A modeling study projected that HPV vaccination programs for adults aged 27 to 45 years could benefit subgroups at higher risk for HPV, but overall, the approach is more costly and less effective than vaccinating younger people.
According to authors, this is the first study to examine the cost-effectiveness and HPV-related cancer prevention of vaccinating subgroups of adults in this age group at higher risk of HPV infection in the US. The findings are published in Annals of Internal Medicine.
In June 2019, the US Advisory Committee on Immunization Practices (ACIP) recommended shared clinical decision-making regarding potential HPV vaccination of adults aged 27 to 45 years. Researchers from Laval University, Quebec City, Quebec used a computer model to evaluate the cost effectiveness and number of people needed to vaccinate (NNV) to prevent one HPV-related cancer if the existing routine and catch-up 9-valent HPV vaccination program of people aged 9-26 years was expanded to include adults aged 27 to 45 years. The subgroups in this age group that the model explored were adults with higher sexual activity and those who recently separated from a long-term intimate partner. Under all scenarios investigated, HPV vaccination of adults aged 27-25 years was much less cost-effective than vaccinating individuals aged 26 years or younger. Additionally, the NNV was notably higher for mid-adults than for those aged 26 or younger. However, the study also projected that vaccinating infrequently screened mid-adult women with higher sexual activity and who have recently separated produced the lowest incremental cost-effectiveness ratio and lowest number needed to vaccinate to prevent 1 infection compared to other subgroups. These results suggest that the cost-effectiveness of extending HPV vaccination to older persons improve if limited to persons at higher risk for infection. HPV vaccination of those aged 26 or younger remains significantly more cost-effective and effective than vaccinating older persons.
