CMAJ • August 28, 2007; 177 (5). First published August 20, 2007; doi:10.1503/cmaj.061709
© 2007 Canadian Medical Association or its licensors
All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association.
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Résumé
Right arrow Online Appendices
Right arrow All Versions of this Article:
cmaj.061709v1
177/5/464    most recent
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Brisson, M.
Right arrow Articles by Boily, M.-C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Brisson, M., PhD
Right arrow Articles by Boily, M.-C., PhD
Related Collections
Right arrow Drugs: immunological products and vaccines
Right arrow Sexually transmitted infections
Right arrow Vaccination
Right arrow Français
Right arrowRelated Articles

Research

Estimating the number needed to vaccinate to prevent diseases and death related to human papillomavirus infection

Marc Brisson, PhD, Nicolas Van de Velde, MSc, Philippe De Wals, MD PhD and Marie-Claude Boily, PhD

From the Département de médecine sociale et préventive (all authors), Université Laval; Unité de recherche en santé des populations (Brisson, Van de Velde), Centre hospitalier affilié universitaire de Québec, Québec, Que.; Unité de recherche en santé publique et santé environnementale (Van de Velde, De Wals), Centre hospitalier universitaire de Québec, Québec, Que.; and the Department of Infectious Disease Epidemiology (Boily), Imperial College, London, UK

Correspondence to: Dr. Marc Brisson, Unité de recherche en santé des populations, Centre hospitalier affilié universitaire de Québec, Hôpital Saint-Sacrement, 1050, chemin Sainte-Foy, Québec QC G1S 4L8; marc.brisson{at}uresp.ulaval.ca

Background: A vaccine against human papillomavirus (HPV) types 6, 11, 16 and 18 is now licensed for use in Canada and many other countries. We sought to estimate the number needed to vaccinate to prevent HPV-related diseases and death.

Methods: A cohort model of the natural history of HPV infection was developed. Model simulations were based on 209 different parameter sets that reproduced Canadian HPV type-specific data for infection, cervical intraepithelial neoplasia, cervical cancer and genital warts. The number needed to vaccinate was calculated as the number of women who would need to be vaccinated to prevent an HPV-related event during their lifetime.

Results: Among 12-year-old girls, we estimated that the number needed to vaccinate to prevent an episode of genital warts would be 8 (80% credibility interval [CrI] 5–15) and a case of cervical cancer 324 (80% CrI 195–757). These estimates were based on the assumption that the vaccine procures lifelong protection and that its efficacy is 95%. If vaccine protection is assumed to wane at 3% per year, the predicted number needed to vaccinate would increase to 14 (80% CrI 6–18) and 9080 (80% CrI 1040–does not prevent), respectively. The latter number would be greatly reduced with the addition of a booster dose, to 480 (80% CrI 254–1572).

Interpretation: Our model predictions suggest that vaccination with the currently available HPV vaccine may significantly reduce the incidence of genital warts, cervical intraepithelial neoplasia and cervical cancer. However, the benefits (particularly in terms of cervical cancer reduction) are highly dependent on the duration of vaccine protection, on which evidence is currently limited.


Related Articles

Highlights of this issue
Can. Med. Assoc. J. 2007 177: 437. [Full Text] [PDF]

Dans ce numéro
Can. Med. Assoc. J. 2007 177: 437. [Full Text] [PDF]

Human papillomavirus vaccines launch a new era in cervical cancer prevention
Meenakshi Dawar, MD MHSc, Shelley Deeks, MD MHSc, and Simon Dobson, MD
Can. Med. Assoc. J. 2007 177: 456-461. [Full Text] [PDF]

Patient information about HPV and the HPV vaccine
Tavé van Zyl, Eric Wooltorton, MD MSc, and Noni MacDonald, MD MSc
Can. Med. Assoc. J. 2007 177: 462. [Full Text] [PDF]

Feasibility of self-collection of specimens for human papillomavirus testing in hard-to-reach women
Gina Ogilvie, MD MSc, Mel Krajden, MD, Juanita Maginley, RN, Judy Isaac-Renton, MD, Greg Hislop, MDCM MSc, Ruth Elwood-Martin, MD, Chris Sherlock, MB, Darlene Taylor, BSN, and Michael Rekart, MD
Can. Med. Assoc. J. 2007 177: 480-483. [Abstract] [Full Text] [PDF]

Human papillomavirus, vaccines and women's health: questions and cautions
Abby Lippman, PhD, Ryan Melnychuk, PhD, Carolyn Shimmin, BJ, and Madeline Boscoe, RN DU
Can. Med. Assoc. J. 2007 177: 484-487. [Full Text] [PDF]

Prophylactic vaccination against human papillomavirus infection and disease in women: a systematic review of randomized controlled trials
Lisa Rambout, BScPhm, Laura Hopkins, MD MSc, Brian Hutton, MSc, and Dean Fergusson, PhD
Can. Med. Assoc. J. 2007 177: 469-479. [Abstract] [Full Text] [PDF]



This article has been cited by other articles:


Home page
 cfpHome page
A. Jayabarathan
What about the boys?
Can Fam Physician, October 1, 2008; 54(10): 1375 - 1375.
[Full Text] [PDF]

Home page
 cfpHome page
M. Steben
Do you approve of spending $300 million on HPV vaccination?: YES
Can Fam Physician, February 1, 2008; 54(2): 174 - 176.
[Full Text] [PDF]

Home page
 cfpHome page
M. Steben
Approuvez-vous les 300 M $ pour la vaccination contre le VPH?: OUI
Can Fam Physician, February 1, 2008; 54(2): 178 - 180.
[Full Text] [PDF]