title: Age-based programs for vaccination against HPV.
abstract: BACKGROUND
  The risk of infection with human papillomavirus (HPV) increases with age. Answering the question of which age groups are appropriate to target for catch-up vaccination with the newly licensed quadrivalent HPV vaccine (types 6/11/16/18) will be important for developing vaccine policy recommendations.
  
  
  OBJECTIVE
  To assess the value of varying female HPV vaccination strategies by specific age groups of a catch-up program in the United States.
  
  
  METHODS
  The authors used previously published mathematical population dynamic model and cost-utility analysis to evaluate the public health impact and cost-effectiveness of alternative quadrivalent HPV (6/11/16/18) vaccination strategies. The model simulates heterosexual transmission of HPV infection and occurrence of cervical intraepithelial neoplasia (CIN), cervical cancer, and external genital warts in an age-structured population stratified by sex and sexual activity groups. The cost-utility analysis estimates the cost of vaccination, screening, diagnosis, and treatment of HPV diseases, and quality-adjusted survival.
  
  
  RESULTS
  Compared with the current screening practices, vaccinating girls and women ages 12 to 24 years was the most effective strategy, reducing the number of HPV6/11/16/18-related genital warts, CIN grades 2 and 3, and cervical cancer cases among women in the next 25 years by 3,049,285, 1,399,935, and 30,021; respectively. The incremental cost-effectiveness ratio of this strategy when compared with vaccinating girls and women ages 12 to 19 years was $10,986 per quality-adjusted life-year gained. CONCLUSION;: Relative to other commonly accepted health-care programs, vaccinating girls and women ages 12 to 24 years appears cost-effective.
authors.affiliation: Merck Research Laboratories, Merck & Co., Inc., NorthWales, PA, USA. elamin_elbasha@merck.com
authors.forename: Elamin H
authors.initials: EH
authors.lastname: Elbasha
authors.forename: Erik J
authors.initials: EJ
authors.lastname: Dasbach
authors.forename: Ralph P
authors.initials: RP
authors.lastname: Insinga
authors.forename: Richard M
authors.initials: RM
authors.lastname: Haupt
authors.forename: Eliav
authors.initials: E
authors.lastname: Barr
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003218:Condylomata Acuminata / Q000191:economics / Q000517:prevention & control; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D005260:Female; D000068857:Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18; D006801:Humans; D032541:Mass Vaccination / Q000191:economics*; D008875:Middle Aged; D017059:Models, Econometric; D030361:Papillomavirus Infections / Q000191:economics* / Q000517:prevention & control; D053918:Papillomavirus Vaccines / Q000191:economics* / Q000627:therapeutic use; D019057:Quality-Adjusted Life Years; D014481:United States; D002583:Uterine Cervical Neoplasms / Q000191:economics / Q000517:prevention & control; D055815:Young Adult
chemical_list: D000068857:Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18; D053918:Papillomavirus Vaccines