Vaccination against human papillomavirus in Switzerland: simulation of the impact on infection rates.
OBJECTIVE
Human papillomavirus (HPV) is a sexually transmitted infection of particular interest because of its high prevalence rate and strong causal association with cervical cancer. Two prophylactic vaccines have been developed and different countries have made or will soon make recommendations for the vaccination of girls. Even if there is a consensus to recommend a vaccination before the beginning of sexual activity, there are, however, large discrepancies between countries concerning the perceived usefulness of a catch-up procedure and of boosters. The main objective of this article is to simulate the impact on different vaccination policies upon the mid- and long-term HPV 16/18 age-specific infection rates.


METHODS
We developed an epidemiological model based on the susceptible-infective-recovered approach using Swiss data. The mid- and long-term impact of different vaccination scenarios was then compared.


RESULTS
The generalization of a catch-up procedure is always beneficial, whatever its extent. Moreover, pending on the length of the protection offered by the vaccine, boosters will also be very useful.


CONCLUSIONS
To be really effective, a vaccination campaign against HPV infection should at least include a catch-up to early reach a drop in HPV 16/18 prevalence, and maybe boosters. Otherwise, the protection insured for women in their 20s could be lower than expected, resulting in higher risks to later develop cervical cancer.
Groupe de Recherche sur la Santé des Adolescents (GRSA), University Hospital Center and University of Lausanne, Lausanne, Switzerland. andre.berchtold@unil.ch
André
A
Berchtold
Pierre-André
PA
Michaud
Denise
D
Nardelli-Haefliger
Joan-Carles
JC
Surís
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D052162:Human papillomavirus 16 / Q000276:immunology; D052161:Human papillomavirus 18 / Q000276:immunology; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data; D008875:Middle Aged; D008962:Models, Theoretical; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000517:prevention & control; D053918:Papillomavirus Vaccines / Q000627:therapeutic use*; D013557:Switzerland / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control; D055815:Young Adult
D053918:Papillomavirus Vaccines