HPV vaccination among gay, bisexual, and other men who have sex with men aged 27–45 years in the United States is potentially Cost-saving

IF 4.5 3区医学 Q2 IMMUNOLOGY

Vaccine Pub Date : 2025-10-06 DOI:10.1016/j.vaccine.2025.127798

Patrick A. Clay , Lauri E. Markowitz , Sameer V. Gopalani , Arden Baxter , Julia W. Gargano , Carla L. DeSisto , Virginia Senkomago , Donatus U. Ekwueme , Md Hafizul Islam , Harrell W. Chesson

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引用次数: 0

Abstract

Background

The Advisory Committee on Immunization Practices (ACIP) recommends routine human papillomavirus (HPV) vaccination at age 11 or 12 years (vaccination can be given starting at age 9 years), with catch-up vaccination for all persons through age 26 years. ACIP recommends shared clinical decision-making for HPV vaccination of persons aged 27 through 45 years, although modeling indicated that broadly vaccinating persons in this age group would not be cost-effective. To help inform clinical decision-making, the objective of this study was to estimate the cost-effectiveness of HPV vaccination among gay, bisexual, and other men who have sex with men (GBMSM) aged 27 through 45 years in the United States.

Method

We used an age-specific, compartmental, susceptible-infectious-susceptible (SIS) model of HPV transmission and disease among GBMSM to estimate changes in HPV, anogenital wart, and HPV-attributable cancer incidence when the upper age for vaccination among GBMSM was raised to age 30, 35, 40, or 45 years. We then estimated changes in quality adjusted life years (QALYs), costs (vaccination costs and direct medical costs of HPV disease), and the incremental cost-effectiveness ratio under each of these scenarios.

Results

Our estimates showed that HPV vaccination of GBMSM was cost-saving through age 45 years, i.e., the costs of vaccination are more than offset by decreases in the direct medical costs of HPV disease. Vaccination of GBMSM through at least age 40 years was cost-saving across most sensitivity analyses.

Conclusions

Vaccination of GBMSM through age 45 years is likely a cost-saving use of public health resources.

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在美国，男同性恋、双性恋和其他与27-45岁男性发生性关系的男性接种HPV疫苗可能会节省成本。

背景：免疫实践咨询委员会（ACIP）建议在11岁或12岁时常规接种人乳头瘤病毒（HPV）疫苗（可从9岁开始接种），所有人在26岁之前都要接种补种疫苗。ACIP建议27岁至45岁人群接种HPV疫苗的共同临床决策，尽管模型表明在该年龄组广泛接种疫苗并不具有成本效益。为了帮助临床决策，本研究的目的是评估美国27至45岁的男同性恋、双性恋和其他男男性行为者（GBMSM）接种HPV疫苗的成本效益。方法：我们使用年龄特异性、室区、易感-感染-易感（SIS）的GBMSM中HPV传播和疾病模型来估计当GBMSM中接种疫苗的最高年龄提高到30岁、35岁、40岁或45岁时，HPV、肛门生殖器疣和HPV归因于的癌症发病率的变化。然后，我们估计了每种情况下质量调整生命年（QALYs）、成本（疫苗接种成本和HPV疾病的直接医疗成本）以及增量成本-效果比的变化。结果：我们的估计显示，GBMSM的HPV疫苗接种在45岁之前节省了成本，即疫苗接种的成本被HPV疾病直接医疗成本的降低所抵消。在大多数敏感性分析中，至少40岁接种GBMSM是节省成本的。结论：45岁以前接种GBMSM疫苗可能是一种节省公共卫生资源的方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Vaccine 医学-免疫学

CiteScore

8.70

自引率

5.50%

发文量

992

审稿时长

131 days

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