METHOD: Pre-study arrangements: A research protocol was formulated and submitted in the form of the LSHTM research CARE form. As the data for this analysis was from secondary data sources, the project did not require ethical approval to be carried out. Approach to economic evaluation: A health services perspective was adopted for this analysis as is recommended by previous guidelines (40). Adopting a societal perspective can be challenging, and there is debate and difficulties around what to include as part of this as well of ways of costing all elements of treatment and care, especially from a patient and carers perspective. We assumed that there would be no changes to the other preventative strategies in place, like cervical screening …show more content…
Details for Modeling used: A previously validated PRIME model, that had been developed as a Microsoft excel based model, to estimate the health and economic effect of vaccination of girls against HPV before sexual debut, was used for this analysis (38). The effect of the 9-valent vaccine was modeled in terms of reduction in age-dependent incidence of cervical cancer and mortality in direct proportion to vaccine efficacy against HPV 16, 18, 31, 33, 45, 52 and 58, vaccine coverage, and HPV type distribution globally, compared to both the bivalent and quadrivalent vaccines. Global Projections for 179 countries – Data to populate the model: Population data: Data was gathered for the different parameters needed to populate the PRIME model in order to run a cost-effectiveness analysis. Different global datasets and literature searches were utilized in order to get the most up to date estimates for the different parameters needed to run the model. UN population estimates were available for 179 countries, and these estimates were used to populate the model with the 12-year old female population levels that would be eligible for HPV vaccinations in each of these countries (41). These figures were calculated from the data for population estimates for the 10-14-year old female age group in each country (medium fertility variant), and dividing this figure by five in order to reach an estimate for the 12-year-old female population.
Single-variable research can answer exciting and important questions like the one in this research, but it does not answer questions about statistical relationships between variables (Jhangiani et al., 2015). Descriptive statistics refers to a set of techniques for summarizing and displaying data (Jhangiani et al., 2015). The study location is within the United States and its territories. The timeline of the study ranges from 2010 – 2015. The logic behind the time is tied to the fact that in 2011, the ACIP endorsed administering the HPV vaccine for adolescent boys with a goal to cover 80% of males aged 13 – 15 years. Therefore, the time frame covers one year before implementation and four years after. There are no anticipated costs associated with this research.
The human papillomavirus (HPV) is a sexually transmitted disease (STD) that is very common throughout the United States and worldwide (World Health Organization (WHO), 2016). There are over 100 different forms of the virus with 13 of these types being capable of causing cancer (WHO, 2016). HPV can lead to the development of serious health problems. Theses health problems are especially an issue for adolescent women due to the highly increasing STD rates among this age group (Kostas-Polston, Johnson-Mallard & Berman, 2012). There is a vaccine for many of the common types of HPV, however, many parents are refusing to vaccinate their daughters for various reasons. With the rising cases of STDs, less birth
Prophylactic vaccination against high risk human papilloma virus 16 and 18 represents an exciting means of protection against HPV related malignancy. However, this strategy alone, even if there is a level of cross protection against other oncogenic viruses, cannot completely prevent cervical cancer. In some countries cervical screening programs have reduced the incidence of invasive cervical cancer by up to 80 percent although this decline has now reached a plateau with current cancers occurring in patients who have failed to attend for screening or where the sensitivity of the tests have proved inadequate. Cervical screening is inevitably associated with significant anxiety for the many women who require investigation and treatment following abnormal cervical cytology. However, it is vitally important to stress the need for continued cervical screening to complement vaccination in order to optimize prevention in vaccines and prevent cervical cancer in older women where the value of vaccination is currently unclear. It is likely that vaccination will ultimately change the natural history of HPV disease by reducing the influence of the highly oncogenic types HPV 16 and 18. In the long term this is likely to lead to an increase in recommended screening intervals. HPV vaccination may also reduce
In young women aged sixteen to thirty years old, does vaccinating for Human Papillomavirus (HPV) compared to not vaccinating lead to a decrease in the expense of treating the complications from HPV?
