title: An exploration of individual- and population-level impact of the 2-dose HPV vaccination schedule in pre-adolescent girls.
abstract: Since 2014, several countries have implemented a 2-dose schedule for Human papillomavirus (HPV) vaccination. Licensure of the 2-dose schedule was based on non-inferiority results from immunobridging studies, comparing the antibody levels of the 2-dose schedule in young girls to those of the 3-dose schedule in young adults. Since licensure, additional data on antibody levels and other aspects of the immune response and clinical effectiveness have become available. This review will discuss the current outcomes on immunogenicity and effectiveness together with an exploration on the population impact of 2-dose schedules from a cost-effectiveness perspective. The 2-dose schedule has important benefits, such as easier logistics, reduced expenditure, potentially higher acceptance and fewer side effects. Policymakers and registration authorities should consider whether these benefits outweigh the likely differences on individual- and population-level impact between the 2- and 3-dose schedules.
authors.affiliation: a Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM) , Bilthoven , The Netherlands.|b Department of Pathology , VU University Medical Center (VUmc) , Amsterdam , The Netherlands.
authors.forename: Robine
authors.initials: R
authors.lastname: Donken
authors.affiliation: a Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM) , Bilthoven , The Netherlands.
authors.forename: Johannes A
authors.initials: JA
authors.lastname: Bogaards
authors.affiliation: a Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM) , Bilthoven , The Netherlands.
authors.forename: Fiona R M
authors.initials: FR
authors.lastname: van der Klis
authors.affiliation: b Department of Pathology , VU University Medical Center (VUmc) , Amsterdam , The Netherlands.
authors.forename: Chris J L M
authors.initials: CJ
authors.lastname: Meijer
authors.affiliation: a Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM) , Bilthoven , The Netherlands.
authors.forename: Hester E
authors.initials: HE
authors.lastname: de Melker
mesh_terms: D000293:Adolescent; D002648:Child; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007115:Immunization Schedule; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage* / Q000276:immunology*
chemical_list: D053918:Papillomavirus Vaccines
keywords: Human Papillomavirus (HPV) infection; antibodies; cervical Intraepithelial neoplasia (CIN); cost-effectiveness; genital warts; human papillomavirus 16; human papillomavirus 18; immunisation schedule; non-inferiority; transmission; vaccination