Canadian vaccination programs may switch to a one-dose, gender-neutral human papillomavirus (HPV) vaccination approach to eliminate cervical cancer, according to a recent study published by Drolet et al in the Canadian Medical Association Journal.
Background
HPV is known to cause cervical cancer and other diseases. Countries across the world are currently exploring whether to move from a two-dose to a one-dose HPV vaccination approach following a 2022 recommendation by the World Health Organization Strategic Advisory Group of Experts on Immunization based on clinical trial evidence.
Study Methods and Results
In this study, researchers modeled various scenarios based on one- and two-dose approaches—with the goal of informing recommendations from the Canadian National Advisory Committee on Immunization and the Comité sur l’immunisation du Québec.
The researchers found that one-dose, gender-neutral HPV vaccination could prevent a similar number of cervical cancers as two doses, provided that vaccine protection remains high during ages in which sexual activity is the highest.
“All one-dose vaccination scenarios, even the most pessimistic, were projected to be a substantially more efficient use of vaccine doses than two-dose vaccination; these scenarios were also all projected to lead to elimination of cervical cancer in Canada between 2032 and 2040,” highlighted the study authors.
The one-dose approach was also found to be a more efficient use of vaccine doses.
Conclusions
“Our results have important policy implications in Canada, and in other similar high-income countries evaluating whether to switch to [one]-dose HPV vaccination,” stressed senior study author Marc Brisson, MSc, PhD, Full Professor at Laval University and Director of the Mathematical Modeling and Health Economics of Infectious Diseases Lab at the Centre de Recherche du CHU de Québec–Université Laval.
The researchers advised regular monitoring of one-dose protection to detect signs of waning protection.
“The COVID-19 pandemic impacted HPV vaccination in Canada, particularly among vulnerable population subgroups. The potential economic savings by switching to one-dose vaccination—and its programmatic flexibility—could allow investments to increase vaccination uptake in regions where coverage is suboptimal and in high HPV burden subgroups to mitigate the pandemic’s impact on programs and to reduce inequalities,” concluded co–study author Chantal Sauvageau, MD, MSc, FRCP, a specialist in community health and a consultant in infectious diseases at the National Institute of Public Health in Quebec.
Disclosure: For full disclosures of the study authors, visit cmaj.ca.
