Tableau d'honneur de la Faculté des études supérieures et postdoctorales, 2016-2017 / Introduction: En 2015, 65 pays avaient des programmes de vaccination contre les VPH. La modélisation mathématique a joué un rôle crucial dans leur implantation. Objectifs: Nous avons réalisé une revue systématique et analysé les prédictions de modèles mathématiques de l’efficacité populationnelle de la vaccination sur la prévalence des VPH-16/18/6/11 chez les femmes et les hommes, afin d’évaluer la robustesse/variabilité des prédictions concernant l’immunité de groupe, le bénéfice ajouté par la vaccination des garçons et l’élimination potentielle des VPH-16/18/6/11. Méthodes: Nous avons cherché dans Medline/Embase afin d’identifier les modèles dynamiques simulant l’impact populationnel de la vaccination sur les infections par les VPH-16/18/6/11 chez les femmes et les hommes. Les équipes participantes ont réalisé des prédictions pour 19 simulations standardisées. Nous avons calculé la réduction relative de la prévalence (RRprev) 70 ans après l’introduction de la vaccination. Les résultats présentés correspondent à la médiane(10ème; 90èmeperccentiles) des prédictions. Les cibles de la vaccination étaient les filles seulement ou les filles & garçons. Résultats: 16/19 équipes éligibles ont transmis leurs prédictions. Lorsque 40% des filles sont vaccinées, la RRprev du VPH-16 est 53%(46%; 68%) chez les femmes et 36%(28%; 61%) chez les hommes. Lorsque 80% des filles sont vaccinées, la RRprev est 93%(90%; 100%) chez les femmes et 83%(75%; 100%) chez les hommes. Vacciner aussi les garçons augmente la RRprev de 18%(13%; 32%) chez les femmes et 35%(27%; 39%) chez les hommes à 40% de couverture, et 7%(0%; 10%) et 16%(1%; 25%) à 80% de couverture. Les RRprev étaient plus élevées pour les VPH-18/6/11 (vs. VPH-16). Si 80% des filles & garçons sont vaccinés, les VPH-16/18/6/11 pourraient être éliminés. Interprétation: Même si les modèles diffèrent entre eux, les prédictions s’accordent sur: 1)immunité de groupe élevée même à basse couverture, 2)RRprev supérieures pour les VPH-18/6/11 (vs. VPH-16), 3)augmenter la couverture chez les filles a un meilleur impact qu’ajouter les garçons, 4)vacciner 80% des filles & garçons pourraient éliminer les VPH-16/18/6/11. / Background: As of 2015, 65 countries have introduced HPV vaccination programmes. Mathematical models have played a key role in the implementation of these programmes. Objectives: We conducted a systematic review and pooled-analysis of model predictions of population-level effectiveness of HPV vaccination against HPV-16/18/6/11 infection in women and men, to examine the robustness/variability of predicted populationnal effects, incremental benefit of vaccinating boys, and potential for HPV vaccine-type elimination. Methods: We searched Medline and Embase (2009-2015) for transmission-dynamic modeling studies predicting the population-level impact of vaccination on HPV-16/18/6/11 infections among women and men in high-income countries. Participating modeling teams produced predictions for 19 standardized scenarios. We derived pooled relative reduction in HPV prevalence (RRprev) 70 years after vaccination, using the median (10th; 90thpercentile) of model predictions. Strategies investigated were Girls-Only and Girls & Boys vaccination at 12 years of age. Findings: 16/19 eligible models, from ten high-income countries provided predictions. With 40% Girls-Only vaccination coverage, HPV-16 RRprev among women and men was 53%(46%; 68%) and 36%(28%; 61%), respectively. With 80% Girls-Only vaccination coverage, HPV-16 RRprev among women and men was 93%(90%; 100%) and 83%(75%; 100%), respectively. Vaccinating boys in addition to girls increased HPV-16 RRprev among women and men by 18%(13%; 32%) and 35%(27%; 39%) for 40% coverage, and 7%(0%; 10%) and 16%(1%; 25%) for 80% coverage, respectively. RRprev were greater for HPV-18/6/11 than HPV-16 for all scenarios. Finally at 80% coverage, most models predicted that Girls & Boys vaccination would eliminate HPV-16/18/6/11, with a median RRprev of 100% for women and men for all types. Interpretation: Although HPV models differ in structure, data used for calibration and setting, population-level predictions were generally concordant: 1) strong herd effects from vaccinating Girls-Only, even with low coverage, 2) greater post-vaccination reductions in HPV-18/6/11 infection (vs. HPV-16), 3) increasing coverage in girls provides greater impact than including boys, and 4) reaching 80% coverage in Girls would eliminate HPV-16/18/6/11, with a median RRprev of 100% for women and men for all types. Interpretation: Although HPV models differ in structure, data used for calibration and setting, population-level predictions were generally concordant: 1) strong herd effects from vaccinating Girls-Only, even with low coverage, 2) greater post-vaccination reductions in HPV-18/6/11 infection (vs. HPV-16), 3) increasing coverage in girls provides greater impact than including boys, and 4) reaching 80% coverage in Girls would eliminate HPV-16/18/6/11, with a median RRprev of 100% for women and men for all types. Interpretation: Although HPV models differ in structure, data used for calibration and setting, population-level predictions were generally concordant: 1) strong herd effects from vaccinating Girls-Only, even with low coverage, 2) greater post-vaccination reductions in HPV-18/6/11 infection (vs. HPV-16), 3) increasing coverage in girls provides greater impact than including boys, and 4) reaching 80% coverage in Girls & Boys could eliminate HPV-16/18/6/11.
| Identifer | oai:union.ndltd.org:LAVAL/oai:corpus.ulaval.ca:20.500.11794/27033 |
| Date | 24 April 2018 |
| Creators | Bénard, Élodie |
| Contributors | Brisson, Marc |
| Source Sets | Université Laval |
| Language | French |
| Detected Language | English |
| Type | mémoire de maîtrise, COAR1_1::Texte::Thèse::Mémoire de maîtrise |
| Format | 1 ressource en ligne (xii, 98 pages), application/pdf |
| Rights | http://purl.org/coar/access_right/c_abf2 |
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