ArticleMDM policy & practice
Impact of Implementing Alternative Human Papillomavirus (HPV) Vaccination Strategies in Kenya: A Modeling Study.
Article in MDM policy & practice. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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5 authors.
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Abstract
Background: Implementation delays reduce population-level effects of evidence-based interventions. We conducted a modeling study to estimate the effect of priority policy decisions on a human papillomavirus (HPV) vaccination program in Kenya. Methods: We used a static cohort model to estimate the health effects and costs of introduction and 1-dose switch delays, switching to nonavalent vaccine (9vHPV), supply disruptions, and various scale-up scenarios. Costs were evaluated from the health system perspective. We estimated cervical cancer cases, deaths, disability-adjusted life-years (DALYs), and program and health care costs. Results: Compared with no vaccination, maintaining current program performance would avert approximately 173,000 (95% UI: 149,000-191,000) cases and 2.7 (2.3-3.0) million DALYs across 2019 to 2100. A gradual scale-up of the current 2-dose quadrivalent vaccine (4vHPV) program would avert an additional 16,000 (14-18,000) cases (9%), increasing to 33,000 (28-37,000) cases (19%) if a multiage catchup is implemented in 2030. Accelerated scale-up of 1-dose bivalent vaccine (2vHPV) would avert 184,000 (164-199,000) cases and 3.0 (2.6-3.2) million DALYs, compared with no vaccination; translating to an additional 11,000 (2-17,000) cases averted (6%) compared with maintaining a 2-dose strategy, but at lower program ($81 million vs $76 million) and treatment costs ($2.09 billion vs $2.07 billion). HPV vaccination introduction in 2015 rather than 2019 would have averted an additional 74,000 (43%) cases. Annual vaccine supply disruptions translates to less than 9,000 (200-16,000) cases (5%) and 212,000 (74-305,000) DALYs averted (7%) compared with a 1-dose strategy. A 1-dose 9vHPV strategy would have more health benefits and save additional treatment costs compared with a 1-dose 2vHPV vaccine. Conclusions: Prompt 1-dose switch and rapid scale-up and adoption of a 9vHPV program should be priority policy decisions for Kenya.
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