建议各国定期为青春期女孩接种一剂或两剂人乳头瘤病毒（HPV）疫苗，以消除宫颈癌这一公共卫生问题。由于现有 HPV 疫苗接种计划的国家（主要是高收入国家）吸收了大部分现有疫苗剂量，因此到 2022 年新国家引进的供应量有限；其中许多是死亡率较高的低收入和中等收入国家。免疫战略咨询专家组考虑了多种疫苗接种策略，以允许更多国家在供应有限的情况下引入疫苗接种。我们研究了从 2020 年到 2030 年向 100 个预引入国家分配有限疫苗剂量的九种策略的影响。两种算法用于优化全球范围内通过有限剂量（背包和特定国家死亡率的降序）可以避免的癌症死亡总数，并使用未优化的算法（人类发展指数的降序）。无论分配算法如何，为 14 岁女孩接种一剂或两剂疫苗，并在供应不再受限时转为常规 9 岁儿童疫苗接种计划，可以预防大多数宫颈癌死亡。未经优化的分配可以避免更少的死亡，因为它首先分配给高收入国家，通常宫颈癌死亡率较低。为了在供应有限的情况下优化通过疫苗接种避免的死亡，重要的是优先考虑高负担国家并首先为年龄较大的女孩接种疫苗。世界卫生组织，比尔

Countries are recommended to immunise adolescent girls routinely with one or two doses of human papillomavirus (HPV) vaccines to eliminate cervical cancer as a public health problem. With most existing vaccine doses absorbed by countries (mostly high-income) with existing HPV vaccination programmes, limited supply has been left for new country introductions until 2022; many of those, low- and middle-income countries with higher mortality. Several vaccination strategies were considered by the Strategic Advisory Group of Experts on Immunization to allow more countries to introduce vaccination despite constrained supplies.We examined the impact of nine strategies for allocating limited vaccine doses to 100 pre-introduction countries from 2020 to 2030. Two algorithms were used to optimise the total number of cancer deaths that can be averted worldwide by a limited number of doses (knapsack and decreasing order of country-specific mortality rates), and an unoptimised algorithm (decreasing order of Human Development Index) were used.Routinely vaccinating 14-year-old girls with either one or two doses and switching to a routine 9-year-old programme when supply is no longer constrained could prevent the most cervical cancer deaths, regardless of allocation algorithm. The unoptimised allocation averts fewer deaths because it allocates first to higher-income countries, usually with lower cervical cancer mortality.To optimise the deaths averted through vaccination when supply is limited, it is important to prioritise high-burden countries and vaccinating older girls first.WHO, Bill & Melinda Gates Foundation.© 2024 The Authors.