Mathematical analyses suggest that public health officials may be able to protect a broader range of the population against HPV infection and related cancers by allocating funds to encourage male HPV vaccination.
“Whether allocating further resources to increase low coverage in adolescent males is more effective than vaccinating females alone remains controversial. Existing studies vary in their conclusions, with most finding that targeting females alone is most cost-effective,” study researcher Marc D. Ryser, PhD, of Duke University, and colleagues wrote.
To investigate the impact coverage-dependent marginal vaccination costs have on optimal resource allocation policies for vaccination against HPV, Ryser and colleagues developed an agent-based modeling framework of HPV transmission among sexually active adolescents aged 14 to 18 years. They then weighed two scenarios: one that assessed optimal resource allocation in countries where HPV vaccine programs do not exist, and another that focused on optimal resource distribution in countries with ongoing programs.
When accounting for unbalanced marginal administration costs in the global scenario, eg, if costs were higher in males vs. females, analysis indicated that as cost difference increased, the optimal strategy focused on female vaccination only. The optimal strategy remained “mixed” when male marginal costs were 25% to 50% greater than the female marginal costs.
In the second scenario, analysis suggested that optimal resource allocation depends on sex-specific disease burden. In the United States, where females have greater vaccine coverage than males, linear cost curves benefited most from spending new resources on females, while convex cost curves benefited most from spending new resources on males.
“HPV vaccination among girls has stagnated at low levels in the United States and parental opposition against the vaccine is increasing,” Ryser told Infectious Diseases in Children. “Therefore, it is quite possible that a further increase in female vaccination would require a steep increase in spending for education and outreach programs to raise awareness about the benefits and safety of vaccination. Accounting for these additional costs, our models predict that we may achieve better results at the same price if we focused more on male vaccination. In other words, boys may represent low-hanging fruit for vaccination programs because the pool of willing parents has not yet been depleted.” – by Amanda Oldt
Disclosure: Ryser reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.