Paper Information

We aimed to quantify the health impact of immediate introduction of a single-dose human papillomavirus (HPV) vaccination program in a high-burden setting as waiting until forthcoming trials are completed to implement single-dose HPV vaccination may result in health losses, particularly for cohorts who would age-out of vaccination eligibility. Two mathematical models fitted to a high-burden setting projected cervical cancer incidence rates associated with (1) immediate implementation of one-dose HPV vaccination versus (2) waiting five years for evidence from randomized trials to determine if one- or two-doses should be implemented. We conducted analyses assuming a single dose was either non-inferior or inferior to two doses. The models projected that immediate implementation of a non-inferior single-dose vaccine led to 7.2-9.6% increase in cancers averted over 2021-2120, compared to waiting five years. Health benefits remained greater with immediate implementation despite an inferior single-dose efficacy (80%), but re-vaccination of one-dose recipients became more important assuming vaccine waning. Under most circumstances, immediate vaccination avoided health losses for those aging out of vaccine eligibility, leading to greater health benefits than waiting for more information in five years.