Аңдатпа
Background Cervical cancer kills 900 women in Kazakhstan annually, despite being preventable by human papillomavirus (HPV) vaccination. The highly oncogenic types, HPV-16 and HPV-18, are targeted by the quadrivalent HPV vaccine, which was introduced through a two-dose schedule into Kazakhstan's national immunization programme in September 2024. We conducted a stakeholder engagement and modelling study to estimate the health impact, cost-effectiveness, and budget impact of HPV vaccination in Kazakhstan and assessed the value of switching to a one-dose schedule. Methods We formed a stakeholder working group of 19 members to collate Kazakhstan-specific data on cervical cancer burden and treatment costs and streamlined 16 ‘what-if’ vaccination scenarios. We used UNIVAC, a static cohort model, to estimate the health impact and cost-effectiveness of vaccinating 10 cohorts of 11-year-old girls (2025–2034) for two-dose and one-dose schedules compared to the counterfactual scenario of no vaccination from the government perspective. Findings Without vaccination, we estimated 22,142 cases and 6770 deaths from cervical cancer across the life course of the cohorts targeted for vaccination. For every 10% increase in vaccine coverage, we estimated an 8% reduction in cervical cancer burden across the lifetime of the vaccinated women. The one-dose schedule was cost-effective in every model iteration (100%), compared to 82% for the two-dose schedule, at a willingness-to-pay threshold of US$7700 based on health opportunity cost. Interpretation The two-dose HPV vaccination programme in Kazakhstan is cost-effective. The budget impact of vaccination costs for the one-dose schedule, which is logistically easier to administer and scale up, is half of that of the two-dose schedule with similar health benefits.