 This study assessed the public health impact and cost-effectiveness of expanded catch-up HPV vaccination through age 45 compared to status quo, using an HPV Dynamic Transmission Infection and Disease Model. The results show that expanding catch-up vaccination would prevent additional cancers, cervical intraepithelial neoplasia, 2,3s, genital warts, and deaths compared with status quo at a cost of 41,000 QALY. With NHANES coverage, the ICER was 6,000 QALY. The June 2019 ACIP recommendation also provided public health benefits with an ICER of 17,000 QALY and expanding catch-up through age 34 improved cost-effectiveness to 7,000 QALY. This article was authored by Vincent Daniels, Vymalanand S Prabhu, Kodi Parma, and others.