Effects of Demography, Disability Weights and Cervical Cancer Burden on HPV Vaccination Impact Estimates in 177 Countries: PRIME Modelling Study
48 Pages Posted: 16 Aug 2019More...
Background: The Papillomavirus Rapid Interface for Modelling and Economics (PRIME) has been used around the world to assess the health impact and cost-effectiveness of HPV vaccination in girls. We updated PRIME with new data and methods for demography, disability weights and cervical cancer burden, and generated revised estimates of the health impact of HPV vaccination in 177 countries.
Methods: Population demography in PRIME was updated with the United Nations World Population Prospects (UNWPP) 2017 release, disability weights of the Global Burden of Disease (GBD) 2017 study, and cervical cancer burden from the Global Cancer Incidence, Mortality and Prevalence (GLOBOCAN) 2018 release. We estimated the lifetime health benefits for routine vaccination of 9-year old girls during 2020-2029 at 90% coverage in 177 countries.
Findings: When the health impact of vaccination was compared to the counterfactual scenario of no vaccination, the combined updates of using UNWPP 2017, disability weights of GBD 2017 study and cervical cancer burden estimates of GLOBOCAN 2018 result in 27%, 53% and 76% increase in cases, deaths and DALYs averted per vaccinated girl respectively, in comparison to previous estimates. The demography update is the major driver for the change in the health impact estimates.
Interpretation: The updated PRIME estimates suggest that HPV vaccination will have higher health benefits in comparison to prior forecasts, and thereby being more cost-effective. The WHO African region is expected to gain the highest relative health benefits and should be prioritised for HPV vaccination.
Funding Statement: Gavi, the Vaccine Alliance and Bill & Melinda Gates Foundation (OPP1157270).
Declaration of Interests: All authors declare that there are no conflicts of interest.
Ethics Approval Statement: The authors state: "All data used were from secondary sources in the public domain, and ethics approval was thereby not required."
Keywords: HPV, vaccine impact modelling, cervical cancer elimination strategy, Papillomavirus Rapid Interface for Modelling and Economics (PRIME)
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