalent vaccine
Author(s)
Turner, Hugo C
Baussano, Iacopo
Garnett, Geoff P
Type
Journal Article
Abstract
Recent trials have indicated that women with prior exposure to Human papillomavirus (HPV) subtypes 16/18 receive protection against reinfection from the HPV vaccines. However, many of the original models investigating the cost effectiveness of different vaccination strategies for the protection of cervical cancer assumed, based on the trial results at that time, that these women received no protection. We developed a deterministic, dynamic transmission model that incorporates the vaccine-induced protection of women with prior exposure to HPV. The model was used to estimate the cost effectiveness of progressively extending a vaccination programme using the bivalent vaccine to older age groups both with and without protection of women with prior exposure. We did this under a range of assumptions on the level of natural immunity. Our modelling projections indicate that including the protection of women with prior HPV exposure can have a profound effect on the cost effectiveness of vaccinating adults. The impact of this protection is inversely related to the level of natural immunity. Our results indicate that adult vaccination strategies should potentially be reassessed, and that it is important to include the protection of non-naive women previously infected with HPV in future studies. Furthermore, they also highlight the need for a more thorough investigation of this protection.
Date Issued
2013-09-26
Date Acceptance
2013-08-19
Citation
PLoS One, 2013, 8 (9), pp.1-9
ISSN
1932-6203
Publisher
Public Library of Science (PLoS)
Start Page
1
End Page
9
Journal / Book Title
PLoS One
Volume
8
Issue
9
Copyright Statement
© 2013 Turner et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Sponsor
Wellcome Trust
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000325220000027&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Grant Number
090285/Z/09/Z
Subjects
Science & Technology
Multidisciplinary Sciences
Science & Technology - Other Topics
HPV-16/18 AS04-ADJUVANTED VACCINE
TRANSMISSION DYNAMIC-MODEL
BLIND PATRICIA TRIAL
OF-STUDY ANALYSIS
CERVICAL-CANCER
UNITED-KINGDOM
ECONOMIC-EVALUATION
HPV VACCINATION
ADULT WOMEN
INFECTION
Publication Status
Published
Article Number
ARTN e75552
Date Publish Online
2013-09-26