Impact of coverage-dependent marginal costs on optimal HPV vaccination strategies.

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2015-06

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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.

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10.1016/j.epidem.2015.01.003

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Ryser, MD, K McGoff, DP Herzog, DJ Sivakoff and ER Myers (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.

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Scholars@Duke

Ryser

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. Dr. Ryser teaches an immersive research seminar for undergraduate students called “Math & Medicine.”

Website: https://sites.duke.edu/marcdryser/

Myers

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 guidelines development and research prioritization.    In addition, I have ongoing collaborations using the tools of decision analysis with faculty in other clinical areas  Research is conducted through the Division of Reproductive Sciences in the Department of Obstetrics and Gynecology, the Evidence Synthesis Group in the Duke Clinical Research Institute, and the Duke Cancer Institute.  I'm also the course director for CRP 259, "Decision Sciences in Clinical Research", in Duke's Clinical Research Training Program.


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