1
|
Hasso-Agopsowicz M, Sparrow E, Cameron AM, Sati H, Srikantiah P, Gottlieb S, Bentsi-Enchill A, Le Doare K, Hamel M, Giersing BK, Hausdorff WP. The role of vaccines in reducing antimicrobial resistance: A review of potential impact of vaccines on AMR and insights across 16 vaccines and pathogens. Vaccine 2024; 42:S1-S8. [PMID: 38876836 DOI: 10.1016/j.vaccine.2024.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 05/01/2024] [Accepted: 06/04/2024] [Indexed: 06/16/2024]
Abstract
In 2019, an estimated 4.95 million deaths were linked to antimicrobial resistance (AMR). Vaccines can prevent many of these deaths by averting both drug-sensitive and resistant infections, reducing antibiotic usage, and lowering the likelihood of developing resistance genes. However, their role in mitigating AMR is currently underutilized. This article builds upon previous research that utilizes Vaccine Value Profiles-tools that assess the health, socioeconomic, and societal impact of pathogens-to inform vaccine development. We analyze the effects of 16 pathogens, covered by Vaccine Value Profiles, on AMR, and explore how vaccines could reduce AMR. The article also provides insights into vaccine development and usage. Vaccines are crucial in lessening the impact of infectious diseases and curbing the development of AMR. To fully realize their potential, vaccines must be more prominently featured in the overall strategy to combat AMR. This requires ongoing investment in research and development of new vaccines and the implementation of additional prevention and control measures to address this global threat effectively.
Collapse
Affiliation(s)
- Mateusz Hasso-Agopsowicz
- Vaccine Product & Delivery Research, Department of Immunization, Vaccines & Biologicals, World Health Organization, Geneva, Switzerland.
| | - Erin Sparrow
- Vaccine Product & Delivery Research, Department of Immunization, Vaccines & Biologicals, World Health Organization, Geneva, Switzerland
| | - Alexandra Meagan Cameron
- Global Coordination and Partnership (GCP), Antimicrobial Resistance Division, World Health Organization, Geneva, Switzerland
| | - Hatim Sati
- Global Coordination and Partnership (GCP), Antimicrobial Resistance Division, World Health Organization, Geneva, Switzerland
| | | | - Sami Gottlieb
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Adwoa Bentsi-Enchill
- Vaccine Product & Delivery Research, Department of Immunization, Vaccines & Biologicals, World Health Organization, Geneva, Switzerland
| | | | - Mary Hamel
- Vaccine Product & Delivery Research, Department of Immunization, Vaccines & Biologicals, World Health Organization, Geneva, Switzerland
| | - Birgitte K Giersing
- Vaccine Product & Delivery Research, Department of Immunization, Vaccines & Biologicals, World Health Organization, Geneva, Switzerland
| | - William P Hausdorff
- Center for Vaccine Access and Innovation, PATH, WA DC, USA; Université Libre de Bruxelles, Brussels, Belgium
| |
Collapse
|
2
|
Martin LB, Tack B, Marchello CS, Sikorski MJ, Owusu-Dabo E, Nyirenda T, Mogasale V, Crump JA. Vaccine value profile for invasive non-typhoidal Salmonella disease. Vaccine 2024; 42:S101-S124. [PMID: 39003017 DOI: 10.1016/j.vaccine.2024.04.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 04/12/2024] [Accepted: 04/14/2024] [Indexed: 07/15/2024]
Abstract
Invasive non-typhoidal Salmonella (iNTS) disease is an under-recognized high-burden disease causing major health and socioeconomic issues in sub-Saharan Africa (sSA), predominantly among immune-naïve infants and young children, including those with recognized comorbidities such as HIV infection. iNTS disease is primarily caused by Salmonella enterica serovar Typhimurium sequence type (ST) 313 and 'African-restricted clades' of Salmonella Enteritidis ST11 that have emerged across the African continent as a series of epidemics associated with acquisition of new antimicrobial resistance. Due to genotypes with a high prevalence of antimicrobial resistance and scarcity of therapeutic options, these NTS serovars are designated by the World Health Organization as a priority pathogen for research and development of interventions, including vaccines, to address and reduce NTS associated bacteremia and meningitis in sSA. Novel and traditional vaccine technologies are being applied to develop vaccines against