Year of Publication



Public Health

Date Available


Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Dr. Glen Mays

Committee Member

Dr. Julia Costich

Committee Member

Dr. Richard Crosby


Prophylactic cancer vaccination presents novel opportunities to improve the health and well-being of populations. Since the approval of a cervical cancer vaccine against human papillomavirus (HPV) in 2006, only three states have passed legislation adding it to their school-entry schedules of required vaccinations. Despite ample evidence of its safety and efficacy, the vaccine remains controversial, and national vaccination rates among both girls and boys remain low. Risk for HPV-related cancers varies by population, and Appalachian Kentucky has among the highest HPV-related morbidity and mortality in the nation. Annual attempts to pass HPV vaccine legislation in Kentucky have so far failed in the absence of directly targeted quantitative data on the risks and rewards of action vs. inaction. We herein present the first known impact assessment of an HPV vaccine school entry requirement for the state of Kentucky, using a transmission-dynamic model to simulate vaccine scenarios in the context of Kentucky’s high HPV disease burden and unique population characteristics. Our findings suggest that over the lifetime of those first vaccinated after passage, such a policy could prevent approximately 18 thousand cancers and 3 thousand deaths; preserve 18 thousand life-years and more than 34 thousand quality-adjusted life years; and save as much as 1.3 billion USD in the state of Kentucky.

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