Global modeling study finds one-dose schedule of HPV vaccine to confer similar health benefits and reduce costs compared to a two-dose program

A new modeling study found that a one-dose regimen for human papillomavirus vaccination (HPV) vaccination has similar health benefits to a two-dose program while simplifying vaccine delivery, reducing costs, and alleviating vaccine supply constraints. Adding a second dose may become cost-effective if there is a shorter duration of protection from one dose, cheaper vaccine and vaccination delivery strategies, and high burden of cervical cancer. Researchers used three independent HPV transmission models, estimating the long-term health benefits and cost-effectiveness of one-dose versus two-dose HPV vaccination, in 188 countries, under scenarios in which one dose of the vaccine gives either a shorter duration of full protection (20 or 30 years) or lifelong protection but lower vaccine efficacy (e.g., 80%) compared to two doses.

The findings showed that over the years 2021–2120, one-dose vaccination at 80% coverage was projected to avert 115.2 million and 146.8 million cervical cancers assuming one dose of the vaccine confers 20 and 30 years of protection, respectively. Should one dose of the vaccine provide lifelong protection at 80% vaccine efficacy, 147.8 million cervical cancer cases could be prevented. If protection wanes after 20 years, 65 to 889 additional girls would need to be vaccinated with the second dose to prevent one case of cervical cancer, depending on the epidemiological profiles of the country. Across all income groups, the threshold cost for the second dose was low: from 1.59 USD in low-income countries to 44.83 USD in high-income countries, assuming one dose confers 30-year protection.