Ryser Marc D, McGoff Kevin, Herzog David P, Sivakoff David J, Myers Evan R
Department of Mathematics, Duke University, Durham, NC 27708, USA.
Department of Mathematics, Duke University, Durham, NC 27708, USA.
Epidemics. 2015 Jun;11:32-47. doi: 10.1016/j.epidem.2015.01.003. Epub 2015 Feb 7.
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.
男性接种人乳头瘤病毒（HPV）疫苗的有效性仍是一个有争议的话题。许多现有研究得出结论，提高女性疫苗接种覆盖率比将资源转向男性接种更有效。最近，发表了几项关于HPV免疫接种的实证研究，提供了边际疫苗接种成本随覆盖率增加的证据。在本研究中，我们使用基于主体的随机建模框架，根据这些新发现重新审视男性疫苗接种的争论。在此框架内，我们评估疫苗分发中与覆盖率相关的边际成本对针对HPV的最佳免疫策略的影响。聚焦于正在进行的疫苗接种计划和新的疫苗接种计划这两种情况，我们分析不同的资源分配政策及其对总体疾病负担的影响。我们的结果表明，如果与男性接种相关的成本与女性接种相关的成本相对接近，那么与覆盖率相关的、不断增加的边际成本可能有利于涉及男女两性免疫接种的疫苗接种策略。特别是，本研究强调有必要对与覆盖率相关的疫苗接种成本的性质进行进一步实证研究。
