Impacts of human papillomavirus vaccination for different populations: A modeling study

Iacopo Baussano, Fulvio Lazzarato, Guglielmo Ronco, Silvia Franceschi

Research output: Contribution to journalArticle

Abstract

International variations in the prevalence of HPV infection derive from differences in sexual behaviors, which are also a key factor of the basic reproductive number (R0) of HPV infection in different populations. R0 affects the strength of herd protection and hence the impact of a vaccination program. Similar vaccination programs may therefore generate different levels of impact depending upon the population's pre-vaccination HPV prevalence. We used IARC's transmission model to estimate (i) the overall effectiveness of vaccination versus no vaccination in women aged 15–34 years measured as percent prevalence reduction (%PR) of HPV16 and (ii) the corresponding herd protection in populations with gender-equal or traditional sexual behavior and with different levels of sexual activity, corresponding to pre-vaccination HPV16 prevalence from 1 to 8% as observed worldwide. Between populations with different levels of gender-equal sexual activity, the highest difference in %PR under girls-only vaccination is observed at 40% coverage (91%PR vs. 48%PR for 1% and 8% pre-vaccination prevalence, respectively). HPV16 elimination is obtained with 55 and 97% coverage, respectively. To achieve desirable levels of HPV16 prevalence after vaccination, different levels of coverage are required in populations with different levels of pre-vaccination HPV16 prevalence, for example, in populations with gender-equal sexual behavior a decrease to 1/1000 HPV16 from pre-vaccination prevalence of 1 and 8% would require coverages of 37 and 96%, respectively. In traditional populations, corresponding coverages would need to be 28 and 93%, respectively. In conclusion, pre-vaccination HPV prevalence strongly influences herd immunity and helps predict the overall effectiveness of HPV vaccination.

Original languageEnglish
Pages (from-to)1086-1092
Number of pages7
JournalInternational Journal of Cancer
Volume143
Issue number5
DOIs
Publication statusPublished - Sep 1 2018

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Vaccination
Population
Sexual Behavior
Herd Immunity
Infection

Keywords

  • coverage threshold
  • herd effect
  • HPV prevalence
  • HPV vaccination

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Impacts of human papillomavirus vaccination for different populations : A modeling study. / Baussano, Iacopo; Lazzarato, Fulvio; Ronco, Guglielmo; Franceschi, Silvia.

In: International Journal of Cancer, Vol. 143, No. 5, 01.09.2018, p. 1086-1092.

Research output: Contribution to journalArticle

Baussano, Iacopo ; Lazzarato, Fulvio ; Ronco, Guglielmo ; Franceschi, Silvia. / Impacts of human papillomavirus vaccination for different populations : A modeling study. In: International Journal of Cancer. 2018 ; Vol. 143, No. 5. pp. 1086-1092.
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