Human papillomavirus (HPV) infection is the cause of cervical cancer, a major public health problem in sub-Saharan Africa (SSA). The project is part of the “Dose Reduction Immunobridging and Safety Study of two HPV vaccines in Tanzanian girls” (DoRIS) – a large clinical trial carried out by the London School of Hygiene and Tropical Medicine (LSHTM) in collaboration with the Mwanza Intervention Trials Unit of the Tanzania National Institute for Medical Research.
The goal of DoRIS is to establish whether a single dose of an HPV vaccine produces immune responses that are likely to be effective in preventing cervical cancer in SSA and whether a 2 dose HPV vaccine strategy for girls aged <15 years has similar vaccine responses in SSA as the previously recommended 3 dose regimen. At the same time, the trial will determine whether the new 9-valent vaccine produces similar vaccine responses as the 2-valent vaccine.
DoRIS results will have major implications for cost-effectiveness of HPV vaccination in SSA. A single dose regimen would considerably reduce costs of vaccination, when compared with 2 dose or three dose regimens. However, the overall effects on cost-effectiveness will depend on efficacy of vaccination as found during the trial. Similarly, the 9-valent vaccine has the potential to prevent a considerably larger proportion of HPV associated cancers but again its impact on cost-effectiveness will depend on efficacy and costs of the vaccine.
This project will estimate the cost-effectiveness of 1 dose regimens compared with 2 and 3 dose regimens, and of the 9-valent vaccine compared with the 2-valent vaccine. The project will use efficacy data collected alongside this trial and updated cost data available from a previous study, supplemented with information on current vaccination, screening and treatment practices in Tanzania.
Quentin W, Terris-Prestholt F, Changalucha J, Soteli S, Edmunds J, Hutubessy R, Ross D, Kapiga S, Hayes Rand, Watson-Jones D (2012): Costs of delivering human papillomavirus vaccination to schoolgirls in Mwanza Region, Tanzania. BMC Medicine; 10:137, doi:10.1186/1741-7015-10-137.