Estimated health and economic impact of quadrivalent HPV (types 6/11/16/18) vaccination in Brazil using a transmission dynamic model

• Published in: BMC infectious diseases 2012-10, Vol.12 (1), p.250-250, Article 250
• Main Authors: Kawai, Kosuke, de Araujo, Gabriela Tannus Branco, Fonseca, Marcelo, Pillsbury, Matthew, Singhal, Puneet K
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age; Aged; Analysis; Brazil - epidemiology; Cancer vaccines; Cervical cancer; Child; Costs and Cost Analysis; Demographics; Disease; Economic aspects; Female; Human papillomavirus; Humans; Hysterectomy; Literature reviews; Medical care, Cost of; Medical screening; Middle Aged; Models, Statistical; Mortality; Papillomavirus infections; Papillomavirus Infections - complications; Papillomavirus Infections - economics; Papillomavirus Infections - epidemiology; Papillomavirus Infections - prevention & control; Papillomavirus Vaccines - administration & dosage; Papillomavirus Vaccines - economics; Pharmaceutical industry; Population; Prevention; Sexual behavior; Uterine Cervical Neoplasms - economics; Uterine Cervical Neoplasms - epidemiology; Uterine Cervical Neoplasms - prevention & control; Vaccination; Vaccination - economics; Vaccination - methods; Vaccines; Womens health; Young Adult
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/1471-2334-12-250

Cervical cancer is the second most common cancer among women in Brazil. We examined the health and economic impacts of quadrivalent HPV vaccination in Brazil. We adapted a previously developed transmission dynamic model to estimate the effectiveness of HPV vaccination on cervical cancer, cervical intraepithelial neoplasia grades 2 and 3 (CIN2/3), CIN1, and genital warts. We evaluated following vaccination strategies: routine vaccination of 12-year-old girls and routine vaccination in combination with a catch-up vaccination of 12 to 26-year-old women. The model projected that the vaccination would reduce the incidence rates of HPV 6/11/16/18-related cervical cancer, CIN2/3, CIN1, and female genital warts by 94% to 98% at year 100. Routine vaccination in combination with a catch-up vaccination could prevent approximately 163,000 cases of cervical cancer, 48,000 deaths from cervical cancer, 2.3 million cases of CIN2/3, and 11.4 million genital warts in the next 50 years. The incremental cost-effectiveness ratios for female vaccination strategies ranged from R$350 to R$720 (US$219 to US$450) per quality-adjusted life year (QALY) gained. Our study demonstrates that quadrivalent HPV female vaccination can be a cost-effective public health intervention that can substantially reduce the burden of cervical diseases and genital warts in Brazil.