Impact of coverage-dependent marginal costs on optimal HPV vaccination strategies.
Abstract
The effectiveness of vaccinating males against the human papillomavirus (HPV) remains
a controversial subject. Many existing studies conclude that increasing female coverage
is more effective than diverting resources into male vaccination. Recently, several
empirical studies on HPV immunization have been published, providing evidence of the
fact that marginal vaccination costs increase with coverage. In this study, we use
a stochastic agent-based modeling framework to revisit the male vaccination debate
in light of these new findings. Within this framework, we assess the impact of coverage-dependent
marginal costs of vaccine distribution on optimal immunization strategies against
HPV. Focusing on the two scenarios of ongoing and new vaccination programs, we analyze
different resource allocation policies and their effects on overall disease burden.
Our results suggest that if the costs associated with vaccinating males are relatively
close to those associated with vaccinating females, then coverage-dependent, increasing
marginal costs may favor vaccination strategies that entail immunization of both genders.
In particular, this study emphasizes the necessity for further empirical research
on the nature of coverage-dependent vaccination costs.
Type
Journal articleSubject
Human papillomavirus vaccinationMale HPV vaccination
Marginal distribution costs
Optimal vaccine distribution
Stochastic agent-based models
Adolescent
Cohort Studies
Cost-Benefit Analysis
Female
Health Care Rationing
Human papillomavirus 16
Humans
Immunization Programs
Male
Papillomavirus Infections
Papillomavirus Vaccines
Permalink
https://hdl.handle.net/10161/9500Published Version (Please cite this version)
10.1016/j.epidem.2015.01.003Publication Info
Ryser, MD; McGoff, K; Herzog, DP; Sivakoff, DJ; & Myers, ER (2015). Impact of coverage-dependent marginal costs on optimal HPV vaccination strategies.
Epidemics, 11. pp. 32-47. 10.1016/j.epidem.2015.01.003. Retrieved from https://hdl.handle.net/10161/9500.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Evan Robert Myers
Walter L. Thomas Distinguished Professor of Obstetrics and Gynecology in the School
of Medicine
My research interests are broadly in the application of quantitative methods, especially
mathematical modeling and decision analysis, to problems in women's health. Recent
and current activities include integration of simulation modeling and systematic reviews
to inform decisions surrounding cervical, ovarian, and breast cancer prevention and
control, screening for postpartum depression, and management of uterine fibroids.
We are also engaged in exploring methods for integrating gui
Marc Daniel Ryser
Assistant Professor in Population Health Sciences
Marc D. Ryser conducts research in cancer early detection, with a particular focus
on breast cancer overdiagnosis and overtreatment. Using a multi-scale approach, his
group generates and analyzes biologic, clinical and population data using a variety
of mathematical, statistical and computational tools. Examples of ongoing projects
include the evolutionary dynamics of early-stage breast cancer; decision support tools
for early-stage breast cancer patients; and estimation of breast can
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