HPV is by far the most common sexually transmitted infection in the United States. Per the Centers for Disease Control and Prevention (CDC), 50 percent of all sexually active men and women will get it at some point in their lives, and 20 million already have it. A vaccine is available that prevents 70% of cervical cancers that arise from sexual intercourse. The human papillomavirus is unknowingly common and is diagnosed in 10,000 women a year, causing 4,000 deaths per year (“HPV Question and Answers”). If we take the responsibility to vaccinate young girls and boys, to be safe, we can eliminate many unnecessary deaths. This vaccine is a great discovery that should be put to good use, the HPV vaccine should be mandated in young teens everywhere.
There are many reasons that this vaccine could be beneficial, not only to our society, but to many of the underdeveloped nations of the world in which HPV and cervical cancer are still considered to be an epidemic (MacDonald). It could save the young women who get the vaccine from the future trouble of dealing with a highly invasive cancer, as well as protect them from the embarrassment that comes with contracting a venereal disease. However, the controversy of this topic is not in whether the vaccine is a benefit to women’s health, which many, including the FDA and the Centers for Disease Control, believe that it is; but in the debate over whether it is the parents’ right, not the states’, to choose what is best for their child. The question of mandatory vaccination raises medical, moral and legal issues that are not easily reconcilable (Lovinger). Many parents are opposed to the mandating of this vaccine for three reasons. First, HPV is not spread by casual contact, as are the other diseases that children are vaccinated against for the safety of the classrooms. Second, the vaccine has only been approved for a short while, thus not all of the side effects and long term effects are known. Last, parents are afraid that by getting their child vaccinated against a sexually transmitted disease they will be encouraging promiscuity. Gardasil would become the first vaccine mandated for school-aged children that targets a
There are many ethical and legal issues that count against a mandatory HPV vaccination for all girls aged 11-12 years old. First, the long-term safety and effectiveness of the vaccination is unknown (Javitt et al., 2008). Clinical trials conducted on the HPV vaccine concluded no short-term adverse effects, but as more girls and young women begin to get the vaccine some adverse effects may appear (Javitt et al., 2008). The extent immunity of the HPV vaccine is also unclear. Studies have shown the vaccine to be present in 3-4 year follow-ups, but the long-term effectiveness has not been studied (Javitt et al., 2008). Furthermore, HPV has a long incubation period, which would only affect a small amount of individuals many years after they finish school (Stewart, 2008).
In addition, the immune system of most women will usually suppress or eliminate HPVs. This is very important because only an ongoing persistent infection has the potential to lead to cervical cancer (HPV). Eleven thousand cases of this kind of cancer were confirmed in 2007 in the United States; the amount undiagnosed is still unclear but believed to be in the tens of thousands. But to give some perspective of the problem you need to understand its effects on a global level. On the world wide scale cervical cancer strikes nearly half a million women each year, claiming more than a quarter of a million lives. “High risk” HPV types 16 and 18 are implicated in Seventy percent of cervical cancers and are hence selected for vaccine targets (The HPV).
HPV vaccinations have been involved in some heated debates involving the general public and the government for some time now; whether the vaccine is worth being administered to young girls is the underlying question and if so at what cost. In the articles “HPV Vaccine Texas Tyranny” and “The HPV Debate” both authors Mike Adams and Arthur Allen provide enlightening information on why the HPV vaccinations should not be mandated through legislation, Adams conveys his bias and explains how the government is over stepping its boundaries when it comes to the publics’ health while Allen on the other hand, is more opt to present analytical data on previous cases similar to the one he is currently facing.
Economic evaluations of preventive interventions are necessary. Public health professionals designing and implementing preventive interventions typically work in the context of limited resources. Economic considerations are important because intervention costs must be justified in light of the benefits achieved (Rossi et al., 2004). As a profession, public health must be concerned about limited resources and about caring for entire populations. For these reasons, public health professionals must make often hard decisions to maximize health benefits while minimizing costs (CDC, n.d., page 1). In circumstances where resources are unlimited, economic evaluations would not be necessary as there would not be a need to reduce costs. In reality,
Among the many arguments for mandatory HPV vaccination, the foremost is that it is an important medical achievement and a major public health milestone. This vaccine has proven to be one-hundred percent effective in preventing the 4 HPV strains that are responsible for seventy percent of cervical cancers and ninety percent of genital warts. In addition, no serious side effects have been identified. Because this vaccine is a preventive measure, administration before onset of sexual activity is ideal; however, even females who have been sexually active can still benefit from this vaccination (Perkins et al., 2010). Nationally and internationally, the HPV vaccine will significantly reduce disease burden by reducing monetary and psychological costs of invasive procedures that remove precancerous and cancerous lesions. By combining vaccination with routine Pap smear screening, these public health efforts have the remarkable opportunity to eradicate cervical cancer (Ramet et al., 2011).
