A Dynamic Model to Assess Human Papillomavirus Vaccination Strategies in a Heterosexual Population Combined with Men Who have Sex with Men
A Dynamic Model to Assess Human Papillomavirus Vaccination Strategies in a Heterosexual Population Combined with Men Who have Sex with Men
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DOI：
10.1007/s11538-020-00830-y
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发表时间：
2021-01-02
影响因子：
3.5
通讯作者：
Rong, Libin
中科院分区：
文献类型：
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作者：
Gao, Shasha;Martcheva, Maia;Rong, Libin
接种疫苗可有效预防人类乳头瘤病毒(HPV)感染。当务之急是调查谁应该接种疫苗，以及最佳疫苗分发策略是什么。在这篇文章中，我们使用一个动态模型来评估在同性恋、双性恋和其他男男性行为者(MSM)中的异性人群中的HPV疫苗接种策略。得到了异性恋女性、异性恋男性和男男性同性恋者的基本繁殖数及其在总人口中的平均值。我们还推导了一个阈值参数，基于基本再现数，用于模型分析。通过分析和数值研究，我们得到了几个结论。(1)为消除HPV感染，应优先为男男性接触者接种疫苗，特别是在已实现女性高覆盖率的国家。异性恋人群受益很大，但男男性同性恋者只从异性恋女性或男性接种疫苗中获得很小的好处。(2)最好的接种策略是首先接种尽可能多的MSM，然后是异性恋女性，最后是异性恋男性。(3)在固定的男男性接触者疫苗接种覆盖率的情况下，仅将剩余的疫苗分发给异性恋女性或男性会导致在整个人口中出现类似的流行率。这一流行率低于向两性分发疫苗时的流行率。分布越均匀，在总人口中的患病率越高。(4)随着接种的疫苗越多，接种疫苗在降低发病率方面的效果就越差。将疫苗分配到疫苗接种率较低的地区更有效。这项研究提供的信息可能有助于政策制定者根据疫苗的可获得性和先前的疫苗接种覆盖率制定疫苗分发指南，以降低HPV流行率。当目标是降低HPV相关癌症发病率时，这些指南是否会受到影响仍有待进一步研究。
Vaccination is effective in preventing human papillomavirus (HPV) infection. It is imperative to investigate who should be vaccinated and what the best vaccine distribution strategy is. In this paper, we use a dynamic model to assess HPV vaccination strategies in a heterosexual population combined with gay, bisexual, and other men who have sex with men (MSM). The basic reproduction numbers for heterosexual females, heterosexual males and MSM as well as their average for the total population are obtained. We also derive a threshold parameter, based on basic reproduction numbers, for model analysis. From the analysis and numerical investigations, we have several conclusions. (1) To eliminate HPV infection, the priority of vaccination should be given to MSM, especially in countries that have already achieved high coverage in females. The heterosexual population gets great benefit but MSM only get minor benefit from vaccinating heterosexual females or males. (2) The best vaccination strategy is to vaccinate MSM firstly as many as possible, then heterosexual females, lastly heterosexual males. (3) Given a fixed vaccination coverage of MSM, distributing the remaining vaccines to only heterosexual females or males leads to a similar prevalence in the total population. This prevalence is lower than that when vaccines are distributed to both genders. The evener the distribution, the higher the prevalence in the total population. (4) Vaccination becomes less effective in reducing the prevalence as more vaccines are given. It is more effective to allocate vaccines to a region with lower vaccination coverage. This study provides information that may help policymakers formulate guidelines for vaccine distribution to reduce HPV prevalence on the basis of vaccine availability and prior vaccination coverage. Whether these guidelines are affected when the objective is to reduce HPV-associated cancer incidence remains to be further studied.