Impact and Cost-effectiveness of Selective Human Papillomavirus Vaccination of Men Who Have Sex With Men. (23rd December 2016)

• Record Type: Journal Article
• Authors: Lin, Allen; Ong, Koh J.; Hobbelen, Peter; King, Eleanor; Mesher, David; Edmunds, W. John; Sonnenberg, Pam; Gilson, Richard; Bains, Irenjeet; Choi, Yoon H.; Tanton, Clare; Soldan, Kate; Jit, Mark
• Is Part Of: Clinical infectious diseases. Volume 64:Number 5(2017)
• Page Start: 580
• Page End: 588
• Publication Date: 2016-12-23
• Subjects: human papillomavirus -- vaccination -- men who have sex with men.; Communicable diseases -- Periodicals; 616.905
• DOI: 10.1093/cid/ciw845
• Languages: English
• ISSNs: 1058-4838

Abstract

Summary: Offering human papillomavirus (HPV) vaccination to men who have sex with men up to age 40 years via genitourinary clinics will have a large impact on HPV-related diseases and is likely to be cost-effective. Abstract: Background: Men who have sex with men (MSM) have a high lifetime risk of anogenital warts and cancers related to infection with human papillomavirus (HPV). They also benefit less from herd protection than heterosexual males in settings with female-only HPV vaccination. Methods: We evaluated the potential health impact and cost-effectiveness of offering vaccination to MSM who visit genitourinary medicine (GUM) clinics. We used a mathematical model of HPV 6/11/16/18 sexual transmission within an MSM population in England, parameterized with sexual behaviour, GUM attendance, HPV prevalence, HIV prevalence, warts, and cancer incidence data. Interventions considered were offering HPV vaccination to either HIV-positive MSM or MSM regardless of HIV status, for age bands 16–25, 16–30, 16–35, and 16–40 years. Results: Substantial declines in anogenital warts and male HPV-related cancer incidence are projected to occur following an offer of vaccination to MSM. MSM not attending GUM clinics will partially benefit from herd protection. Offering vaccination to HIV-positive MSM up to age 40 is likely to be cost-effective if vaccine procurement and administration costs are below £96.50 a dose. At £48 a dose, offering vaccination to all MSM up to age 40 is likely to be cost-effective. Conclusions: Quadrivalent HPV vaccination of MSM via GUM clinics is likely to be an effective and cost-effective way of reducing the burden of HPV-related disease in MSM.