HPV vaccination for boys? A systematic review of economic studies

Introduction. HPV vaccination is recommended in many countries, including Italy, for girls in their twelfth year of age. In some countries, the goal of vaccination coverage has not been reached, and extension to boys has thus been debated. Objective. Aim of this study is to perform a systematic review of pharmaco-economic studies considering the extension of HPV vaccination to boys. Methods. An electronic literature search was performed on Pubmed to identify studies published from 2005 to 2015 in English and Italian. Four search strategies were used, including the terms << HPV >>, << boys >>, << vaccination >>, << economic evaluation >>, << cost effectiveness >>, and << epidemiological impact >>. Screening of titles, abstracts, and full texts was conducted, and economical evaluation of the extension of HPV vaccination to males was considered a criteria of inclusion. A total of 289 articles were identified. Only 15 articles were finally considered pertinent. Results. The extension of HPV vaccination to boys was cost-effective or potentially cost-effective in 53% and 7% of the studies, respectively. Six studies did not positively evaluate the implementation of this intervention. However, taking into account both the new two-dose vaccination schedule available for all subjects <= 13 years, and the dramatic reduction in the price of vaccines in the last few years, the advantages of universal vaccination are more consistent. Conclusion. The extension of HPV vaccination to boys is therefore foreseen to become increasingly implemented in the near future.