A dramatic drop in genital warts is evidence the $10 million
approximate annual cost of the human papillomavirus (HPV)
vaccine is justified, the co-author of a new study says.
Prof Tony Blakely, of the University of Otago's Wellington
campus, said this was despite coverage of 47% in the period
It had since risen to more than 55%, but was still
significantly lower than in Australia and the United Kingdom.
''Incidence of warts has fallen quite dramatically, which is
good news,'' Prof Blakely said.
The study recommends New Zealand consider following Australia
and not offer a GP-delivered vaccine as an alternative to the
''Having the option to either have the vaccination at school
or to delay a few years and get it from the GP is likely
causing a lot of parents to delay.
''One possible way to achieve higher coverage might therefore
be to have only a free school-based programme, as in
Australia, with the requirement to pay the full market price
in other settings.''
Introduced in 2008, the vaccine has been offered to girls
through schools in year 8, or through primary care (aged 12
to 20) since 2011.
Surveillance clinics around the country reported a declining
number of first presentations for genital warts and the
steepest reductions were occurring in women aged 15 to 19.
Pharmaceutical data for genital warts treatment also showed a
downward trend. Prof Blakely said the three-shot programme
cost more than $750 per person, of which more than $330 was
for the vaccine.
It was an expensive programme, and there was scope to reduce
costs, he believed.
Signals from the World Health Organisation suggested the
third shot might be unnecessary, and it might be dropped in
If this occurred, it would further increase the programme's
Warts were an early indicator for cervical cancer reduction,
which would take more time to gauge. More could be done to
push the benefits of the vaccine's potential to reduce
cancer, he said.
''Our view is that greater emphasis could be given to
[explaining] that it will protect against multiple other
cancers that affect both men and women, and that it is best
given well before the typical age of sexual debut, to
maximise its benefit.''
Prof Blakely recommended health authorities consider giving
the vaccine at the same time as other vaccines given to the
same age group, to reduce cost.