iNTS disease, and the results of the first clinical trials in the infant target population should become available in the near future. The "Vaccine Value Profile" (VVP) addresses information related predominantly to invasive disease caused by Salmonella Enteritidis and Salmonella Typhimurium prevalent in sSA. Information is included on stand-alone iNTS disease candidate vaccines and candidate vaccines targeting iNTS disease combined with another invasive serotype, Salmonella Typhi, that is also common across sSA. Out of scope for the first version of this VVP is a wider discussion on either diarrheagenic NTS disease (dNTS) also associated with Salmonella Enteritidis and Salmonella Typhimurium or the development of a multivalent Salmonella vaccines targeting key serovars for use globally. This VVP for vaccines to prevent iNTS disease is intended to provide a high-level, holistic assessment of the information and data that are currently available to inform the potential public health, economic, and societal value of pipeline vaccines and vaccine-like products. Future versions of this VVP will be updated to reflect ongoing activities such as vaccine development strategies and a "Full Vaccine Value Assessment" that will inform the value proposition of an iNTS disease vaccine. This VVP was developed by a working group of subject matter experts from academia, non-profit organizations, public private partnerships, and multi-lateral organizations, and in collaboration with stakeholders from the World Health Organization African Region. All contributors have extensive expertise on various elements of the iNTS disease VVP and collectively aimed to identify current research and knowledge gaps. The VVP was developed using only existing and publicly available information.
Collapse
Affiliation(s)
| | - Bieke Tack
- Department of Clinical Sciences, Institute of Tropical Medicine Antwerp, Belgium and Department of Microbiology, Immunology and Transplantation, KU Leuven, Belgium.
| | | | - Michael J Sikorski
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA.
| | | | | | | | - John A Crump
- Centre for International Health, University of Otago, New Zealand.
| |
Collapse
|
3
|
McElwee F, Newall A. The Value of Flexible Vaccine Manufacturing Capacity: Value Drivers, Estimation Methods, and Approaches to Value Recognition in Health Technology Assessment. PHARMACOECONOMICS 2024; 42:187-197. [PMID: 38819720 PMCID: PMC11230966 DOI: 10.1007/s40273-024-01396-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/12/2024] [Indexed: 06/01/2024]
Abstract
Expanding flexible vaccine manufacturing capacity (FVMC) for routine vaccines could facilitate more timely access to novel vaccines during future pandemics. Vaccine manufacturing capacity is 'flexible' if it is built on a technology platform that allows rapid adaption to new infectious agents. The added value of routine vaccines produced using a flexible platform for pandemic preparedness is not currently recognised in conventional health technology assessment (HTA) methods. We start by examining the current state of play of incentives for FVMC and exploring the relation between flexible and spare capacity. We then establish the key factors for estimating FVMC and draw from established frameworks to identify relevant value drivers. The role of FVMC as a countermeasure against pandemic risks is deemed an additional value attribute that should be recognised. Next, we address the gap in the vaccine-valuation literature between the conceptual understanding of the value of additional FVMC and the availability of accurate and reliable tools for its estimation to facilitate integration into HTA. Three practical approaches for estimating the value of additional FVMC are discussed: stated and revealed preference studies, macroeconomic modelling, and benefit-cost analysis. Lastly, we review how value recognition of additional FVMC can be realised within the HTA process for routine vaccines manufactured on flexible platforms. We argue that, while the value of additional FVMC is uncertain and further research is needed to help to better estimate it, the value of increased pandemic preparedness is likely to be too large to be ignored.
Collapse
Affiliation(s)
- Frederick McElwee
- Office of Health Economics, 2nd Floor, Goldings House, Hay's Galleria, London, SE1 2HB, UK.
