Benefit-risk assessment of HPV vaccination programs in Australia, the United States, and Japan

BACKGROUND: Human papillomavirus (HPV) vaccination is a global strategy for the prevention of cervical cancer (CC). Although Australia and the United States (US) have achieved high coverage, the cumulative HPV rate of the first vaccination for Japanese females born in 2008 was approximately 55%, despite policy efforts. This study compared the situation in Japan with that in Australia and the US, where vaccination rates are higher. METHODS: We conducted a unified benefit-risk assessment using disability-adjusted life year (DALY) rates to quantify the expected net value (ENV) of HPV vaccination programs per 100,000 eligible girls in Australia (2013-2020), the US (2013-2020), and Japan (2013-2024). Data on vaccination coverage, adverse events (AEs), and CC incidence were sourced from national health agencies and the Global Burden of Disease Study 2019. RESULTS: The vaccination coverage was 78.3% in Australia, 50.1% in the US, and 21.4% in Japan during the survey period. The ENV gained were 52.9 for Australia, 56.7 for the US, and 23.4 for Japan, reflecting differences in vaccination rates and CC burden. Across countries, the reporting rate of AEs was