Strategies for the introduction of human papillomavirus vaccination: modelling the optimum age- and sex-specific pattern of vaccination in Finland

• Published in: British journal of cancer Vol. 96; no. 3; pp. 514 - 518
• Main Authors: FRENCH, K. M, BARNABAS, R. V, LEHTINEN, M, KONTULA, O, PUKKALA, E, DILLNER, J, GARNETT, G. P
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing Group 12.02.2007
• Subjects: Adaptive immunity; Adolescence; Adolescent; Adolescents; Adult; Age; Age Factors; Biological and medical sciences; Cancer; Cancer and Oncology; Cancer och onkologi; Cancer research; Cervical cancer; Child; Clinical Medicine; Cost-Benefit Analysis; Epidemiology; Female; Females; Finland; HPV; Human papillomavirus; Humans; Infection; Infections; Klinisk medicin; Lesions; Male; Mathematical models; Medical and Health Sciences; Medical research; Medical sciences; Medical screening; Medicin och hälsovetenskap; modelling; Papillomavirus Vaccines - economics; Papillomavirus Vaccines - immunology; Risk groups; Sex Factors; sexual behavior; Sexual intercourse; Teenagers; Tumors; Uterine Cervical Neoplasms - prevention & control; Vaccination; Vaccines; Womens health; young adults; Europe; Finland; United States > US; Vaccination; Sex; Papovaviridae; modelling; HPV; Infection; Papillomavirus; Virus; Prevention; Human papillomavirus; Cancerology; Viral disease; Age
• ISSN: 0007-0920; 1532-1827; 1532-1827
• DOI: 10.1038/sj.bjc.6603575

Phase III trials have demonstrated the efficacy of human papillomavirus (HPV) vaccines in preventing transient and persistent high-risk (hr) HPV infection and precancerous lesions. A mathematical model of HPV type 16 infection and progression to cervical cancer, parameterised to represent the infection in Finland, was used to explore the optimal age at vaccination and pattern of vaccine introduction. In the long term, the annual proportion of cervical cancer cases prevented is much higher when early adolescents are targeted. Vaccinating against hr HPV generates greater long-term benefits if vaccine is delivered before the age at first sexual intercourse. However, vaccinating 12 year olds delays the predicted decrease in cervical cancer, compared to vaccinating older adolescents or young adults. Vaccinating males as well as females has more impact on the proportion of cases prevented when vaccinating at younger ages. Implementing catch-up vaccination at the start of a vaccination programme would increase the speed with which a decrease in HPV and cervical cancer incidence is observed.