Is HPV Vaccination Worth the Cost?

| November 16, 2011 | 0 Comments

The development of vaccination was a significant step forward in the prevention of infectious diseases. However, implementing vaccination in the developing world has proven to be a challenge, largely due to financial costs and administrative burdens. Thus the introduction of several new vaccines is now being accompanied by a critical assessment of the practical barriers to distributing these vaccines.

Image Courtesy of Wikimedia Commons

A few years ago, the Human Papilloma Virus (HPV) vaccine was introduced into the American health care system.  In response to a decline in the number of girls receiving the HPV vaccine, the Centers for Disease Control (CDC) have recommended that boys be vaccinated to reduce transmission of the virus.[1] The recent recommendation has come in light of a debate on the cost-effectiveness of the HPV vaccine, which prevents 30% of infections from transmission. Although this strategy is a solution to decreased transmission, it is essential to investigate  the  underlying factors contributing to  the decrease in administered vaccinations.

Erroneous reports about the side-effects of the vaccine, even mentions of death, distributed by the media contribute to the reluctance towards HPV vaccination. Contrary to these reports, research on the HPV vaccine has proven that no serious side-effects could be attributed to the vaccine.  Because HPV is linked to several cases of cancers, including cervical cancer, vaccination can mean an increase in quality of life for an individual as well as benefits that are evident at the population level in reduction of potential transmission.

Then, perhaps the most well-known factor contributing to reduced HPV vaccination rates is the financial burden of vaccination. Administered in three doses, the vaccine costs approximately $365.[1] For underprivileged populations, the high cost of the vaccine may be an obstacle to access and may deter doctors from stocking the vaccine.  Still, people who find the vaccine unaffordable may be eligible for government funding in more developed nations, increasing availability and accessibility of the vaccine.

In addition to the administration of the vaccine at age 11 or 12 to prevent future risk of sexual transmission, screening is also recommended usually starting at age 21.[2] The existing screenings, according to the CDC, can also prevent cervical cancer or detect it early on. Yet, this could deter parents from choosing to vaccinate children who they do not believe will be at risk until their early twenties.  Another concern that may exist is that screenings must continue even after vaccination.  Still, according to a study analysis, vaccination is more cost-effective compared to current practices of screening.[2]

Overall, does the benefit of foregoing costs related to HPV treatment outweigh the cumulative costs of vaccination and screening?  For countries where HPV is prevalent, this would certainly be case. If many people were infected, the costs of treatment would be significantly greater than the overall cost of regular screenings in conjunction with vaccination. However, for some countries with low cervical cancer mortality and HPV-related diseases, the financial burden of vaccination may be problematic and not cost-effective – the Netherlands serves as a primary example.[3] In 2005, the Netherlands had a low mortality rate of 1.6 per 100,000 women per year through the current practice of prevention.  According to research led by Inge M. C. M. de Kok at Erasmus MC, under both favorable and less favorable conditions in efficacy, compliance, and doses, the quality adjusted life year was not significant in comparison to the price of the vaccine.[4]

Although vaccinations are favorable in the prevention of potential diseases, vaccine availability and accessibility is a challenge for many countries, particularly developing countries. What must be taken into account is not only the effectiveness of the vaccine but whether this effectiveness outweighs the costs of administering the vaccine.

 


[1] Bixler, Jennifer. “CDC committee recommends boys receive HPV vaccine.” CNN. 201.

[2] Sanders, Gillian D., Al V. Taira. “Cost Effectiveness of a Potential Vaccine for Human papillomavirus.” Emerging Infectious Diseases. 9 (2003): 38-48.

[3] Nelson, Roxanne. “HPV Vaccination Is Not Cost-Effective in the Netherlands.” Medscape Today. 2009.

[4] de Kok, Inge  M. C. M., Marjolein van Ballegooijen, and J. Dik F. Habbema. “Cost-Effectiveness Analysis of Human Papillomavirus Vaccination in the Netherlands.” Journal of the National Cancer Institute. 101 (2009): 1083-1092.

Tags: , , ,

Category: Infectious, Online

About the Author ()

Leave a Reply