{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T18:19:51Z","timestamp":1783621191388,"version":"3.55.0"},"reference-count":44,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Women's Health"],"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>The postpartum period represents an opportunity to increase human papillomavirus (HPV) vaccination rates for those not vaccinated previously. This study aimed to evaluate the health outcomes and cost-effectiveness of a postpartum HPV vaccination program.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A Markov model was constructed to estimate the cost-effectiveness of a postpartum HPV vaccination program. A theoretical cohort of 400,000 vaccine-eligible postpartum individuals was simulated based on the U.S. birth rates and HPV vaccination data for those aged 18\u201326. Simulated health outcomes included diagnoses of cervical intraepithelial neoplasia grade 1 (CIN1), CIN2+ (CIN grade 2 or 3), and early-stage cervical cancer. Inputs were derived from the literature. Cost-effectiveness was assessed in terms of healthcare costs and patient time\/quality of life. The cost of the program is represented as the cost of vaccination with staff support per person in 2024 U.S. dollars. We used an incremental cost-effectiveness ratio (ICER) threshold of $100,000 per quality-adjusted life year (QALY). Sensitivity analyses were conducted to assess the impact of varying model parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Compared to no vaccination program, the postpartum HPV vaccination strategy resulted in 2,575 fewer CIN1 cases, 2,809 fewer CIN2+ cases, and 27 fewer cases of early-stage cervical cancer in our simulated population. The program yielded 3,476 additional QALYs at an incremental cost of $79.7 million. The ICER was $22,922\/QALY and thus was cost-effective. The program remained cost-effective across 99% of probabilistic simulations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>A postpartum HPV vaccination program is a cost-effective strategy to reduce cervical dysplasia and cancer, meeting standards for preventative care and intervention. These results highlight the postpartum period as an opportunity to complete the HPV vaccine series.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15409996261467346","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T09:53:12Z","timestamp":1783417992000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Cost-Effectiveness of an HPV Vaccination Program in the Postpartum Period"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1172-2079","authenticated-orcid":false,"given":"Ava","family":"Mandelbaum","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of California Los Angeles, Los Angeles, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine GT.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Oregon Health &amp; Science University, Portland, Oregon, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross F.","family":"Harrison","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Oregon Health &amp; Science University, Portland, Oregon, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron B.","family":"Caughey","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Oregon Health &amp; Science University, Portland, Oregon, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda S.","family":"Bruegl","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Oregon Health &amp; Science University, Portland, Oregon, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,7]]},"reference":[{"key":"e_1_3_4_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)30298-3"},{"key":"e_1_3_4_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa061741"},{"key":"e_1_3_4_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1405044"},{"issue":"05","key":"e_1_3_4_5_1","first-page":"1","article-title":"Human papillomavirus vaccination: Recommendations of the Advisory Committee on Immunization Practices (ACIP)","volume":"63","author":"Markowitz LE","year":"2014","unstructured":"4.Markowitz LE, , Dunne EF, , Saraiya M, et al.; Centers for Disease Control and Prevention (CDC). 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