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The clinical and economic benefits of school‐based quadrivalent HPV vaccination in Singapore
Author(s) -
Tay Sun Kuie,
Hsu TunYing,
Shcheprov Andrei,
Walia Anuj,
Kulkarni Amit S.
Publication year - 2017
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12126
Subject(s) - medicine , genital warts , vaccination , cervical cancer , cervical intraepithelial neoplasia , incidence (geometry) , regimen , gynecology , demography , pediatrics , cancer , immunology , physics , sociology , optics
Objective To investigate the clinical and economic impacts of school‐based administration of the quadrivalent HPV vaccine. Methods A retrospective health‐economic analysis was conducted using data collected in Singapore between 2004 and 2005. A dynamic transmission model was adapted for universal vaccination that provided 80% coverage among students aged 11–12 years. Strategy 1 involved only girls, with a 5‐year catch‐up vaccination to provide 50% coverage among those aged 13–17 years. Strategy 2 included both girls and boys with no catch‐up vaccination. Outcomes included the predicted incidence of HPV ‐related disease over 100 years. Results Current coverage was assumed to be 5%. Strategy 1 would reduce cervical intraepithelial neoplasia grade 1 ( CIN 1) by 63.8%, cervical intraepithelial neoplasia grade 2–3 ( CIN 2–3) by 62.9%, cervical cancer by 50.9%, and genital warts by 78.0% (female individuals) and 73.6% (male individuals). Strategy 2 would reduce CIN 1 by 64.0%, CIN 2–3 by 63.1%, cervical cancer by 50.7%, and genital warts by 79.9% (female individuals) and 80.1% (male individuals). The incremental cost‐effectiveness ratio was S$12 464 for strategy 1 and $27 837 for Strategy 2. These values decreased to $7477 and $22 574, respectively, if a two‐dose regimen was adapted. Conclusion School‐based quadrivalent HPV vaccination offered clinical and economic benefits, and is cost‐effective in Singapore.