Single-dose HPV vaccination in the United States — a multi-modeling analysis

IF 7 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Americas Pub Date : 2026-03-01 Epub Date: 2026-01-10 DOI:10.1016/j.lana.2025.101361

Emily A. Burger , Jean-François Laprise , Jennifer C. Spencer , Stephen Sy , Mary Caroline Regan , Melanie Drolet , Éléonore Chamberland , Marc Brisson , Jane J. Kim

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引用次数: 0

Abstract

Background

Evidence supporting the non-inferior efficacy of single-dose human papillomavirus (HPV) vaccination has prompted reconsideration of existing multi-dose HPV vaccination schedules. We evaluated the long-term health impact of adopting single-dose HPV vaccination in the United States to inform policy deliberations.

Methods

We applied two validated individual-based simulation models of HPV transmission and cervical cancer to project the impact of switching from a two-dose to a single-dose HPV vaccination schedule in 2025 in the context of historical HPV vaccination uptake in the United States. Four scenarios were simulated: continuation of two-dose vaccination (or equivalent single-dose efficacy of 98%) and three alternative pessimistic single-dose strategies with lower vaccine efficacy (90%) and/or duration of protection (average of 25 years). Outcomes included age-standardized incidence rates of HPV-16 infection and cervical cancer from years 2005–2099. Additional analyses examined effects under lower vaccination coverage observed in select U.S. regions.

Findings

Maintaining two doses or switching to a non-inferior single-dose HPV vaccination schedule was projected to nearly eliminate HPV-16 infections and reduce cervical cancer incidence by over 90% by the end of the century. Scenarios assuming a lower efficacy or waning protection showed increases in cervical cancer incidence of less than 2 percentage points decades after a switch to single-dose vaccination with no impact on the timeframe to cervical cancer elimination.

Interpretation

Switching to a single-dose HPV vaccination schedule is projected to maintain reductions in cervical cancer, even under pessimistic efficacy and durability assumptions. Continued monitoring of single-dose HPV vaccine efficacy over time remains critical.

Funding

PATH on behalf of the Single-Dose HPV Vaccine Evaluation Consortium; Bill and Melinda Gates Foundation (grant No. OPP48979), and the US National Institutes of Health/National Cancer Institute (Grant Number U01 CA253912).

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美国单剂量HPV疫苗接种-多模型分析

背景：支持单剂量人乳头瘤病毒（HPV）疫苗非劣效的证据促使人们重新考虑现有的多剂量HPV疫苗接种计划。我们评估了在美国采用单剂量HPV疫苗的长期健康影响，为政策审议提供信息。方法：我们应用了两个经过验证的基于个体的HPV传播和宫颈癌模拟模型，在美国历史HPV疫苗接种的背景下，预测2025年从双剂量到单剂量HPV疫苗接种计划转换的影响。模拟了四种情况：继续接种两剂疫苗（或等效的单剂效力为98%）和三种悲观的单剂策略，疫苗效力（90%）和/或保护持续时间（平均25年）较低。结果包括2005-2099年HPV-16感染和宫颈癌的年龄标准化发病率。其他分析考察了在美国某些地区观察到的较低疫苗接种覆盖率下的效果。研究结果预计，到本世纪末，维持两剂或改用非次等单剂HPV疫苗接种计划几乎可以消除HPV-16感染，并将宫颈癌发病率降低90%以上。假设效力较低或保护作用减弱的情况显示，在转向单剂量疫苗接种几十年后，宫颈癌发病率增加不到2个百分点，对消除宫颈癌的时间框架没有影响。转换到单剂量HPV疫苗接种计划预计将保持宫颈癌的减少，即使在悲观的疗效和持久性假设下。持续监测单剂HPV疫苗的长期效力仍然至关重要。代表单剂量HPV疫苗评估联盟资助适宜卫生技术研究项目；比尔及梅琳达·盖茨基金会OPP48979)，以及美国国立卫生研究院/国家癌症研究所（资助号U01 CA253912）。

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

Lancet Regional Health-Americas Multiple-

CiteScore

8.00

自引率

0.00%

发文量

期刊介绍： The Lancet Regional Health – Americas, an open-access journal, contributes to The Lancet's global initiative by focusing on health-care quality and access in the Americas. It aims to advance clinical practice and health policy in the region, promoting better health outcomes. The journal publishes high-quality original research advocating change or shedding light on clinical practice and health policy. It welcomes submissions on various regional health topics, including infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, emergency care, health policy, and health equity.