The study modelled a one-time HPV 16/18 catch-up vaccination campaign in 2026 across 132 low- and middle-income countries. It used METHIS, a cervical cancer simulation platform run by the International Agency for Research on Cancer. Coverage of 90% among females aged 9-30 was projected to avert 6.93 million cervical cancer cases and 3.56 million deaths. Past vaccination accounted for a further 2.70 million cases and 1.57 million deaths averted. The campaign would require 951 million doses and US$11,349 million. Median country costs were 0.17% of five-year health expenditure and 19.7% of immunisation budgets. Catch-up was cost-effective to age 30 in five of six countries assessed, and to age 23 in one. Only six of the 132 countries had data adequate for cost-effectiveness analysis.
Why it is interesting: It gives country-specific upper age limits for HPV catch-up rather than a single global rule. The costs are set against immunisation budgets, not willingness-to-pay thresholds alone.
Abstract — the authors' own words, CC BY
To support the WHO global strategy to accelerate cervical cancer elimination in low- and middle-income countries (LMICs), we conducted a comprehensive health-economic impact assessment of HPV catch-up vaccination across different age ranges up to age 30, using IARCs METHIS modelling platform. A one-time catch-up campaign (targeting HPV 16/18; 90% coverage) in 2026 across 132 LMICs among females aged 9-30 could prevent 6.93 million cervical cancer cases and 3.56 million deaths, on top of 2.70 and 1.57 million cases and deaths averted by past vaccination, requiring 951 million doses and 11,349 million US$. Median country-specific costs represented 0.17% of five-year health expenditure and 19.7% of immunization budgets. Among six countries with diverse epidemiological profiles and sufficient data for cost-effectiveness analyses, catch-up was cost-effective until age 30 in all but one country, where it was cost-effective until age 23 only. Female catch-up could be cost-effective and impactful for cervical cancer prevention in LMICs.
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