O17.4 Evaluating the Cost Effectiveness of Targeted Vaccination Strategies to Reduce Incidence of HPV-Related Cancer and Other Clinical Outcomes in Men Who Have Sex with Men (MSM) in British Columbia, Canada
Bibliographic record
Abstract
Background Of late, there has been discussion around the potential for vaccinating males in addition to the routine female human papillomavirus (HPV) vaccination programme against cervical cancer. While men who have sex with women (MSW) will likely receive some protection from female vaccination, men who have sex with men (MSM) remain vulnerable. Incidence rates of vaccine preventable cancers are disproportionately represented among MSM. Methods Based on the natural history of infection progression for HPV subtypes 6, 11, 16 and 18, mathematical transmission dynamics and cost-effectiveness analysis models were developed to assess the prevalence and incidence of these subtypes among the MSM population in the Greater Vancouver Area, British Columbia, Canada. Model parameters, demographic, and epidemiological data were informed from provincial data and the literature. We simulated three additional vaccination strategies, in combination with the current programme (Grade 6 schoolgirls (with 70% vaccine coverage)): first, vaccination of Grade 6 boys (with 70% vaccine coverage); second, vaccinating 18-year old self-identified MSM (with 25, 50 or 75% vaccine coverage); and finally, vaccinating any MSM within the vaccine-approved age range (with 25, 50 or 75% vaccine coverage). Results There is significant variability of cost estimates associated with clinical outcomes related to the HPV vaccine-preventable strains in the literature. Our sensitivity analysis indicates that the implementation of any scenario tested is incrementally cost effective, assuming a baseline of the current girls-only immunisation programme. On average, overall incidence of anal, penile, and oropharyngeal cancer cases attributable to vaccine-preventable strains will be reduced by approximately 90%, within 50 years, and given effective prophylaxis and lifelong immunity. Conclusion All targeted MSM immunisation scenarios tested were cost-effective by averting high costs related to each cancer case avoided and given the relatively low number of vaccine doses required within this population, compared to the male population at large.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".