Smith Megan A, Canfell Karen
Lowy Cancer Research Centre, Prince of Wales Clinical School, University of New South Wales, Sydney, NSW 2052, Australia.
BMC Res Notes. 2014 Feb 25;7:109. doi: 10.1186/1756-0500-7-109.
Vaccination against human papillomavirus (HPV), predominantly targeting young females, has been introduced in many countries. Decisions to implement programs, which have involved substantial investment by governments, have in part been based on findings from cost-effectiveness models. Now that vaccination programs have been in place for some years, it is becoming possible to observe their effects, and compare these with model effectiveness predictions made previously.
Australia introduced a publicly-funded HPV vaccination program in 2007. Recently reported Australian data from a repeat cross-sectional survey showed a substantial (77%) fall in HPV16 prevalence in women aged 18-24 years in 2010-2011, compared to pre-vaccination levels. We have previously published model predictions for the population-wide reduction in incident HPV16 infections post-vaccination in Australia. We compared prior predictions from the same model (including the same assumed uptake rates) for the reduction in HPV16 prevalence in women aged 18-24 years by the end of 2010 with the observed data. Based on modelled vaccine uptake which is consistent with recent data on three-dose uptake (78% at 12-13 years; lower uptake in older catch-up age cohorts), we had predicted a 70% reduction in prevalence in 18-24 year old females by the end of 2010. Based on modelled vaccine uptake consistent with recent national data for two-dose coverage and similar to that reported by women in the cross-sectional study, we had predicted a 79% reduction.
A close correspondence was observed between the prior model predictions and the recently reported findings on the rapid drop in HPV prevalence in Australia. Because broadly similar effectiveness predictions have been reported from other models used for cost-effectiveness predictions, this provides reassurance that the substantial public investment in HPV vaccination has been grounded in valid estimates of the effects of vaccination.
许多国家已推行针对人乳头瘤病毒（HPV）的疫苗接种，主要针对年轻女性。实施这些涉及政府大量投入的项目的决策，部分是基于成本效益模型的研究结果。鉴于疫苗接种项目已实施数年，现在有可能观察其效果，并将这些效果与之前模型预测的效果进行比较。
澳大利亚于2007年推出了一项由公共资金支持的HPV疫苗接种项目。最近从澳大利亚一项重复横断面调查中报告的数据显示，与接种疫苗前的水平相比，2010 - 2011年18 - 24岁女性中HPV16的流行率大幅下降（77%）。我们之前曾发表过关于澳大利亚接种疫苗后全人群HPV16感染发病率下降情况的模型预测。我们将同一模型（包括相同的假设接种率）之前对2010年底18 - 24岁女性中HPV16流行率下降情况的预测与观察数据进行了比较。基于与近期三剂次接种数据（12 - 13岁时为78%；大龄补种年龄组接种率较低）一致的模型接种率，我们曾预测到2010年底18 - 24岁女性中流行率将下降70%。基于与近期全国两剂次接种覆盖率数据一致且与横断面研究中女性报告情况相似的模型接种率，我们曾预测下降79%。
观察到之前的模型预测与近期澳大利亚报告的HPV流行率快速下降的研究结果之间存在密切对应关系。由于用于成本效益预测的其他模型也报告了大致相似的效果预测，这让人放心，对HPV疫苗接种的大量公共投资是基于对疫苗接种效果的有效估计。
