Human Technology Assessment for HPV Vaccine

This study critically assesses the HPV vaccine for the treatment of different types of cancer and warts. It examines the evidence relating to decision making, clinical evidence, economic considerations, uncertainties, and recommendations for Australia.

Running head: HUMAN TECHNOLOGY ASSESSMENT
Human Technology Assessment
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Abstract
This study is based on the critical assessment of a health technology and for this purpose, HPV
vaccine is considered for the treatment of different types of cancer and warts. As per the
findings, the HPV vaccination program is one of the cost ways of eradicating the HPV
infections. The funds or the budget allocation are well between the range of budgetary
allocations and it is beneficial for the girls, women in comparison to the girls. Australian
government can take up the policy of conducting herd vaccination and this will be cost effective
in comparison to the single screening methods.

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Table of Contents
Introduction......................................................................................................................................3
Human Papillomavirus vaccine.......................................................................................................3
Evidence relating to decision making..............................................................................................4
Evidence relating to clinical evidence.............................................................................................5
Evidence related to the key components of economic considerations............................................5
Uncertainties related to HPV vaccine..............................................................................................6
Recommendation and applicability in Australia..............................................................................6
Conclusion.......................................................................................................................................7
Reference.........................................................................................................................................8

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Introduction
Human papillomavirus (HPV) vaccine protects the humans from the human
papillomavirus. Studies have shown that the HPV is a part of 200 major related viruses and
among them 40 viruses directly spread by direct sexual contact. Among the different types of
viruses, the HPV causes genital warts and other type of HPV causes the vaginal, vulvar, penile,
oropharyngeal, anal and cervical cancer. one of the HPV vaccine is the Gardasil 9 and this
protects from the 9 different types of the HPV (Schiller, Lowy and Markowithz 2012). This
study is based on the critical assessment of a health technology and for this purpose, HPV
vaccine is considered for the treatment of different types of cancer and warts.
Human Papillomavirus vaccine
HPV is a most common virus that affects both females and males and he people that were
eve once sexually active can get infected from these viruses at some point of their life. Thus, it is
important mention that the majority of the cervical cancer is caused by HPV. HPV is one of the
contagious and can cause a variety of cancer and this includes the genital warts. Thus to
effectively prevent infection from the HPV it is mandatory to consider he HPV vaccines. There
are 3 brand of HPV vaccines- Cervarix, Gardasil 9, Gardasil. All these vaccines provide
protection from the HPV type 18, type 16 and also from type 2 which causes the majority of the
cervical cancers. The vaccines Gardasil also provides protection from the type 11 and type 6
which causes 90 percent of the genital warts. The Gardasil vaccine is also effective in providing
protection against the 5 other types of HPV that includes the types 58, 52, 45, 333, 31 and this
can later on lead to the cancer of vagina, vulva, anus, cervix (Crowe et al. 2014).

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The HPV vaccines are applicable in the wide array of protection from HPV and it
protects the people that are within the age group of 15 to 26. The HPV comes in three different
shots. According to the various sources, the second shot is given just after the 2 months of the
second shot. The third shot is given just after the 4 months of the second shot. Thus, the whole
process of the vaccination takes around 6 months. The vaccination is also reduced for the people
aged between 9 to 14. One of the important aspect of the medicine is that the if a person is
already infected with the HPV then the vaccine cannot treat the person of the HPV infection
(Markowitz et al. 2012).
Evidence relating to decision making
High rates of HPV vaccination is capable of reducing the burden of HPV and the HPV
related diseases in United States. several studies have clearly shown that the recommendation of
the physicians play a major role in increasing the rates of acceptance of the parents of the
patients and the patients themselves. It has been seen that if the gynaecologists, obstetrician and
along with the other healthcare provider must stress on the patient and the parents of the patients
regarding the safety and the benefits of HPV vaccine. As per the findings of the centres of
disease control and prevention, the rates of the HPV vaccination has increased due to the
increased rates of recommendation by the physicians and the other healthcare providers. Due to
increased rates of recommendation by the healthcare providers the percentage of acceptance
among the patients regarding the usage of HPV vaccine has increased by 80 percent (Acog.org
2018). Several studies have been conducted which heighted the fact that the acceptance of the
HPV vaccine has increased among the adolescent and women die to the knowledge related to the
virus. The other reasons for the acceptance of the vaccine is effectiveness of the vaccine, safety
of the vaccine, sexually transmitted diseases. The intention of getting vaccinated among women

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is associated with the awareness and the knowledge of the virus. Several studies have shown that
the in several countries like Africa, Australia, Canada, Europe and United States majority of the
women and men have inadequate knowledge regarding the cervical cancer and its linkages with
the HPV. This lack of knowledge and awareness have caused the unacceptance of the HPV
vaccine (Loke, Chan and Wong 2017).
Evidence relating to clinical evidence
A randomized double blind placebo study was conducted to assess the efficiency of a
vaccine that targets the HPV and the several types that are associated with the cause of 70
percent of the cervical cancer. The study also includes the HPV of type 6, 11, 18 and 16. In this
study 277 young women are considered and all the women are assigned with the quadrivalent
HPV. While virus like particle vaccine was given to some of the women that underwent the
placebo preparations at the 1st day, 2nd month and 6th month. The women then underwent several
examinations based on the pap testing, test for the serum antibodies to HPV, sampling of the
cervical for the HPV DNA, regular gynaecological examinations. The results suggested that the
women that are assigned with the HPV vaccine, the incidence of HPV reduced by 90 percent in
comparison to the ones that are assigned with placebo. The HPV vaccine that targeted the HPV
types 18, 16, 11 and 6 significantly reduced the infection caused by the common types of the
HPV types (Villa et al. 2005).
Evidence related to the key components of economic considerations
In this study, the cost effectiveness of adding the HPV vaccination in the National
Cervical Screening Program in comparison to adding the HPV vaccination in the screening
procedures was examined. A model was used called the Markov model which incorporated the
natural history of the HPV infection and it included the vaccination, screening into the model. A

