Targeted human papillomavirus vaccination for young men who have sex with men in Australia yields significant population benefits and is cost-effective. Issue 37 (5th September 2017)

• Record Type: Journal Article
• Authors: Zhang, Lei; Regan, David G.; Ong, Jason J.; Gambhir, Manoj; Chow, Eric P.F.; Zou, Huachun; Law, Matthew; Hocking, Jane; Fairley, Christopher K.
• Is Part Of: Vaccine. Volume 35:Issue 37(2017)
• Page Start: 4923
• Page End: 4929
• Publication Date: 2017-09-05
• Subjects: Human papillomavirus -- Vaccination -- Men who have sex with men -- Mathematical modelling -- Cost-effectiveness analysis; Vaccines -- Periodicals; 615.372
• DOI: 10.1016/j.vaccine.2017.07.078
• Languages: English
• ISSNs: 0264-410X

Abstract

Abstract: Background: We investigated the effectiveness and cost-effectiveness of a targeted human papillomavirus (HPV) vaccination program for young (15–26) men who have sex with men (MSM). Methods: We developed a compartmental model to project HPV epidemic trajectories in MSM for three vaccination scenarios: a boys program, a targeted program for young MSM only and the combination of the two over 2017–2036. We assessed the gain in quality-adjusted-life-years (QALY) in 190, 000 Australian MSM. Results: A targeted program for young MSM only that achieved 20% coverage per year, without a boys program, will prevent 49, 283 (31, 253–71, 500) cases of anogenital warts, 191 (88–319) person-years living with anal cancer through 2017–2036 but will only stablise anal cancer incidence. In contrast, a boys program will prevent 82, 056 (52, 100–117, 164) cases of anogenital warts, 447 (204–725) person-years living with anal cancers through 2017–2036 and see major declines in anal cancer. This can reduce 90% low- and high-risk HPV in young MSM by 2024 and 2032, respectively, but will require vaccinating ≥84% of boys. Adding a targeted program for young MSM to an existing boys program would prevent an additional 14, 912 (8479–21, 803) anogenital wart and 91 (42–152) person-years living with anal cancer. In combination with a boys' program, a catch-up program for young MSM will cost an additional $AUD 6788 ($4628–11, 989) per QALY gained, but delaying its implementation reduced its cost-effectiveness. Conclusions: A boys program that achieved coverage of about 84% will result in a 90% reduction in HPV. A targeted program for young MSM is cost-effective if timely implemented.