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
| | - Anthony Newall
- School of Population Health, Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia
| |
Collapse
|
4
|
Smith DRM, Turner J, Fahr P, Attfield LA, Bessell PR, Donnelly CA, Gibb R, Jones KE, Redding DW, Asogun D, Ayodeji OO, Azuogu BN, Fischer WA, Jan K, Olayinka AT, Wohl DA, Torkelson AA, Dinkel KA, Nixon EJ, Pouwels KB, Hollingsworth TD. Health and economic impacts of Lassa vaccination campaigns in West Africa. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.02.26.24303394. [PMID: 38978680 PMCID: PMC11230338 DOI: 10.1101/2024.02.26.24303394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
Lassa fever is a zoonotic disease identified by the World Health Organization (WHO) as having pandemic potential. This study estimates the health-economic burden of Lassa fever throughout West Africa and projects impacts of a series of vaccination campaigns. We also model the emergence of "Lassa-X" - a hypothetical pandemic Lassa virus variant - and project impacts of achieving 100 Days Mission vaccination targets. Our model predicted 2.7M (95% uncertainty interval: 2.1M-3.4M) Lassa virus infections annually, resulting over ten years in 2.0M (793.8K-3.9M) disability-adjusted life years (DALYs). The most effective vaccination strategy was a population-wide preventive campaign primarily targeting WHO-classified "endemic" districts. Under conservative vaccine efficacy assumptions, this campaign averted $20.1M ($8.2M-$39.0M) in lost DALY value and $128.2M ($67.2M-$231.9M) in societal costs (International dollars 2021). Reactive vaccination in response to local outbreaks averted just one-tenth the health-economic burden of preventive campaigns. In the event of Lassa-X emerging, spreading throughout West Africa and causing approximately 1.2M DALYs within two years, 100 Days Mission vaccination averted 22% of DALYs given a vaccine 70% effective against disease, and 74% of DALYs given a vaccine 70% effective against both infection and disease. These findings suggest how vaccination could alleviate Lassa fever's burden and assist in pandemic preparedness.
Collapse
|
5
|
Hausdorff WP, Madhi SA, Kang G, Kaboré L, Tufet Bayona M, Giersing BK. Facilitating the development of urgently required combination vaccines. Lancet Glob Health 2024; 12:e1059-e1067. [PMID: 38636529 PMCID: PMC11099297 DOI: 10.1016/s2214-109x(24)00092-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/25/2024] [Accepted: 02/22/2024] [Indexed: 04/20/2024]
Abstract
The essence of a vaccine lies in its ability to elicit a set of immune responses specifically directed at a particular pathogen. Accordingly, vaccines were historically designed, developed, registered, recommended, procured, and administered as monopathogen formulations. Nonetheless, the control and elimination of an astonishing number of diseases was realised only after several once-separate vaccines were provided as combinations. Unfortunately, the current superabundance of recommended and pipeline vaccines is now at odds with the number of acceptable vaccine administrations and feasible health-care visits for vaccine recipients and health-care providers. Yet, few new combinations are in development because, in addition to the scientific and manufacturing hurdles intrinsic to coformulation, developers face a gauntlet of regulatory, policy, and commercialisation obstacles in a milieu still largely designed for monopathogen vaccines. We argue here that national policy makers and public health agencies should prospectively identify and advocate for the development of new multipathogen combination vaccines, and suggest ways to accelerate the regulatory pathways to licensure of combinations and other concrete, innovative steps to mitigate current obstacles.
Collapse
Affiliation(s)
- William P Hausdorff
- Center for Vaccine Innovation and Access, PATH, Washington, DC, USA; Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium.
| | - Shabir A Madhi
- South African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Lassané Kaboré
- PATH, Center for Vaccine Innovation and Access, Dakar, Senegal; Gavi, The Vaccine Alliance, Geneva, Switzerland
| | | | - Birgitte K Giersing
- WHO Department of Immunization, Vaccines and Biologicals, Geneva, Switzerland
| |
Collapse
|
6
|
Cassels FJ, Khalil I, Bourgeois AL, Walker RI. Special Issue on Enterotoxigenic Escherichia coli (ETEC) Vaccines: ETEC Infection and Vaccine-Mediated Immunity. Microorganisms 2024; 12:1087. [PMID: 38930469 PMCID: PMC11205504 DOI: 10.3390/microorganisms12061087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 05/21/2024] [Indexed: 06/28/2024] Open
Abstract
Enterotoxigenic Escherichia coli (ETEC) is the most prevalent bacterial pathogen causing young children to suffer acute watery diarrhea in Low- and Middle-Income Countries (LMICs) [...].
