目的：相较于世界平均水平，中国的人乳头瘤病毒（HPV）相关疾病负担颇重，而为年轻适龄女性接种HPV疫苗经许多研究论证，是HPV防治的最佳策略。然而，目前针对是否应对适龄的男性儿童同时进行HPV疫苗接种，进一步避免HPV的传播，并防止其他例如生殖器疣等男性也相关的疾病负担，中国尚未有明确定论。本研究将对比包括男童在内的不同疫苗接种方案进行卫生经济学评价，为卫生部门制定HPV相关防治政策提供理论依据。方法：本研究利用TreeAge Pro2022构建马尔科夫模型，建立100,000名13岁儿童的队列，模拟高危HPV16/18与低危HPV6/11的自然病程（包括子宫颈癌与生殖器疣）直至队列自然死亡，并结合覆盖男女的不同疫苗接种方案（二价、四价）对其进行卫生经济学评价。模型中使用了中国HPV相关流行病学数据、治疗、疫苗成本以及3%贴现率等参数，以及1倍人均GDP作为意愿支付阈值。结果：在五种不同疫苗接种方案对比下，与无疫苗接种的基线方案相比，任何不同男女疫苗接种方案可以减少26.02%~27.16%的子宫颈癌前病变、10.38%~11.32%的子宫颈癌、0%~27.04%的生殖器疣的发病风险，挽救10787至59935生命年，增加1787至5935的贴现QALY以及增加的总效益值为152851523至473268355元。当HPV主要防治效果目标为可挽救生命年时，男女儿童同时实施四价疫苗的接种计划为最具有经济性的优选方案，ICER为534.50元，即每多挽救一个生命年，仅需额外花费534.50元，即非常符合成本效果原则。在成本效用分析中，男女儿童同时实施四价疫苗的接种计划所产出的效用是最多的，ICUR为5455.16元/QALY，小于WTP阈值并且符合成本效用原则。在进行敏感性分析后，模型参数值的改变并不影响研究结果，蒙特卡洛模拟后的结果也证实了模型的可靠性。结论：研究结果表明，在不考虑成本以及疫苗供给的限制性条件下，相较于仅对女性儿童开展疫苗接种，增加适龄男性儿童至HPV疫苗受众人群是具有经济性的方案。模型中使用了中国人均GDP作为意愿支付阈值，当各省市在实施开展HPV疫苗接种计划之前，应参考当地的经济情况、疫苗供给量以及HPV相关发病率，进一步调整模型参数，制定出适合当地情况的疫苗接种策略。

Objective: China bears a significant burden of human papillomavirus (HPV)-related diseases compared to the global average. Numerous studies have demonstrated that vaccination of young eligible females with HPV vaccines is the most effective strategy for HPV prevention and control. However, a clear consensus regarding the vaccination of eligible male children with HPV vaccines to further prevent HPV transmission and other male-related diseases, such as genital warts, is lacking in China. This study aims to compare various vaccination strategies, including those targeting male children, using a health economics evaluation to provide a theoretical foundation for health departments in formulating HPV-related prevention and control policies.Methods: In this study, a Markov model was constructed using TreeAge Pro2022, creating a cohort of 100,000 13-year-old children. The model simulates the natural progression of high-risk HPV16/18 and low-risk HPV6/11 (including cervical cancer and genital warts) until the cohort‘s natural mortality. The health economics evaluation of different vaccination strategies (bivalent and quadrivalent) was conducted for both males and females. Chinese HPV-related epidemiological data, treatment, vaccine costs, a 3% discount rate, and a willingness-to-pay threshold equivalent to the GDP per capita were utilized in the model.Results: In comparison to the baseline scenario of no vaccination, any of the five different male and female vaccination programs can reduce the incidence risk of cervical cancer precursors by 26.02% to 27.16%, cervical cancer by 10.38% to 11.32%, and genital warts by 0% to 27.04%, saving 10,787 to 59,935 life years, increasing 1,787 to 5,935 discounted quality-adjusted life years (QALYs), and generating a total benefit value of 152,851,523 to 473,268,355 yuan. When the measurement of effectiveness is life years saved, the implementation of a quadrivalent vaccine program for both boys and girls is the most cost-effective option with ICER of 534.50 which means to save one additional life year, only an extra cost of CNY 534.50 is needed, which is considered to be highly cost-effectiveness. In cost-utility analysis, the simultaneous implementation of a quadrivalent vaccine program for boys and girls produces the most utility, with an incremental cost-effectiveness ratio (ICUR) of CNY 5,455.16 /QALY, which is below the willingness-to-pay (WTP) threshold and consistent with the cost-effectiveness principle. After sensitivity analysis, the changes in model parameter values do not affect the analysis results, and the results of Monte Carlo simulation also confirm the reliability of the model.Conclusion: The findings of this study suggest that, without considering cost and vaccine supply constraints, including eligible male children in the HPV vaccine target population is an economically viable option compared to vaccinating female children only. The model employs China‘s GDP per capita as the willingness-to-pay threshold. Before implementing an HPV vaccination program, provinces and cities should consider local economic conditions and vaccine supply to further adjust model parameters and develop vaccination strategies suitable for their specific circumstances. This research offers valuable insights for health departments in formulating comprehensive and effective HPV-related prevention and control policies that take into account both male and female populations, ultimately contributing to a broader reduction in the burden of HPV-related diseases.