OBJECTIVES: The  incidence of cervical cancer in Spain is about 10/100,000 women per year, one of the lowest in Europe. Screening  programs and the population vaccination against HPV are the two health care  interventions aiming to reduce cancer development.The objective of this study is to analyse the efficiency of  the population vaccination program in Spanish girls aged 11-14.  METHODS: A simulation discrete event model with a horizon of 20 years, under the perspective of the National Health System, applied to the context of a high level of coverage Spanish region (La Rioja) was developed. The cytological results of the population screening program (14,760 women) and a review of literature on Spanish papers as well as official statistics were used in the model. Finally, the model took also into account the impact of some progression  co-factors and the decrease on the immunity along time. RESULTS: According to the model outputs, from the 2725 girls of the first vaccination camping, 38.2% will not get infected by the  HPV, 56.1% will clear the virus in a spontaneous way, 3.8% will either not progress or do not confirm the diagnoses, and, consequently,  1.9% would  confirm a  cervical lesion (29 LSIL and 23 HSIL), without considering the vaccination effect.A population vaccination program (that reached  a 97.5% coverage) vs no vaccination at all will have an Incremental Cost Effectiveness Ratio of 43,657.8 euros per avoided pre-cancer cervical lesion. CONCLUSIONS: Although some primary preventative measures are convenient from a public health perspective, their final health and economic outcomes should be analysed. According to the results of this study, targeting only some risk populations should be considered as a way of increasing the low efficiency of the general population vaccination program.