ArticleBMJ global health2023
Health and economic effects of introducing single-dose or two-dose human papillomavirus vaccination in India.
Article in BMJ global health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.
- Comparative effectiveness and immunogenicity of single-dose and multi-dose human papillomavirus vaccination: a systematic review.BMC public health · 2025Pooled it
- Decision-making considerations for single-dose HPV vaccination, including drivers of schedule adoption or switch: insights from immunisation stakeholders in 19 low-income and middle-income countries.BMJ global health · 2026Article
- Optimizing HPV vaccine effectiveness: impact of vaccination age and dose schedule on immunogenicity and cervical cancer prevention.Frontiers in public health · 2025Review
- Single-dose human papillomavirus vaccination: an update.Journal of the National Cancer Institute. Monographs · 2024Article
- Article
- Regional Disparities in the Impact of Human Papillomavirus-Induced Lesions after 10 Years of HPV Vaccination Program in Brazil.Asian Pacific journal of cancer prevention : APJCP · 2024Article
- Leveraging single-dose human papillomavirus vaccination dose-efficiency to attain cervical cancer elimination in resource-constrained settings.Journal of the National Cancer Institute. Monographs · 2024Article
- Adult vaccination in India: A rapid review of current status & implementation challenges.The Indian journal of medical research · 2024Review
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Authors and funding
14 authors at 3 institutions in 3 countries.
Funding
Abstract
backgroundCervical cancer is a major public health problem in India, where access to prevention programmes is low. The WHO-Strategic Advisory Group of Experts recently updated their recommendation for human papillomavirus (HPV) vaccination to include a single-dose option in addition to the two-dose option, which could make HPV vaccination programmes easier to implement and more affordable.
methodsWe combined projections from a type-specific HPV transmission model and a cancer progression model to assess the health and economic effects of HPV vaccination at national and state level in India. The models used national and state-specific Indian demographic, epidemiological and cost data, and single-dose vaccine efficacy and immunogenicity data from the International Agency for Research on Cancer India vaccine trial with 10-year follow-up. We compared single-dose and two-dose HPV vaccination for a range of plausible scenarios regarding single-dose vaccine protection, coverage and catch-up. We used a healthcare sector payer perspective with a time horizon of 100 years.
resultsUnder the base-case scenario of lifelong protection of single-dose vaccination in 10-year-old girls with 90% coverage, the discounted incremental cost-effectiveness ratio (ICER) of nationwide vaccination relative to no vaccination was US$406 (₹INR30 000) per DALY (disability-adjusted life-years) averted. This lay below an opportunity-cost-based threshold of 30% Indian gross domestic product per capita in each Indian state (state-specific ICER range: US$67-US$593 per DALY averted). The ICER of two-dose vaccination versus no vaccination vaccination was US$1404 (₹INR104 000). The ICER of two-dose vaccination versus single-dose vaccination, assuming lower initial efficacy and waning of single-dose vaccination, was at least US$2282 (₹INR169 000) per DALY averted.
conclusionsNationwide introduction of single-dose HPV vaccination at age 10 in India is highly likely to be cost-effective whereas extending the number of doses from one to two would have a less favourable profile.
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