Protecting the next generation: what is the role of the duration of human papillomavirus vaccine-related immunity?
BACKGROUND
There is strong evidence that human papillomavirus (HPV) is necessary for the development of cervical cancer. A prophylactic HPV vaccine with high reported efficacy was approved in North America in 2006.


METHODS
A mathematical model of HPV transmission dynamics was used to simulate different scenarios of natural disease outcomes and intervention strategies. A sensitivity analysis was performed to compensate for uncertainties surrounding key epidemiological parameters.


RESULTS
The expected impact that HPV vaccines have on cervical cancer incidence and HPV prevalence in the province of British Columbia in Canada revealed that, for lifelong vaccine-related protection, an immunization routine targeting younger females (grade 6), combined with a 3-year program for adolescent females (grade 9), is the most effective strategy. If vaccine-related protection continues for <10 years, then the targeting of adolescent females would be more beneficial than the targeting of younger females. The incremental benefit if boys, as well as girls, are vaccinated is small.


CONCLUSIONS
Optimization of the design of immunization strategies for treatment of HPV depends substantially on the duration of vaccine-induced immunity. Given the uncertainty in estimating this duration, it may be prudent to assume a value close to the lower limit reported and adjust the program when more-accurate information for the length of vaccine-induced immunity becomes available.
Günther
Oliver P
OP
University of British Columbia Centre for Disease Control, Vancouver, British Columbia.
Ogilvie
Gina
G
Naus
Monika
M
Young
Eric
E
Patrick
David M
DM
Dobson
Simon
S
Duval
Bernard
B
Noël
Pierre-André
PA
Marra
Fawziah
F
Miller
Dianne
D
Brunham
Robert C
RC
Pourbohloul
Babak
B
D000293:Adolescent; D017677:Age Distribution; D052685:Alphapapillomavirus / Q000276:immunology*; D002648:Child; D003198:Computer Simulation; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008954:Models, Biological; D030361:Papillomavirus Infections / Q000276:immunology / Q000517:prevention & control* / Q000635:transmission / Q000821:virology; D053918:Papillomavirus Vaccines / Q000008:administration & dosage / Q000276:immunology*; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control / Q000821:virology
D053918:Papillomavirus Vaccines