Cost-effectiveness evaluation of gender-based vaccination programs against sexually transmitted infections
Jane M. Heffernan - Mprime Centre for Disease Modelling, York Institute of Health Research, Department of Mathematics and Statistics, York University, Toronto, Ontario, M3J 1P3, Canada (email)
The ultimate goal of a vaccination program is to interrupt pathogen transmission so as to eradicate the disease from the population in the future, and/or to decrease morbidity and mortality due to the disease in the short term. For sexually transmitted infections (STI) the determination of an optimal vaccination program is not straightforward since (1) the transmission probabilities between two different sexes are normally unequal (weighted to a greater probability from males to females than vice versa), (2) demographic parameters between the two sexes are unequal, (3) the prevalence of disease in one sex may have a greater impact on the morbidity and mortality of the next generation (transmission to the neonate) and, (4) the existence of pathogens closely related to the STI in question (i.e. herpes - HSV-1 vs. HSV-2, different strains of Chlamydia trachomatis, different strains of Neisseria which cause Gonorrhea, and others) may induce immunity in individuals that render a vaccine ineffective.
Keywords: Sexually transmitted infection, vaccine, mathematical model, cost-effectiveness.
Received: April 2013; Revised: October 2013; Published: February 2014.
2014 5-year IF.957