Model-based impact of HPV vaccination on HPV type 16/18 infection prevalence in the US 公开

Qian, Fangming (2017)

Permanent URL: https://etd.library.emory.edu/concern/etds/44558f248?locale=zh
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Abstract

Background: Persistent human papillomavirus (HPV) infection can result in cervical cancer, a leading cause of cancer mortality among females. HPV vaccines provide protection against certain types of human papillomavirus that cause most cervical cancer cases. HPV vaccination was first recommended for female adolescents by the Advisory Committee on Immunization Practices (ACIP) in 2006, but coverage has remained suboptimal.

Methods: We modeled the prevalence of HPV type 16/18 was analyzed for females aged 14 to 34 from 2007 to 2012 using existing data on age-specific vaccine uptake, vaccine efficacy, and baseline infection rates. We computed models for baseline, best and worst scenario sensitivity models based on confidence intervals, and an ideal condition assuming meeting Healthy People 2020 vaccination goals.

Results: Between 2007 and 2012, HPV vaccination at currently levels reduced the prevalence of HPV type 16/18 infection by 39% among 14-19 year-olds (5.8% to 3.6%), 24.8 % for 20-24 year-olds (13.7% to 10.3%), 9.5% reduction for females aged 25 to 29 (7.4% to 6.7%), while infections increased by 2.7% among female who are aged 30 to 34, who had the lowest opportunity for vaccination. Accounting for the uncertainty in the estimates used for our data inputs, these estimates can range from decreases of 36.5% to 40.0% for 14-19 year-olds, 22.3% to 27.2% for those who are 20-24 years old, and 8.0% to 11.1% for females aged 25-29. While vaccination reduced infection prevalence to 3.6% for 14-19 year-old females, if Healthy People 2020 goals were reached, infection prevalence in this age group could have been reduced to 1.7%. While this corresponds to a decrease of over 446,000 infections in this age group compared to the pre-vaccine era, there are still over 242,000 infections occurring that could have been prevented by reaching HP2020 goals.

Conclusion: Although improvements have been made in preventing high-risk HPV infections by vaccination, there is room for improvement since we do not reach optimal vaccination levels every year. This finding indicates we need apply multi-focal interventions to improve HPV vaccination coverage among adolescents and young adults.

Table of Contents

Table of Contents

Introduction.......................................................1

Method..............................................................2

Model structure..............................................2

Input data.....................................................3

Model development ........................................3

Sensitivity analysis..........................................4

Result.................................................................4

Discussion...........................................................5

Reference............................................................9

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