Collapse
Affiliation(s)
| | - Ibrahim Khalil
- Department of Global Health, University of Washington, Seattle, WA 98105, USA;
| | | | | |
Collapse
|
7
|
Seedat F, Procter S, Dangor Z, Leahy S, Santhanam S, John HB, Bassat Q, Aerts C, Abubakar A, Nasambu C, Libster R, Yanotti CS, Paul P, Chanda J, Gonçalves BP, Horváth-Puhó E, Lawn JE, Jit M. Long-term healthcare utilisation, costs and quality of life after invasive group B Streptococcus disease: a cohort study in five low-income and middle-income countries. BMJ Glob Health 2024; 9:e014367. [PMID: 38749511 PMCID: PMC11097862 DOI: 10.1136/bmjgh-2023-014367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 04/16/2024] [Indexed: 05/18/2024] Open
Abstract
INTRODUCTION There are no published data on the long-term impact of invasive group B Streptococcus disease (iGBS) on economic costs or health-related quality of life (HRQoL) in low-income and middle-income countries. We assessed the impact of iGBS on healthcare utilisation, costs and HRQoL in Argentina, India, Kenya, Mozambique and South Africa. METHODS Inpatient and outpatient visits, out-of-pocket (OOP) healthcare payments in the 12 months before study enrolment, and health-state utility of children and caregivers (using the EuroQol 5-Dimensions-3-Level) were collected from iGBS survivors and an unexposed cohort matched on site, age at recruitment and sex. We used logistic or Poisson regression for analysing healthcare utilisation and zero-inflated gamma regression models for family and health system costs. For HRQoL, we used a zero-inflated beta model of disutility pooled data. RESULTS 161 iGBS-exposed and 439 unexposed children and young adults (age 1-20) were included in the analysis. Compared with unexposed participants, iGBS was associated with increased odds of any healthcare utilisation in India (adjusted OR 11.2, 95% CI 2.9 to 43.1) and Mozambique (6.8, 95% CI 2.2 to 21.1) and more frequent healthcare visits (adjusted incidence rate ratio (IRR) for India 1.7 (95% CI 1.4 to 2.2) and for Mozambique 6.0 (95% CI 3.2 to 11.2)). iGBS was also associated with more frequent days in inpatient care in India (adjusted IRR 4.0 (95% CI 2.3 to 6.8) and Kenya 6.4 (95% CI 2.9 to 14.3)). OOP payments were higher in the iGBS cohort in India (adjusted mean: Int$682.22 (95% CI Int$364.28 to Int$1000.16) vs Int$133.95 (95% CI Int$72.83 to Int$195.06)) and Argentina (Int$244.86 (95% CI Int$47.38 to Int$442.33) vs Int$52.38 (95% CI Int$-1.39 to Int$106.1)). For all remaining sites, differences were in the same direction but not statistically significant for almost all outcomes. Health-state disutility was higher in iGBS survivors (0.08, 0.04-0.13 vs 0.06, 0.02-0.10). CONCLUSION The iGBS health and economic burden may persist for years after acute disease. Larger studies are needed for more robust estimates to inform the cost-effectiveness of iGBS prevention.
