Johannes Bogaards and colleagues use mathematical models to investigate whether vaccinating females only, males only, or both sexes is the best way to achieve the most effective reduction in the population prevalence of sexually-transmitted infection

AP Cox

AR Giuliano

AR Kreimer

B Donovan

BG Williams

BY Hernandez

C Miralles-Guri

Chris J. L. M. Meijer

DM Parkin

DP Wilson

EA van Lier

EF Dunne

EH Elbasha

F Dorleans

FH Chen

G von Krogh

GP Garnett

H De Vuyst

HW Hethcote

J Berkhof

J Paavonen

J Wallinga

JA Bogaards

Jacco Wallinga

JD Allen

Jeremy D. Goldhaber-Fiebert

JJ Carter

JJ Kim

JM Palefsky

Johannes A. Bogaards

Johannes Berkhof

JR Williams

KA Ault

L Tracy

M Brisson

M Jit

M Kretzschmar

MA Smith

Maria Xiridou

Mirjam Kretzschmar

MS Handcock

N Li

NJ Veldhuijzen

NW Bulkmans

O Diekmann

PE Castle

PV Chin-Hong

RH Gray

RM Anderson

RT Gray

S Franceschi

SC Hull

SJ Goldie

V Brown

VM Coupé

English

PubMed

Crossref

PLoS Medicine

Sex-Specific Immunization for Sexually Transmitted Infections Such as Human Papillomavirus: Insights from Mathematical Models

Bogaards, J.A.

Krezschmar, M.

Xiridou, M.

Meijer, C.J.L.M.

Berkhof, J.

Wallinga, J.

DSpace at VU

Sex-specific immunization for sexually transmitted infections such as human papillomavirus: insights from mathematical models

NARCIS 

Sex-specific differences regarding the transmissibility and the course of infection are the rule rather than the exception in the epidemiology of sexually transmitted infections (STIs). Human papillomavirus (HPV) provides an example: disease outcomes differ between men and women, as does the potential for transmission to the opposite sex. HPV vaccination of preadolescent girls was recently introduced in many countries, and inclusion of boys in the vaccination programs is being discussed. Here, we address the question of whether vaccinating females only, males only, or both sexes is the most effective strategy to reduce the population prevalence of an STI like HPV.We use a range of two-sex transmission models with varying detail to identify general criteria for allocating a prophylactic vaccine between both sexes. The most effective reduction in the population prevalence of infection is always achieved by single-sex vaccination; vaccinating the sex with the highest prevaccine prevalence is the preferred strategy in most circumstances. Exceptions arise only when the higher prevaccine prevalence is due to a substantially lower rate of natural immunity, or when natural immunity is lifelong, and a prolonged duration of infectiousness coincides with increased transmissibility. Predictions from simple models were confirmed in simulations based on an elaborate HPV transmission model. Our analysis suggests that relatively inefficient genital transmission from males to females might render male vaccination more effective in reducing overall infection levels. However, most existing HPV vaccination programs have achieved sufficient coverage to continue with female-only vaccination.Increasing vaccine uptake among preadolescent girls is more effective in reducing HPV infection than including boys in existing vaccination programs. As a rule, directing prophylactic immunization at the sex with the highest prevaccine prevalence results in the largest reduction of the population prevalence.Please see later in the article for the Editors' Summar

Bogaards Johannes A.

Kretzschmar Mirjam

Xiridou Maria

Meijer Chris J. L. M.

Berkhof Johannes

Wallinga Jacco

Public Library of Science (PLOS)

BACKGROUND: Sex-specific differences regarding the transmissibility and the course of infection are the rule rather than the exception in the epidemiology of sexually transmitted infections (STIs). Human papillomavirus (HPV) provides an example: disease outcomes differ between men and women, as does the potential for transmission to the opposite sex. HPV vaccination of preadolescent girls was recently introduced in many countries, and inclusion of boys in the vaccination programs is being discussed. Here, we address the question of whether vaccinating females only, males only, or both sexes is the most effective strategy to reduce the population prevalence of an STI like HPV. METHODS AND FINDINGS: We use a range of two-sex transmission models with varying detail to identify general criteria for allocating a prophylactic vaccine between both sexes. The most effective reduction in the population prevalence of infection is always achieved by single-sex vaccination; vaccinating the sex with the highest prevaccine prevalence is the preferred strategy in most circumstances. Exceptions arise only when the higher prevaccine prevalence is due to a substantially lower rate of natural immunity, or when natural immunity is lifelong, and a prolonged duration of infectiousness coincides with increased transmissibility. Predictions from simple models were confirmed in simulations based on an elaborate HPV transmission model. Our analysis suggests that relatively inefficient genital transmission from males to females might render male vaccination more effective in reducing overall infection levels. However, most existing HPV vaccination programs have achieved sufficient coverage to continue with female-only vaccination. CONCLUSIONS: Increasing vaccine uptake among preadolescent girls is more effective in reducing HPV infection than including boys in existing vaccination programs. As a rule, directing prophylactic immunization at the sex with the highest prevaccine prevalence results in the largest reduction of the population prevalence

Johannes A Bogaards

Chris J L M Meijer

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Sex-Specific Immunization for Sexually Transmitted Infections Such as Human Papillomavirus: Insights from Mathematical Models

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