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The value of including boys in an HPV vaccination programme: a cost-effectiveness analysis in a low-resource setting
J J Kim1, B Andres-Beck, S J Goldie
1Department of Health Policy and Management, Harvard School of Public Health, Program in Health Decision Science, 718 Huntington Avenue, 2nd Floor, Boston, MA 02115, USA. jkim@hsph.harvard.edu
Abstract:
We assessed the cost-effectiveness of including boys vs girls alone in a pre-adolescent vaccination programme against human papillomavirus (HPV) types 16 and 18 in Brazil. Using demographic, epidemiological, and cancer data from Brazil, we developed a dynamic transmission model of HPV infection between males and females. Model-projected reductions in HPV incidence under different vaccination scenarios were applied to a stochastic model of cervical carcinogenesis to project lifetime costs and benefits. We assumed vaccination prevented HPV-16 and -18 infections in individuals not previously infected, and protection was lifelong. Coverage was varied from 0-90% in both genders, and cost per-vaccinated individual was varied from IUSD 25 to 400. At 90% coverage, vaccinating girls alone reduced cancer risk by 63%; including boys at this coverage level provided only 4% further cancer reduction. At a cost per-vaccinated individual of USD 50, vaccinating girls alone was
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