ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2024
Switching from a 2-dose to a 1-dose program of gender-neutral routine vaccination against human papillomavirus in Canada: a mathematical modelling analysis.
Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Single-dose HPV vaccination in the United States - a multi-modeling analysis.Lancet regional health. Americas · 2026Article
- Public Health Impact and Cost-Effectiveness of 2-Dose vs 1-Dose Human Papillomavirus Vaccination Regimen in Saudi Arabia.Journal of health economics and outcomes research · 2026Article
- HPV Testing, Self-Collection, and Vaccination: A Comprehensive Approach to Cervical Cancer Prevention.Current oncology (Toronto, Ont.) · 2025Review
- Cervical Cancer Elimination Requires Systems, Trust, and Action.Current oncology (Toronto, Ont.) · 2025Article
- Modeling cervical cancer elimination: a pathway to inform policy decisions.Cancer biology & medicine · 2025Article
- Strong Herd Effects of Human Papillomavirus Vaccination.The Journal of infectious diseases · 2025Article
- MCMC-Driven mathematical modeling of the impact of HPV vaccine uptake in reducing cervical cancer.Scientific African · 2025Article
- Summary of the National Advisory Committee on Immunization (NACI) Statement: Updated guidance on human papillomavirus (HPV) vaccines.Canada communicable disease report = Releve des maladies transmissibles au Canada · 2024Article
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9 authors.
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Abstract
backgroundWorldwide, countries are examining whether to implement 1-dose human papillomavirus (HPV) vaccination instead of using 2 doses. To inform policy, we sought to project the population-level impact and efficiency of switching from 2-dose to 1-dose gender-neutral routine HPV vaccination in Canada.
methodsWe used HPV-ADVISE, an individual-based transmission-dynamic model of HPV infections and diseases, to mathematically model vaccination programs in 2 provinces, Quebec, a province with high HPV vaccination coverage (around 85%), and Ontario, which has lower coverage (around 65%). We examined non-inferior and pessimistic scenarios of the efficacy (vaccine efficacy of 98% or 90%) and average vaccine duration (lifelong, 30 yr, or 25 yr) of 1 dose compared with 2 doses (98% vaccine efficacy, lifelong vaccine duration). Our main outcomes were the relative reduction in HPV-16 (by sex) and cervical cancers, and the number of doses needed to prevent 1 cervical cancer.
resultsOur model projected that 1-dose HPV vaccination would avert a similar number of cervical cancers as 2 doses in Canada, under various scenarios. Under the most pessimistic scenario (25-yr vaccine duration), 1-dose vaccination would avert fewer cervical cancers than 2 doses, by about 3 percentage points over 100 years. All 1-dose scenarios were projected to lead to elimination of cervical cancer (< 4 cervical cancers/100 000 female-years) and to be a substantially more efficient use of vaccine doses than a 2-dose scenario (1-dose v. no vaccination = 800-1000 doses needed to prevent 1 cervical cancer; incremental doses for 2-dose v. 1-dose vaccination > 10 000 doses needed to prevent 1 additional cervical cancer).
interpretationIf the average duration of 1-dose protection is longer than 25 years, a 1-dose HPV vaccination program would protect those vaccinated during their peak ages of sexual activity and prevent a similar number of HPV-related cancers as a 2-dose program, while being a more efficient use of vaccine doses.
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