HPV vaccination is cost effective but coverage needs improving – researchers

Professor Tony Blakely from the University’s Burden of Disease Epidemiology, Equity and Cost Effectiveness (BODE3) Programme says vaccination coverage in New Zealand is ‘nudging 55 percent’ in school-aged girls for three doses.

‘Because of slightly higher coverage for Māori girls, and higher than anticipated future HPV-related disease rates, the programme makes a contribution to reducing health inequalities.

‘But a more intensive school-only vaccination programme (73 percent coverage as in Australia) would achieve more health gain and still be cost-effective.’

In this Public Health Expert Blog, Professor Blakely discusses the findings of the study and how New Zealand could catch-up to the much higher HPV vaccination coverage levels seen in Australia and the UK. The study, published in Vaccine, can also be accessed from the blog.

The HPV vaccination programme was introduced in 2008 and has been routinely offered through schools in year 8 or through primary care (aged 12 to 20 years) since 2011. Since then, the study says, sentinel surveillance clinics around the country (sexual health, Family Planning and student and youth health clinics) have reported a declining number of first presentations for genital warts, with the steepest reductions occurring in young women aged 15 to 19.

Pharmaceutical data for genital warts treatment also indicates a favourable downward trend.

The researchers modelled the cost-effectiveness of moving from the status quo to a more intensive school-based only programme of vaccinating girls. This shift in coverage achieved more health gain and was still cost-effective.

Professor Blakely says having the option to either have the vaccination at school or to delay a few years and get it from a GP is likely causing a lot of parents to delay. ‘One possible way to achieve higher coverage might therefore be to have only a free school-based programme, as in Australia, with the requirement to pay the full market price in other settings.’
 
He says an additional approach is to enrich the information to school girls and parents about the vaccination.
 
‘Our view is that greater emphasis could be given to explain that it will protect against multiple other HPV-related cancers that affect both men and women, and that it is best given well before the typical age of sexual debut to maximise its benefit.’

Options could also be explored for boosting the cost-effectiveness of the vaccination even further, for example through delivery to girls at the same time the current diphtheria/tetanus/pertussis boost is given to 11-year-olds at school.