Collapse
Affiliation(s)
- Farah Seedat
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- Maternal, Adolescent, Reproductive & Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK
- Institute of Infection and Immunity, St George's University of London, London, UK
| | - Simon Procter
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- Maternal, Adolescent, Reproductive & Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Ziyaad Dangor
- Medical Research Council: Vaccines and Infectious Diseases Analytical Unit, Faculty of Health Sciences, University of the Witwatersrand Johannesburg, Johannesburg, Gauteng, South Africa
| | - Shannon Leahy
- Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand Johannesburg, Johannesburg, Gauteng, South Africa
| | - Sridhar Santhanam
- Neonatology Department, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
| | - Hima B John
- Neonatology Department, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
| | - Quique Bassat
- Centro de Investigação em Saúde de Manhiça, Manhica, Maputo, Mozambique
- Hospital Clínic, Universitat de Barcelona, ISGlobal, Barcelona, Spain
| | - Celine Aerts
- Hospital Clínic, Universitat de Barcelona, ISGlobal, Barcelona, Spain
| | - Amina Abubakar
- Neuroscience Research Group, Department of Clinical Sciences, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Institute of Human Development, The Aga Khan University - Kenya, Nairobi, Nairobi, Kenya
| | - Carophine Nasambu
- Neuroscience Research Group, Department of Clinical Sciences, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | | | | | - Proma Paul
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- Maternal, Adolescent, Reproductive & Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Jaya Chanda
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- Maternal, Adolescent, Reproductive & Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Bronner P Gonçalves
- Department of Comparative Biomedical Sciences, School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | | | - Joy E Lawn
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- Maternal, Adolescent, Reproductive & Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Mark Jit
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| |
Collapse
|
8
|
Dutt D, Mazzucato M, Torreele E. An mRNA technology transfer programme and economic sustainability in health care. Bull World Health Organ 2024; 102:344-351. [PMID: 38680466 PMCID: PMC11046156 DOI: 10.2471/blt.24.291388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 05/01/2024] Open
Abstract
The World Health Organization (WHO) set up the messenger ribonucleic acid (mRNA) technology transfer programme in June 2021 with a development hub in South Africa and 15 partner vaccine producers in middle-income countries. The goal was to support the sustainable development of and access to life-saving vaccines for people in these countries as a means to enhance epidemic preparedness and global public health. This initiative aims to build resilience and strengthen local vaccine research, and development and manufacturing capacity in different regions of the world, especially those areas that could not access coronavirus disease 2019 (COVID-19) vaccines in a timely way. This paper outlines the current global vaccine market and summarizes the findings of a case study on the mRNA technology transfer programme conducted from November 2022 to May 2023. The study was guided by the vision of the WHO Council on the Economics of Health for All to build an economy for health using its four work streams of value, finance, innovation and capacity. Based on the findings of the study, we offer a mission-oriented policy framework to support the mRNA technology transfer programme as a pilot for transformative change towards an ecosystem for health innovation for the common good. Parts of this vision have already been incorporated into the governance of the mRNA technology transfer programme, while other aspects, especially the common good approach, still need to be applied to achieve the goals of the programme.
Collapse
Affiliation(s)
- Devika Dutt
- King’s College London, Bush House NE 4.08, 30 Aldwych, WC2B 4BG, London, England
| | - Mariana Mazzucato
- Institute for Innovation and Public Purpose, University College London, London, England
| | | |
Collapse
|
9
|
White RG, Menzies NA, Portnoy A, Clark RA, Toscano CM, Weller C, Tufet Bayona M, Silal SP, Karron RA, Lee JS, Excler JL, Lauer JA, Giersing B, Lambach P, Hutubessy R, Jit M. The Full Value of Vaccine Assessments Concept-Current Opportunities and Recommendations. Vaccines (Basel) 2024; 12:435. [PMID: 38675817 PMCID: PMC11053419 DOI: 10.3390/vaccines12040435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 04/03/2024] [Accepted: 04/06/2024] [Indexed: 04/28/2024] Open
Abstract
For vaccine development and adoption decisions, the 'Full Value of Vaccine Assessment' (FVVA) framework has been proposed by the WHO to expand the range of evidence available to support the prioritization of candidate vaccines for investment and eventual uptake by low- and middle-income countries. Recent applications of the FVVA framework have already shown benefits. Building on the success of these applications, we see important new opportunities to maximize the future utility of FVVAs to country and global stakeholders and provide a proof-of-concept for analyses in other areas of disease control and prevention. These opportunities include the following: (1) FVVA producers should aim to create evidence that explicitly meets the needs of multiple key FVVA consumers, (2) the WHO and other key stakeholders should develop standardized methodologies for FVVAs, as well as guidance for how different stakeholders can explicitly reflect their values within the FVVA framework, and (3) the WHO should convene experts to further develop and prioritize the research agenda for outcomes and benefits relevant to the FVVA and elucidate methodological approaches and opportunities for standardization not only for less well-established benefits, but also for any relevant research gaps. We encourage FVVA stakeholders to engage with these opportunities.
