Impact of an expanded male catch-up HPV vaccination program on the clinical and economic burden of HPV-associated diseases in Denmark: a modeling study

BACKGROUND: Denmark's publicly funded routine HPV vaccination program has included boys born from 2005 onward, leaving earlier birth cohorts of young men potentially unprotected. METHODS: A published deterministic dynamic transmission metapopulation model was adapted to evaluate the impacts of a 3-year male catch-up vaccination program on the cases, deaths, and costs of HPV-associated diseases in Denmark over a 100-year time horizon. Routine gender-neutral HPV vaccination of adolescents with a nonavalent vaccine was modeled with and without a male catch-up program, at 4 catch-up vaccination coverage rates (VCRs) from 40% to 70%. RESULTS: Adding a temporary catch-up program for men born in 1997-2005 was projected to avert 253 HPV-associated cancer cases and 89 deaths at a VCR of 40%. Increasing coverage to 70% was estimated to avert 359 cases and 128 deaths. Catch-up vaccination may be considered cost-effective at all modeled VCRs, with incremental cost-effectiveness ratios of €35,584-35,755 per quality-adjusted life year compared to routine adolescent vaccination alone. CONCLUSIONS: Expanding Denmark's male catch-up HPV vaccination program to include all men born in 1997-2005 would reduce the burden of HPV-associated cancers and diseases and may represent a cost-effective public health strategy.