title: Benefits of catch-up in vaccination against human papillomavirus in medium- and low-income countries.
abstract: Human papillomavirus (HPV) vaccination of a birth cohort of girls in the 9-13 age range is recommended as a priority, but decreases in HPV vaccine cost may make catch-up of a few additional cohorts more attractive not only in high-income countries. We assessed the reduction in HPV16 and 18 infections that could be achieved in a medium- (Poland) and a low-income (Guinea) country by adding one-time catch-up of 12- to 19-year-old girls to the vaccination of 11-year-old girls. According to our ad hoc adapted dynamic model of HPV infection transmission, the addition of catch-up was estimated to bring forward the 50% reduction of HPV16/18 prevalence due to vaccination in women ≤35 by as much as 5 years. Catch-up of 12- to 15-year olds reduced the cumulative probability of HPV16/18 infections by age 35 in the relevant cohorts by about 30% in both countries. Catch-up of 16- to 19-year-old girls added little. Regardless of the chosen catch-up strategy, 16 to 20% of HPV16/18 prevention from vaccination was attributable to herd immunity. Assuming a sufficiently low vaccine cost, the addition of a catch-up round is, therefore, worth considering in medium/low-income countries to extend vaccine benefits to less young adolescent girls whose future access to cervical screening is uncertain.
authors.affiliation: International Agency for Research on Cancer, Lyon, France. baussanoi@iarc.fr
authors.forename: Iacopo
authors.initials: I
authors.lastname: Baussano
authors.forename: Fulvio
authors.initials: F
authors.lastname: Lazzarato
authors.forename: Guglielmo
authors.initials: G
authors.lastname: Ronco
authors.forename: Joakim
authors.initials: J
authors.lastname: Dillner
authors.forename: Silvia
authors.initials: S
authors.lastname: Franceschi
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D003362:Cost-Benefit Analysis; D019049:Developed Countries / Q000191:economics; D003906:Developing Countries / Q000191:economics; D005260:Female; D016701:Guinea / Q000453:epidemiology; D052162:Human papillomavirus 16 / Q000276:immunology; D052161:Human papillomavirus 18 / Q000276:immunology; D006801:Humans; D032541:Mass Vaccination; D030361:Papillomavirus Infections / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control* / Q000635:transmission; D053918:Papillomavirus Vaccines / Q000008:administration & dosage / Q000191:economics / Q000276:immunology; D011044:Poland / Q000453:epidemiology; D015995:Prevalence; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000517:prevention & control*; D014611:Vaccination / Q000191:economics; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines
keywords: HPV vaccination; adolescent girls; catch-up