ArticleThe Lancet regional health. Western Pacific2026
Cost-effectiveness and health impact of gender-neutral and single-dose HPV vaccination in Hong Kong: a modeling analysis.
Article in The Lancet regional health. Western Pacific, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Since 2019, Hong Kong has implemented a routine nonavalent human papillomavirus (HPV) vaccination program for schoolgirls aged 10-12 years with two-dose uptake of over 85%. However, Hong Kong is one of the high-income populations in Asia that lacks an assessment of the impacts of gender-neutral vaccination (GNV) with a single-dose schedule. This study evaluates the cost-effectiveness of expanding the two-dose female-only vaccination (2dFOV) to GNV and reducing the schedule to one dose. Methods: We modeled the impacts of 2dFOV and GNV (a single- or two-dose schedule) on the burden of HPV-related cancers and genital warts in both genders. We estimated the associated costs and health outcomes over a time horizon of 100 years with a 3% annual discount rate. We compared the incremental cost-effectiveness ratio (ICER) of expanding 2dFOV to GNV to a threshold of one gross domestic product per capita (US$52,120). Findings: Assuming a base case vaccination cost of US$177 per dose and 85% uptake for both genders, two-dose GNV (2F2M) has an ICER of US$71,105 (90% prediction interval: (US$44,085, US$153,197)) compared to 2dFOV and is not cost-effective. Compared to 2dFOV, giving one dose to both genders (1F1M) is cost-effective or dominant in all simulations, if boys' uptake is more than 50% and if the single-dose schedule provides 30 years of protection. If the single-dose schedule gives only 20 years of protection, 1F1M is cost-effective or dominant in 92% and 73% of simulations if boys' uptake is 85% and 50%, respectively. Interpretation: Expanding the current 2dFOV to GNV with a one-dose schedule for males (1F1M or 2F1M) could be a cost-effective strategy if the uptake among boys is sufficiently high. Funding: Health and Medical Research Fund, AIR@InnoHK.
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