TP 46 The Estimated Impact of HPV Vaccination Coverage on Lifetime Cervical Cancer Cases Among Girls Currently Aged 12 Years and Younger in the United States

Tuesday, June 10, 2014
Exhibit Hall
Harrell Chesson, PhD1, Lauri Markowitz, MD2 and Eileen Dunne, MD, MPH1, 1Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, 2Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA

Background: One of the immunization objectives of Healthy People 2020 is to increase 3-dose human papillomavirus (HPV) vaccine coverage to 80% among females by age 13 to 15 years.  Currently, however, 3-dose coverage in this age group is about 30%.  We estimated the potential lifetime benefits of increasing HPV vaccine coverage from 30% to 80% among young females in terms of cervical cancer prevention. 

Methods: We used a published, deterministic, dynamic, population-based HPV model.  We calculated lifetime cervical cancer incidence among 13 birth cohorts of girls (those currently aged 12 years old and younger) in the United States under four HPV vaccine coverage scenarios, in the context of current cervical cancer screening: (1) no HPV vaccination, (2) vaccination at age 12 years with 30% coverage, (3) vaccination at age 12 with 80% coverage, and (4) vaccination at age 12 with 30% coverage in year 1 and 80% in subsequent years.  For simplicity, we did not include vaccination of females at ages other than 12 years and we did not include male vaccination at any age.  We assumed 95%, lifelong vaccine efficacy against HPV 16 and HPV 18, with no “cross-protection” against other high risk HPV types.

Results: Among the 26 million girls currently aged 12 years and younger in the United States, HPV vaccination would avert 45,500 cervical cancer cases (including 14,600 deaths) at 30% coverage and 98,900 cervical cancer cases (including 31,700 deaths) at 80% coverage.  Each year that vaccination coverage remains at 30% instead of the target of 80% results in a missed opportunity to prevent 4,400 lifetime cervical cancer cases and 1,400 cervical cancer deaths.

Conclusions: Our modeling results suggest substantial reductions in the burden of cervical cancer can be achieved over time, particularly if 80% vaccine coverage is achieved.