2021
DOI: 10.1016/s1473-3099(20)30860-4
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Optimal human papillomavirus vaccination strategies to prevent cervical cancer in low-income and middle-income countries in the context of limited resources: a mathematical modelling analysis

Abstract: Background Introduction of human papillomavirus (HPV) vaccination has been slow in low-income and middleincome countries (LMICs) because of resource constraints and worldwide shortage of vaccine supplies. To help inform WHO recommendations, we modelled various HPV vaccination strategies to examine the optimal use of limited vaccine supplies and best allocation of scarce resources in LMICs in the context of the WHO global call to eliminate cervical cancer as a public health problem.Methods In this mathematical … Show more

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Cited by 52 publications
(53 citation statements)
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References 19 publications
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“…to maximize health benefits of a limited supply of HPV vaccine doses. 8 Furthermore, assuming an inferior but lifelong single-dose HPV vaccine, a revaccination MAC campaign approach averted nearly as many cancer cases as revaccinating 100% of previously vaccinated women, which is likely due to the health benefits associated with providing a second opportunity for unvaccinated women to receive their first HPV vaccine dose (effectively increasing vaccine coverage).…”
Section: Discussionmentioning
confidence: 99%
“…to maximize health benefits of a limited supply of HPV vaccine doses. 8 Furthermore, assuming an inferior but lifelong single-dose HPV vaccine, a revaccination MAC campaign approach averted nearly as many cancer cases as revaccinating 100% of previously vaccinated women, which is likely due to the health benefits associated with providing a second opportunity for unvaccinated women to receive their first HPV vaccine dose (effectively increasing vaccine coverage).…”
Section: Discussionmentioning
confidence: 99%
“…Fig 1 provides an overview of the data sources and key steps of the modelling framework described in the following sections. We synthesised the long-term population-wide impact of HPV vaccination on cervical cancer incidence by age and time predicted by three published transmission dynamic models: (i) the Public Health England (PHE) model, a compartmental dynamic model set in the UK (32); (ii) the HPV-ADVISE model, an individual-based dynamic model set in Uganda, Nigeria, India, Vietnam (27,33), and Canada (34,35); and (iii) the Harvard model, a hybrid model that links two individual-based models, set in the US, Uganda, El Salvador, and Nicaragua (14,36). In total, we combined results from 10 model-country scenarios.…”
Section: Methodsmentioning
confidence: 99%
“…Such effects can be examined using HPV transmission dynamic models. To date, model-based analyses set in the United Kingdom (UK) (25), the United States (US), and Uganda (26,27) suggest that one-dose schedules would be cost-effective and would prevent almost as many cancers as two-dose or three-dose schedules if one dose confers at least 20 years of protection or has at least 80% efficacy against HPV 16/18 infection.…”
Section: Introductionmentioning
confidence: 99%
“…As a low-middle income county, Iran falls in the category of countries with less than 30% coverage of HPV vaccination. Therefore, it is necessary to focus on screening programs and de ning the most valuable and effective methods based on local situations [12].…”
Section: Introductionmentioning
confidence: 99%