TITLE

Evaluating human papillomavirus vaccination programs in Canada: should provincial healthcare pay for voluntary adult vaccination?

AUTHOR(S)
Llamazares, Marco; Smith?, Robert J.
PUB. DATE
January 2008
SOURCE
BMC Public Health;2008, Vol. 8, p114
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Recently, provincial health programs in Canada and elsewhere have begun rolling out vaccination against human papillomavirus for girls aged 9-13. While vaccination is voluntary, the cost of vaccination is waived, to encourage parents to have their daughters vaccinated. Adult women who are eligible for the vaccine may still receive it, but at a cost of approximately CAN$400. Given the high efficacy and immunogenicity of the vaccine, the possibility of eradicating targeted types of the virus may be feasible, assuming the vaccination programs are undertaken strategically. Methods: We develop a mathematical model to describe the epidemiology of vaccination against human papillomavirus, accounting for a widespread childhood vaccination program that may be supplemented by voluntary adult vaccination. A stability analysis is performed to determine the stability of the disease-free equilibrium. The critical vaccine efficacy and immunogenicity thresholds are derived, and the minimum level of adult vaccination required for eradication of targeted types is determined. Results: We demonstrate that eradication of targeted types is indeed feasible, although the burden of coverage for a childhood-only vaccination program may be high. However, if a small, but non-negligible, proportion of eligible adults can be vaccinated, then the possibility of eradication of targeted types becomes much more favourable. We provide a threshold for eradication in general communities and illustrate the results with numerical simulations. We also investigate the effects of suboptimal efficacy and immunogenicity and show that there is a critical efficacy below which eradication of targeted types is not possible. If eradication is possible, then there is a critical immunogenicity such that even 100% childhood vaccination will not eradicate the targeted types of the virus and must be supplemented with voluntary adult vaccination. However, the level of adult vaccination coverage required is modest and may be achieved simply by removing the cost burden to vaccination. Conclusion: We recommend that provincial healthcare programs should pay for voluntary adult vaccination for women aged 14-26. However, it should be noted that our model results are preliminary, in that we have made a number of simplifying assumptions, including a lack of age-dependency in sexual partner rates, a lack of sexual activity outside of the vaccine age-range among females and a uniform age of sexual debut; thus, further work is desired to enhance the external generalisability of our results.
ACCESSION #
51485615

 

Related Articles

  • Two percent of women have completed HPV vaccine since FDA approval. Sutherland, Andrea // Hem/Onc Today;7/25/2008, Vol. 9 Issue 13, p18 

    The article reports that only two percent of the total number of eligible women in the U.S. have completed the human papillomavirus (HPV) vaccine in 2008. According to a survey conducted before the approval of HPV vaccine in 2006, physicians are likely to vaccinate their patients against HPV....

  • GLOBAL INTIMACIES: INNOVATING THE HPV VACCINE FOR WOMEN'S HEALTH. Carpenter, Laura M.; Casper, Monica J. // Women's Studies Quarterly;Spring/Summer2009, Vol. 37 Issue 1/2, p80 

    The article discusses the development of vaccines for the human papillomavirus (HPV) of the women in the U.S. The emergence of HPV as a globalized biomedical technology was driven by the inequalities and gender role in the health care system in the country. It also led to the creation of the...

  • Cut-price QOF set to be 'mandatory'. Ireland, Tom // GP: General Practitioner;11/14/2008, p1 

    The article reveals that British Primary Care Trusts (PCT) are urging general practitioners (GP) to cut costs by denying human papillomavirus jabs to women outside the vaccination program. It notes that 12 of the 25 PCTs who responded to a Freedom of Information request had sent letters to GPs...

  • School nurses fear £8.9m cervical cancer prevention plan will fail. Duffin, Christian // Nursing Standard;5/14/2008, Vol. 22 Issue 36, p11 

    The article reports on plans of the government to vaccinate all schoolgirls in England against cervical cancer. These plans could fail because of insufficient staff and funds. A nurse recommends girls receive the vaccine at school and states that primary care trusts are responsible for...

  • HPV vaccine delivery strategy depends on country.  // PharmacoEconomics & Outcomes News;8/4/2012, Issue 659, p8 

    The article discusses the results of studies on uptake rates of human papillomavirus (HPV) vaccine in Japan, Tanzania, and Hong Kong, China. The Japanese government has launched an educational campaign to promote clinic-based HPV vaccination in the country. The vaccination rate in Tanzania was...

  • Few women finished HPV vaccine regimen. Harris, Jason // Infectious Diseases in Children;Dec2010, Vol. 23 Issue 12, p35 

    The article reports that only one-third of the women who initiated human papillomavirus vaccine were only able to complete a full course of the vaccine.

  • Less Is More: A Step in the Right Direction for Human Papillomavirus (HPV) Vaccine Implementation. Wheeler, Cosette Marie // JNCI: Journal of the National Cancer Institute;Oct2011, Vol. 103 Issue 19, p1424 

    The author discusses the proper direction for human papillomavirus (HPV) vaccine implementation. According to the author, the cost of HPV vaccination continues to be a significant obstacle to implementation in many countries. The author notes that in the U.S., where HPV vaccine delivery is...

  • Human papillomavirus vaccine. Souter, Jacqui // South African Family Practice;Sep/Oct2013, Vol. 55 Issue 5, p427 

    The article discusses human papillomavirus (HPV) infection and HPV vaccines. There are over 100 identified types of HPV and about 60 types are the cause of common skin warts. HPV infection is also the most common sexually transmitted disease globally. Ways to prevent HPV infection include sexual...

  • Possible Role of Cost-Effectiveness of HPV Vaccination within the Decision Context on Inclusion of HPV in the Country-Specific National Immunization Programs. Rozenbaum, Mark Hermannes; Grahlmann, Carolin; Postma, Maarten Jacobus // Open Pharmacoeconomics & Health Economics Journal;2010, Vol. 2, p1 

    Background: Vaccination against HPV presents a new primary prevention strategy against cervical cancer and is now being introduced in countries all over Europe. Health-economic modelling plays an increasingly important role in the decision making process when introducing new health-care...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics