Peer-reviewed article

Societal and fiscal gains from HPV vaccination in Poland - return on investment from extending access to HPV vaccination.

Rafal Jaworski, Nikolaos Kotsopoulos, Marcin Czech, Mark P Connolly, Andrew Pavelyev et al. · 9 Sept 2026

Abstract

OBJECTIVE: To evaluate the societal and fiscal impact of extending the current human papillomavirus (HPV) vaccination program in Poland (boys and girls aged 9-14 with average 20% vaccine coverage) by expanding age eligibility (9-17 years) and increasing vaccination coverage. METHODS: A cost-benefit analysis was conducted from both a macroeconomic (societal) and public economic (fiscal) perspective. A dynamic transmission model (DTM) was used to project the incidence and mortality of HPV-related diseases over a 100-year time horizon. Epidemiological outcomes were translated into economic outcomes using societal and fiscal frameworks incorporating productivity losses, tax revenues, and healthcare costs, and were compared with incremental vaccination costs. All costs and benefits were discounted at an annual rate of 3%. RESULTS: Compared with the current national immunization program, extending vaccination to boys and girls aged 9-17 and increasing coverage to 60% is projected to result in incremental reductions of 16% in HPV-related diseases and 13% in deaths. Achieving 90% coverage was associated with reductions of 33% in HPV-related diseases and 27% in deaths. These health gains are estimated to translate into societal benefits of EUR 4.5 billion and EUR 9.8 billion, and fiscal benefits of EUR 2.4 billion and EUR 5.1 billion, under the 60% and 90% coverage scenarios, respectively. Incremental vaccination costs are estimated at EUR 1.1 billion and EUR 2.1 billion for respective coverage scenarios. The benefit-cost analysis indicates that every EUR 1 invested yields returns of EUR 4.2 (societal) and EUR 2.2 (fiscal) at 60% coverage, and EUR 4.6 (societal) and EUR 2.4 (fiscal) at 90% coverage. All results represent incremental gains relative to the existing program. CONCLUSION: Expanding HPV vaccination eligibility and coverage in Poland is expected to generate substantial societal and fiscal returns. Higher vaccination coverage not only reduces the burden of HPV-related diseases and associated mortality but also delivers a strong and sustainable return on investment.