The HPV vaccine is cancer prevention. Over thousands of cases of HPV cancers are detected every year in men and women. The HPV vaccination is important because it can prevent these cancers. The United States Food and Drug Administration approved this vaccine and it is one hundred percent safe. This vaccine is preventive care for the second leading cancer in women. It has been proven to be one hundred percent effective in prevention of cervical cancer, but the vaccine must be given to children between the age of 11 -17 before they become sexually active. After the age seventeen with young women most become sexually active and receive their first pap smear from their gynecologist, receiving the vaccine at this point is not as effective in prevention of cancers. Another benefit of receiving the vaccine during adolescent, is it supports people who may not have the medical knowledge or access to regular medical services.
Human papillomavirus (HPV) is a killer. It is an awful disease that is the culprit of many deaths each year. We have the means for its prevention, yet HPV vaccination for girls is a controversial topic to some. This controversy carries over to the current question on whether or not males should also be vaccinated. The issue is starting to play a huge role in the media; Fox news recently broadcasted a story on male HPV vaccinations. This story makes clear the benefits that would come from vaccinating males, including a statement from the Center for Disease Control that, “The HPV vaccine will afford protection against certain HPV-related conditions and cancers in males, and vaccination of males with HPV may also provide indirect protection
According to the Sexuality Information and Education Council of the United States (SIECUS) the human papillomavirus (HPV) is the most common sexually transmitted infection (STI). I wasn’t aware that it impacts so many people; SIECUS reports that each year there are approximately 6.2 million new cases of HPV and that 75% of people between ages 15 and 49 have had a genital HPV infection. This isn’t something that I hear about as an adult male in this country. Before conducting research, I was only aware that HPV was tied to cervical cancer and there was a vaccine for young women. In the last decade, the understanding of HPV has increased considerably. Although schools don’t require the vaccination it’s recommended that children age 11-12. People have till their mid-20’s to receive a “catch up” immunization. HPV is responsible for causing more than 90% of anal and cervical cancers, about 70% of vaginal and vulvar cancers, and more than 60% of penile cancers and HPV is linked to 70% of oropharynx cancers (CDC, 2015). Not all people infected have complications, in fact, most people are asymptomatic and
A sexually transmitted agent, human papillomavirus (HPV) is the causative agent for genital warts and most invasive forms of cervical cancer and other cancers of the anogenital tract (Trottier & Franco, 2006). In the United States (US), about 80 million people are infected with at least one strain of HPV, resulting to a prevalence rate of 50-80% among sexually active adolescents. This ranks HPV infections among the most commonly diagnosed sexually transmitted diseases (STDs) in the US (Faridi, Zahra, Khan, & Idrees, 2011; Gerend & Shepherd, 2012). According to (Gerend & Shepherd, 2012)), an estimated 12,000 cases of invasive cervical cancer, and 4,000 resulting deaths occur in the US annually due to low HPV vaccine uptake, thus predisposing sexually active adolescents to HPV infection (Baseman & Koutsky, 2005; Trottier & Franco, 2006). HPV vaccines have been shown to be safe and effective in preventing genital warts, and cancers of the anogenital tract, yet parental consent to vaccinate is still very low. The low vaccination rate can be attributed to vaccine safety concerns, “license” for adolescents to engage in sexual intercourse, lack of knowledge among the US population about HPV as a cause of genital warts and cancer, its mode of transmission, cost, and missed opportunities by HCPs to either recommend or administer the vaccine to adolescents (Dempsey & Zimet, 2008; Faridi et al., 2011). A child’s HCP is consistently cited as the determining factor in parental vaccine