一剂与两剂人类乳头瘤病毒疫苗接种计划的全球影响和成本效益:比较建模分析
Kiesha Prem1,2, Yoon Hong Choi3, Élodie Bénard4
1Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK. kiesha.prem@lshtm.ac.uk.
BMC medicine
|August 27, 2023
概括
一剂人乳头瘤病毒 (HPV) 疫苗可以预防数以百万计的宫癌病例,简化了分娩并降低了与两剂方案相比的成本. 这种方法为全球HPV疫苗接种计划提供了可比的健康益处.
科学领域:
- 公共卫生 公共卫生
- 疫苗学 疫苗学 疫苗学
- 流行病学 流行病学
背景情况:
- 世界卫生组织建议为青少年女孩进行例行人类乳头瘤病毒 (HPV) 疫苗接种,以消除宫癌.
- 实施挑战,包括财务和后勤障碍,阻碍了两剂HPV疫苗接种计划的广泛采用.
- 许多国家在现有的婴儿免疫计划之外,在提供第二剂疫苗时遇到困难.
研究的目的:
- 评估一剂与两剂HPV疫苗接种策略的长期健康益处和成本效益.
- 在单剂量保护持续时间和疗效的不同情景下比较结果.
- 通过评估简化剂量的影响,为全球HPV疫苗接种政策提供信息.
主要方法:
- 利用三个独立的人类乳头瘤病毒 (HPV) 传播模型来模拟188个国家的疫苗接种结果.
- 从2021-2120年开始,以80%的覆盖率对10岁女孩用9价值HPV疫苗进行模拟例行疫苗接种.
- 包括一个为期一年的10-14岁的追赶活动,覆盖率为80%,分析了一剂剂量提供20-30年或终身保护的场景 (80%的疗效).
主要成果:
- 预计到2120年,一剂接种疫苗可以预防115.2至147.8万例子宫癌,这取决于保护的持续时间和有效性.
- 一次剂量 (80%有效率) 的终身保护可以预防大约1.478亿例病例.
- 第二剂的成本效益门很低,特别是在低收入国家,如果保护在20年后减弱.
结论:
- 一次剂量HPV疫苗接种证明了与两剂量计划相比的健康益处,同时简化了分娩,降低了成本,并缓解了供应限制.
- 单剂量策略在预防全球数百万宫癌病例方面是有效的.
- 第二剂的必要性和成本效益取决于免疫力下降,疫苗成本,输送策略和疾病负担.
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