Distemper in a Dolphin

12-year-old girls only is dominated by the vaccination of 18-year-old women plus a catch-up strategy (women 18–24 years of age), although older groups have lower coverages. In addition, I point out 2 particulars. First, epidemiology of HPV varies between countries (2), probably because of differences in culture and sexual habits. Thus, vaccination at older ages should be considered in countries in which prevalence of adolescent sexual activity or HPV is low. Second, higher vaccine coverage in older groups would decrease ICERs of these strategies (1). Both facts could refl ect the real situation in some countries, e.g., Spain (2,3). In conclusion, economic evaluations of HPV vaccination strategies should have broader sensitivity analysis to include as many country-specifi c realities as possible. To avoid misunderstandings that could lead policymakers to misallocate funds, these results should be evident to readers.