Comparison of 2-Dose and 3-Dose 9-Valent Human Papillomavirus Vaccine Schedules in the United States: A Cost-effectiveness Analysis

J Infect Dis. 2016 Sep 1;214(5):685-8. doi: 10.1093/infdis/jiw227. Epub 2016 May 27.


A recent clinical trial using the 9-valent human papillomavirus virus (HPV) vaccine has shown that antibody responses after 2 doses are noninferior to those after 3 doses, suggesting that 2 and 3 doses may have comparable vaccine efficacy. We used an individual-based transmission-dynamic model to compare the population-level effectiveness and cost-effectiveness of 2- and 3-dose schedules of 9-valent HPV vaccine in the United States. Our model predicts that if 2 doses of 9-valent vaccine protect for ≥20 years, the additional benefits of a 3-dose schedule are small as compared to those of 2-dose schedules, and 2-dose schedules are likely much more cost-efficient than 3-dose schedules.

Keywords: HPV vaccination; cost-effectiveness; human papillomavirus (HPV); transmission-dynamic modeling.

Publication types

  • Comparative Study

MeSH terms

  • Cost-Benefit Analysis
  • Humans
  • Immunization Schedule*
  • Papillomavirus Infections / prevention & control*
  • Papillomavirus Vaccines / administration & dosage*
  • Papillomavirus Vaccines / immunology*
  • United States


  • Papillomavirus Vaccines