为了消除宫颈癌作为公共卫生问题，世界卫生组织建议在性行为启动前对青少年女孩进行两剂人乳头瘤病毒(HPV)疫苗常规接种。然而，许多国家因为财政或物流方面的障碍而尚未实施HPV疫苗接种，无法脱离婴儿免疫计划给予两剂疫苗。通过使用三个独立的HPV传播模型，我们估计了一剂和两剂HPV疫苗接种的长期健康效益和成本效益，在188个国家中，在哪种情况下只有一剂疫苗提供短期的完全保护(20 或 30 年)，或者终身保护但疫苗功效较低(例如80%)与两剂相比。我们模拟了2021年至2120年在80%接种率下的9价HPV疫苗例行接种，针对10岁女孩，在计划的首年进行1年的80%补赶接种活动，覆盖率。在2021年至2120年期间，假设疫苗一剂接种提供20 年和30 年的保护时间，80%的接种覆盖率下，可以避免1.152亿(中位数范围:85.1-130.4)和1.468亿(114.1-161.6)例宫颈癌。如果一剂疫苗提供80%的疫苗功效，可预防1.478亿(140.6-169.7)例宫颈癌。如果保护效果在20年后减弱，根据国家的流行病学特征，需要额外接种第二剂疫苗的女孩数量在65至889之间，才能预防一例宫颈癌。在所有收入群体中，第二剂疫苗的阈值成本较低：从低收入国家的1.59美元(0.14-3.82)到高收入国家的44.83美元(3.75-85.64)，假设一剂疫苗提供30年的保护。结果在三个独立模型中一致，并表明一剂疫苗接种具有与两剂接种方案相似的健康效益，同时简化了疫苗接种的方法、降低了成本并缓解了疫苗供应限制。如果一剂疫苗提供较短的保护期、便宜的疫苗和接种策略以及宫颈癌的高负担，则第二剂疫苗可能具有成本效益。 © 2023. BioMed Central Ltd. 版权所有，属于Springer Nature的一部分。

To eliminate cervical cancer as a public health problem, the World Health Organization had recommended routine vaccination of adolescent girls with two doses of the human papillomavirus (HPV) vaccine before sexual initiation. However, many countries have yet to implement HPV vaccination because of financial or logistical barriers to delivering two doses outside the infant immunisation programme.Using three independent HPV transmission models, we estimated the long-term health benefits and cost-effectiveness of one-dose versus two-dose HPV vaccination, in 188 countries, under scenarios in which one dose of the vaccine gives either a shorter duration of full protection (20 or 30 years) or lifelong protection but lower vaccine efficacy (e.g. 80%) compared to two doses. We simulated routine vaccination with the 9-valent HPV vaccine in 10-year-old girls at 80% coverage for the years 2021-2120, with a 1-year catch-up campaign up to age 14 at 80% coverage in the first year of the programme.Over the years 2021-2120, one-dose vaccination at 80% coverage was projected to avert 115.2 million (range of medians: 85.1-130.4) and 146.8 million (114.1-161.6) cervical cancers assuming one dose of the vaccine confers 20 and 30 years of protection, respectively. Should one dose of the vaccine provide lifelong protection at 80% vaccine efficacy, 147.8 million (140.6-169.7) cervical cancer cases could be prevented. If protection wanes after 20 years, 65 to 889 additional girls would need to be vaccinated with the second dose to prevent one cervical cancer, depending on the epidemiological profiles of the country. Across all income groups, the threshold cost for the second dose was low: from 1.59 (0.14-3.82) USD in low-income countries to 44.83 (3.75-85.64) USD in high-income countries, assuming one dose confers 30-year protection.Results were consistent across the three independent models and suggest that one-dose vaccination has similar health benefits to a two-dose programme while simplifying vaccine delivery, reducing costs, and alleviating vaccine supply constraints. The second dose may become cost-effective if there is a shorter duration of protection from one dose, cheaper vaccine and vaccination delivery strategies, and high burden of cervical cancer.© 2023. BioMed Central Ltd., part of Springer Nature.