ArticleProceedings of the National Academy of Sciences of the United States of America2016
National- and state-level impact and cost-effectiveness of nonavalent HPV vaccination in the United States.
Article in Proceedings of the National Academy of Sciences of the United States of America, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
41 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Cost-effectiveness modeling for gender-neutral human papillomavirus vaccines: A systematic literature review.Human vaccines & immunotherapeutics · 2025Pooled it
- Pooled it
- Efficacy, Immunogenicity, and Safety of a 9-Valent Human Papillomavirus Vaccine: Subgroup Analysis of Participants From Asian Countries.The Journal of infectious diseases · 2018Trial
- Impact of switching from a quadrivalent to a nonavalent HPV vaccine on HPV infections and cervical cancer in Colombia: a mathematical modelling study.Lancet regional health. Americas · 2026Article
- Susceptibility of naturally human papillomavirus type 16 major capsid protein L1 variants to vaccines and predictions of future evolutionary trends.Tumour virus research · 2026Article
- Public health impact of increasing human papillomavirus vaccination and cervical cancer screening.Journal of the National Cancer Institute · 2026Article
- Article
- Cervical Cancer Screening, HPV Vaccination, and Cervical Cancer Elimination.JAMA network open · 2025Article
- Projected health and economic effects of nonavalent versus bivalent human papillomavirus vaccination in preadolescence in the Netherlands.BMC medicine · 2025Article
- State-level disparities in cervical cancer prevention and outcomes in the United States: a modeling study.Journal of the National Cancer Institute · 2025Article
- Human Papillomavirus-Related Cancer Vaccine Strategies.Vaccines · 2024Review
- State-level disparities in cervical cancer prevention and outcomes in the U.S.: A modeling study.medRxiv : the preprint server for health sciences · 2024Article
- A Systematic Review of Human Papillomavirus Vaccination Challenges and Strategies to Enhance Uptake.Vaccines · 2024Review
- Vaccinating women previously treated for human papillomavirus-related cervical precancerous lesions is highly cost-effective in China.Frontiers in immunology · 2023Article
- HPV vaccination uptake among foreign-born Blacks in the US: insights from the National Health Interview Survey 2013-2017.Cancer causes & control : CCC · 2022Article
- HPV vaccine for men: Where to? (Review).Experimental and therapeutic medicine · 2021Review
- Public health impact and cost effectiveness of routine and catch-up vaccination of girls and women with a nine-valent HPV vaccine in Japan: a model-based study.BMC infectious diseases · 2021Article
- Cost-effectiveness of Interventions to Increase HPV Vaccine Uptake.Pediatrics · 2020Article
- Spatio-temporal dynamics of measles outbreaks in Cameroon.Annals of epidemiology · 2020Article
- Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
Every year in the United States more than 12,000 women are diagnosed with cervical cancer, a disease principally caused by human papillomavirus (HPV). Bivalent and quadrivalent HPV vaccines protect against 66% of HPV-associated cervical cancers, and a new nonavalent vaccine protects against an additional 15% of cervical cancers. However, vaccination policy varies across states, and migration between states interdependently dilutes state-specific vaccination policies. To quantify the economic and epidemiological impacts of switching to the nonavalent vaccine both for individual states and for the nation as a whole, we developed a model of HPV transmission and cervical cancer incidence that incorporates state-specific demographic dynamics, sexual behavior, and migratory patterns. At the national level, the nonavalent vaccine was shown to be cost-effective compared with the bivalent and quadrivalent vaccines at any coverage despite the greater per-dose cost of the new vaccine. Furthermore, the nonavalent vaccine remains cost-effective with up to an additional 40% coverage of the adolescent population, representing 80% of girls and 62% of boys. We find that expansion of coverage would have the greatest health impact in states with the lowest coverage because of the decreasing marginal returns of herd immunity. Our results show that if policies promoting nonavalent vaccine implementation and expansion of coverage are coordinated across multiple states, all states benefit both in health and in economic terms.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.