Collapse
Affiliation(s)
- Richard G. White
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (R.A.C.); (M.J.)
| | - Nicolas A. Menzies
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA;
- Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA;
| | - Allison Portnoy
- Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA;
- Department of Global Health, Boston University School of Public Health, Boston, MA 02118, USA
| | - Rebecca A. Clark
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (R.A.C.); (M.J.)
| | - Cristiana M. Toscano
- Department of Collective Health, Institute for Tropical Medicine and Public Health, Federal University of Goiás (UFG), Goiânia 74690-900, Brazil;
| | | | | | - Sheetal Prakash Silal
- Modelling and Simulation Hub, Africa, Department of Statistical Sciences, University of Cape Town, Cape Town 7701, South Africa;
- Centre for Global Health, Nuffield Department of Medicine, Oxford University, Oxford OX3 7BN, UK
| | - Ruth A. Karron
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA;
| | - Jung-Seok Lee
- Policy and Economic Research Department, International Vaccine Institute, Seoul 08826, Republic of Korea;
| | | | - Jeremy A. Lauer
- Department of Management Science, Strathclyde Business School, Strathclyde University, Glasgow G1 1XQ, UK;
| | - Birgitte Giersing
- Immunization, Vaccines and Biologicals Department, WHO, 1211 Geneva, Switzerland; (B.G.); (P.L.); (R.H.)
| | - Philipp Lambach
- Immunization, Vaccines and Biologicals Department, WHO, 1211 Geneva, Switzerland; (B.G.); (P.L.); (R.H.)
| | - Raymond Hutubessy
- Immunization, Vaccines and Biologicals Department, WHO, 1211 Geneva, Switzerland; (B.G.); (P.L.); (R.H.)
| | - Mark Jit
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (R.A.C.); (M.J.)
| |
Collapse
|
10
|
Jansen M, Spasenoska D, Nadjib M, Ararso D, Hutubessy R, Kahn AL, Lambach P. National Immunization Program Decision Making Using the CAPACITI Decision-Support Tool: User Feedback from Indonesia and Ethiopia. Vaccines (Basel) 2024; 12:337. [PMID: 38543971 PMCID: PMC10974132 DOI: 10.3390/vaccines12030337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 03/05/2024] [Accepted: 03/06/2024] [Indexed: 04/21/2024] Open
Abstract
To ensure that limited domestic resources are invested in the most effective interventions, immunization programs in low- and middle-income countries (LMICs) must prioritize a growing number of new vaccines while considering opportunities to optimize the vaccine portfolio, as well as other components of the health system. There is a strong impetus for immunization decision-making to engage and coordinate various stakeholders across the health system in prioritization. To address this, national immunization program decision-makers in LMICs collaborated with WHO to structure deliberation among stakeholders and document an evidence-based, context-specific, and transparent process for prioritization or selection among multiple vaccination products, services, or strategies. The output of this effort is the Country-led Assessment for Prioritization on Immunization (CAPACITI) decision-support tool, which supports using multiple criteria and stakeholder perspectives to evaluate trade-offs affecting health interventions, taking into account variable data quality. Here, we describe the user feedback from Indonesia and Ethiopia, two initial countries that piloted the CAPACITI decision-support tool, highlighting enabling and constraining factors. Potential immunization program benefits and lessons learned are also summarized for consideration in other settings.
Collapse
Affiliation(s)
- Maarten Jansen
- Immunization, Vaccines and Biologicals Department, World Health Organization, 1202 Geneva, Switzerland; (R.H.); (A.-L.K.); (P.L.)
| | - Dijana Spasenoska
- Department of Social Policy, London School of Economics and Political Science, London WC2A 2AE, UK;
| | - Mardiati Nadjib
- Department of Health Policy and Administration, Faculty of Public Health, Universitas Indonesia, Depok 16424, Indonesia;
| | - Desalegn Ararso
- Ethiopian Public Health Institute, Addis Ababa 1242, Ethiopia;
| | - Raymond Hutubessy
- Immunization, Vaccines and Biologicals Department, World Health Organization, 1202 Geneva, Switzerland; (R.H.); (A.-L.K.); (P.L.)