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HPV vaccine was chosen that effectively prevents the action of the HPV 16/18 and also has the
efficiency of acting on 80 percent of the cases. The program also was set up in a school setting
that included the girls aged between 12 years and it compared the program in conjunction with
the current screening procedures and screening alone procedures. The sensitivity analysis was
conducted that included the cost-effectiveness of a program including the 12-26 year olds. The
results of the study indicated that the vaccination with screening provided costs around 51,000
dollars while the single screening costs around 18,700 dollars. The cost per vaccine was
considered to be 115 dollars. The costs associated with vaccinating the people ranging from 14 to
26 was more attractive for the girls only. While the cost of vaccinating both the girls and boys
was expensive in comparison to the herd immunisation. The results of the study indicated that
the implementation of the HPV vaccination screening effectively reduced the incidence of the
cervical cancer. Additionally, the cost of interventions is also cost effective considering the
strategy of prevention via screening alone (Kulasingam et al. 2007).
Uncertainties related to HPV vaccine
The uncertainties are related to the debates related to the vaccine in general. The vital
questions that are raised with respect to HPV vaccine are effectiveness and safety. There are
ongoing controversies related to the function of HPV vaccine as preventer of the sexually
transmitted diseases among the adolescents. Also another major aspect is the lack of the proper
communication regarding the communication strategies. The HPV vaccination requires proper
communication regarding its benefits and the effectively of the same. The lack of the same
hinders the trust and confidence of the patients on the HPV vaccine (Alcaraz and Arnold 2014).

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Recommendation and applicability in Australia
As per the findings Kulasingam et al (2007), the HPV vaccination program is one of the
cost ways of eradicating the HPV infections. The funds or the budget allocation are well between
the range of budgetary allocations and it is beneficial for the girls, women in comparison to the
girls. Australian government can take up the policy of conducting herd vaccination and this will
be cost effective in comparison to the single screening methods.
Conclusion
From the above study it can be concluded that the Human papillomavirus (HPV) vaccine
protects the humans from the human papillomavirus. Studies have shown that the HPV is a part
of 200 major related viruses and among them 40 viruses directly spread by direct sexual contact.
High rates of HPV vaccination is capable of reducing the burden of HPV and the HPV related
diseases in United States. several studies have clearly shown that the recommendation of the
physicians play a major role in increasing the rates of acceptance of the parents of the patients
and the patients themselves. Due to increased rates of recommendation by the healthcare
providers the percentage of acceptance among the patients regarding the usage of HPV vaccine
has increased by 80 percent.

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Reference
Acog.org, 2018. Human Papillomavirus Vaccination - ACOG. [online] Acog.org. Available at:
https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-
Adolescent-Health-Care/Human-Papillomavirus-Vaccination [Accessed 30 Sep. 2018].
Alcaraz, K.I. and Arnold, L.D., 2014. Why are patients uncertain about the human
papillomavirus vaccine's effectiveness?. Journal of comparative effectiveness research, 3(4),
pp.321-323.
Crowe, E., Pandeya, N., Brotherton, J.M., Dobson, A.J., Kisely, S., Lambert, S.B. and
Whiteman, D.C., 2014. Effectiveness of quadrivalent human papillomavirus vaccine for the
prevention of cervical abnormalities: case-control study nested within a population based
screening programme in Australia. Bmj, 348, p.g1458.
Kulasingam, S., Connelly, L., Conway, E., Hocking, J.S., Myers, E., Regan, D.G., Roder, D.,
Ross, J. and Wain, G., 2007. A cost-effectiveness analysis of adding a human papillomavirus
vaccine to the Australian National Cervical Cancer Screening Program. Sexual Health, 4(3),
pp.165-175.
Loke, A.Y., Chan, A.C.O. and Wong, Y.T., 2017. Facilitators and barriers to the acceptance of
human papillomavirus (HPV) vaccination among adolescent girls: a comparison between
mothers and their adolescent daughters in Hong Kong. BMC research notes, 10(1), p.390.
Markowitz, L.E., Tsu, V., Deeks, S.L., Cubie, H., Wang, S.A., Vicari, A.S. and Brotherton, J.M.,
2012. Human papillomavirus vaccine introduction–the first five years. Vaccine, 30, pp.F139-
F148.

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Schiller, J., Lowy, D. and Markowithz, L., 2012. Human papillomavirus vaccines. Vaccines. 6th
ed. Philadelphia, PA: Saunders, pp.235-256.
Villa, L.L., Costa, R.L., Petta, C.A., Andrade, R.P., Ault, K.A., Giuliano, A.R., Wheeler, C.M.,
Koutsky, L.A., Malm, C., Lehtinen, M. and Skjeldestad, F.E., 2005. Prophylactic quadrivalent
human papillomavirus (types 6, 11, 16, and 18) L1 virus-like particle vaccine in young women: a
randomised double-blind placebo-controlled multicentre phase II efficacy trial. The lancet
oncology, 6(5), pp.271-278.