An age-structured Markov model, calibrated to 13 African countries, compared six HPV vaccination strategies for women with HIV against routine two-dose vaccination at 14. Mean disability-adjusted life-years averted per 100,000 females ranged from 8.21 for a booster at age 24 to 81.36 for high-coverage booster plus catch-up at 24. Counting avoided cancer treatment, 68 of 78 comparisons were cheaper and more effective for the health system, although every strategy raised vaccination programme costs.
Why it is interesting: Whether the extra doses save money depends on which budget the costs are counted against.
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