| | - Anna-Lea Kahn
- Immunization, Vaccines and Biologicals Department, World Health Organization, 1202 Geneva, Switzerland; (R.H.); (A.-L.K.); (P.L.)
| | - Philipp Lambach
- Immunization, Vaccines and Biologicals Department, World Health Organization, 1202 Geneva, Switzerland; (R.H.); (A.-L.K.); (P.L.)
| |
Collapse
|
11
|
Trotter C, Giersing B, Lindstrand A, Bar-Zeev N, Cernuschi T, Franzel-Sassanpour L, Friede M, Hombach J, Jansen M, Hasso-Agopsowicz M, Koh M, Sim SY, Spasenoska D, Yeung KHT, Lambach P. A Practical Guide to Full Value of Vaccine Assessments. Vaccines (Basel) 2024; 12:201. [PMID: 38400184 PMCID: PMC10892982 DOI: 10.3390/vaccines12020201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/31/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024] Open
Abstract
Articulating the wide range of health, social and economic benefits that vaccines offer may help to overcome obstacles in the vaccine development pipeline. A framework to guide the assessment and communication of the value of a vaccine-the Full Value of Vaccine Assessment (FVVA)-has been developed by the WHO. The FVVA framework offers a holistic assessment of the value of vaccines, providing a synthesis of evidence to inform the public health need of a vaccine, describing the supply and demand aspects, its market and its impact from a health, financial and economic perspective. This paper provides a practical guide to how FVVAs are developed and used to support investment in vaccines, ultimately leading to sustained implementation in countries. The FVVA includes a range of elements that can be broadly categorised as synthesis, vaccine development narrative and defining vaccine impact and value. Depending on the features of the disease/vaccine in question, different elements may be emphasised; however, a standardised set of elements is recommended for each FVVA. The FVVA should be developed by an expert group who represent a range of stakeholders, perspectives and geographies and ensure a fair, coherent and evidence-based assessment of vaccine value.
Collapse
Affiliation(s)
- Caroline Trotter
- Disease Dynamics Unit, Department of Veterinary Medicine, University of Cambridge, Cambridge CB3 0ES, UK
- Imperial College, London W12 7TA, UK
| | - Birgitte Giersing
- Immunization Department, World Health Organization, 1202 Geneva, Switzerland; (B.G.); (L.F.-S.); (S.Y.S.); (K.H.T.Y.)
| | - Ann Lindstrand
- Immunization Department, World Health Organization, 1202 Geneva, Switzerland; (B.G.); (L.F.-S.); (S.Y.S.); (K.H.T.Y.)
| | - Naor Bar-Zeev
- Immunization Department, World Health Organization, 1202 Geneva, Switzerland; (B.G.); (L.F.-S.); (S.Y.S.); (K.H.T.Y.)
| | - Tania Cernuschi
- Immunization Department, World Health Organization, 1202 Geneva, Switzerland; (B.G.); (L.F.-S.); (S.Y.S.); (K.H.T.Y.)
| | - Lauren Franzel-Sassanpour
- Immunization Department, World Health Organization, 1202 Geneva, Switzerland; (B.G.); (L.F.-S.); (S.Y.S.); (K.H.T.Y.)
| | - Martin Friede
- Immunization Department, World Health Organization, 1202 Geneva, Switzerland; (B.G.); (L.F.-S.); (S.Y.S.); (K.H.T.Y.)
| | - Joachim Hombach
- Immunization Department, World Health Organization, 1202 Geneva, Switzerland; (B.G.); (L.F.-S.); (S.Y.S.); (K.H.T.Y.)
| | - Maarten Jansen
- Immunization Department, World Health Organization, 1202 Geneva, Switzerland; (B.G.); (L.F.-S.); (S.Y.S.); (K.H.T.Y.)
| | - Mateusz Hasso-Agopsowicz
- Immunization Department, World Health Organization, 1202 Geneva, Switzerland; (B.G.); (L.F.-S.); (S.Y.S.); (K.H.T.Y.)
