To assess public health impact of the introduction of nine-valent human papillomavirus (HPV) vaccine program for females in Hungary.
A previously published HPV dynamic transmission model was adapted and calibrated to the Hungarian setting. The model simulated the natural history of cervical cancer, anogenital caners, and genital warts in Hungary. It was assumed that the vaccination program would be combined with current cervical cancer screening in Hungary. The model assumed that 85% of females aged 13-14 years would receive two doses of the nanovalent HPV vaccine. The relative effectiveness of two dose of the nine-valent HPV vaccine was assumed to be the same as three doses and the duration of protection of the nine-valent HPV vaccine to be life-long. Impact of other HPV types except the nine HPV types in the nine-valent HPV vaccine was not considered. The nine-valent female HPV vaccination program (combined with cervical cancer screening) was compared with no HPV immunization (cervical cancer screening only). The time horizon for the model was 100 years. Costs were discounted at 3.7%.
For the comparison with no HPV immunization, over a 100 years, the introduction of the nine-valent vaccination program in females showed cumulative percent reduction in the incidence of 6/11/16/18/31/33/45/52/58 HPV related cervical cancer by 52%, CIN1 by 69%, and CIN2/3 by 66%, anal cancer in females and males by 41% and 34% respectively, cervical cancer related deaths by 49%, anal cancer related death by 40% in females and 32% in males, HPV 6/11 related genital warts in females and males by 78% and 71% respectively. By the end of the 100 year timeframe of the model, the nine-valent HPV vaccine reduced the monitored incidence rates and related death cases for cervical and anal cancers to near zero. Over a 100 years, the nine-valent HPV vaccine would reduce cumulative cost of 6/11/16/18/31/33/45/52/58 HPV related cervical cancer by 18%, CIN1 by 34%, CIN2/3 by 31%, anal cancer in females and males by 12% and 10% respectively, and HPV 6/11 related genital warts in females and males by 51% and 44% respectively.
The introduction of the nine-valent HPV vaccination program for females in Hungary will significantly reduce cervical and anal cancer cases and associated costs. The burden and costs related to various 6/11/16/18/31/33/45/52/58 HPV-related conditions could be substantially reduced by the introduction of a nine-valent HPV vaccination program for females in Hungary.