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Vaccinating women previously exposed to human papillomavirus: a cost-effectiveness analysis of the bivalent vaccine

Title: Vaccinating women previously exposed to human papillomavirus: a cost-effectiveness analysis of the bivalent vaccine
Authors: Turner, HC
Baussano, I
Garnett, GP
Item 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.
Issue Date: 26-Sep-2013
Date of Acceptance: 19-Aug-2013
URI: http://hdl.handle.net/10044/1/76852
DOI: 10.1371/journal.pone.0075552
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/Funder: Wellcome Trust
Funder's Grant Number: 090285/Z/09/Z
Keywords: 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
Adolescent
Adult
Aged
Child
Cost-Benefit Analysis
Female
Humans
Middle Aged
Models, Economic
Papillomaviridae
Papillomavirus Infections
Papillomavirus Vaccines
Vaccination
Young Adult
Humans
Papillomaviridae
Papillomavirus Infections
Vaccination
Models, Economic
Adolescent
Adult
Aged
Middle Aged
Child
Cost-Benefit Analysis
Female
Papillomavirus Vaccines
Young Adult
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
General Science & Technology
Publication Status: Published
Article Number: ARTN e75552
Online Publication Date: 2013-09-26
Appears in Collections:School of Public Health