OBJECTIVES: To assess the epidemiological and economic impact of gender-neutral vaccination (GNV) with nine-valent HPV vaccine (9vHPV) with vaccine coverage rate (VCR) 80% girls and 50% boys in the 11-12 years old age group in comparison with four-valent HPVv GNV from Kazakhstan National Immunization program perspective.

METHODS: A published HPV transmission dynamic model was calibrated to simulate the natural history of HPV infections and estimate the costs associated with HPV-related diseases. Local DRG tariffs were the source for direct medical costs for HPV-related diseases, epidemiological inputs and screening patterns were informed by HPV Information Centre data for Kazakhstan and data provided by Republican Center for Healthcare Development. The model assumed two-dose schedule over a 100-year time-horizon with lifelong immunity, herd immunity and a discount rate of 3%.

RESULTS: The model demonstrated that 9vHPV GNV can prevent overall 97,714 cases of HPV-related diseases over 100 years in comparison with 4vHPV GNV in Kazakhstan. Overall number of prevented HPV-related deaths will equal 8,527. 21,439 cervical cancer cases (18.7%) and 24,452 CIN2+ cases (42.2%) can be averted by 9HPVv GNV in females over 100 years. The cumulative number of quality-adjusted life years gained over this period will be 20,438. The decrease of HPV-related disease treatment costs is anticipated to be around 6.6 bln KZT (14.7 mln USD).

CONCLUSIONS: Gender-neutral vaccination with the nine-valent HPV vaccine (VCR: 80% girls and 50% boys) in the 11-12 years old age group will show a significant decrease in the incidence and mortality associated with HPV-related diseases in Kazakhstan. Positive economic impact due to decreased HPV-related treatment costs will be achieved as well.