| | - Mitsuki Koh
- Immunization Department, World Health Organization, 1202 Geneva, Switzerland; (B.G.); (L.F.-S.); (S.Y.S.); (K.H.T.Y.)
| | - So Yoon Sim
- Immunization Department, World Health Organization, 1202 Geneva, Switzerland; (B.G.); (L.F.-S.); (S.Y.S.); (K.H.T.Y.)
| | - Dijana Spasenoska
- Immunization Department, World Health Organization, 1202 Geneva, Switzerland; (B.G.); (L.F.-S.); (S.Y.S.); (K.H.T.Y.)
| | - Karene Hoi Ting Yeung
- Immunization Department, World Health Organization, 1202 Geneva, Switzerland; (B.G.); (L.F.-S.); (S.Y.S.); (K.H.T.Y.)
| | - Philipp Lambach
- Immunization Department, World Health Organization, 1202 Geneva, Switzerland; (B.G.); (L.F.-S.); (S.Y.S.); (K.H.T.Y.)
| |
Collapse
|
12
|
Montalbán-Hernández K, Cogollo-García A, Girón de Velasco-Sada P, Caballero R, Casanovas M, Subiza JL, Conejero L. MV130 in the Prevention of Recurrent Respiratory Tract Infections: A Retrospective Real-World Study in Children and Adults. Vaccines (Basel) 2024; 12:172. [PMID: 38400155 PMCID: PMC10893268 DOI: 10.3390/vaccines12020172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/25/2024] [Accepted: 01/30/2024] [Indexed: 02/25/2024] Open
Abstract
Respiratory tract infections (RTIs) are among the most common and important problems in clinical medicine, making antibiotics the gold standard therapeutic option regardless of their frequent viral etiology. Their excessive and inappropriate use contributes to the rapid rise of antibiotic resistance and underscores the need for alternative strategies, especially when dealing with recurrent RTIs. Prevention is the ideal alternative, but specific vaccines targeting a wide range of respiratory pathogens are scarce. MV130 is a sublingual bacterial vaccine that induces trained immunity and provides non-specific protection against respiratory pathogens in various clinical settings according to the concept of TIbV (Trained Immunity-based Vaccine). A retrospective real-world study (RWS) was conducted to evaluate the annual incidence of RTIs and the consumption of antibiotics before and after the administration of MV130, using data sourced from the medical records of 599 patients (186 children and 413 adults) who suffered from recurrent RTIs. The median number of infectious episodes in children was significantly reduced by more than 70% from 5 episodes (interquartile range (IQR) 4.0-6.0) to 1 (IQR, 0.0-2.0) (p < 0.001) after MV130. Similarly, in adults, the median number of episodes before MV130 immunization was 5 (IQR, 4.0-6.0), which dropped by more than 80% to 1 (IQR, 0.0-1.0) during the year following MV130 immunization (p < 0.001). The median number of antibiotic courses also significantly decreased for both children and adults by over 80% (p < 0.001). This RWS showed that MV130 is an effective strategy for the prevention of respiratory infections and the reduction of associated antibiotic consumption.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Laura Conejero
- Inmunotek S.L., 28805 Madrid, Spain; (K.M.-H.); (A.C.-G.); (P.G.d.V.-S.); (R.C.); (M.C.)
| |
Collapse
|
13
|
Hausdorff WP, Anderson JD, Bourgeois AL, Clifford A, Fleming JA, Muhib F, Pecenka C, Puett C, Riddle MS, Scheele S, Bagamian KH. Reassessing potential economic value and health impact of effective Shigella vaccines. Bull World Health Organ 2024; 102:65-74. [PMID: 38164339 PMCID: PMC10753284 DOI: 10.2471/blt.23.290163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/22/2023] [Accepted: 10/20/2023] [Indexed: 01/03/2024] Open
Abstract
The gram-negative bacterium Shigella is a leading cause of diarrheal morbidity and mortality in children in low- and middle-income countries. Several promising vaccine candidates are in late stages of clinical development against this increasingly antibiotic-resistant pathogen. However, considering the increasingly crowded and costly paediatric immunization schedule, and likely advent of other important new vaccines, it is unclear whether introduction of a Shigella vaccine would represent a high priority for international agencies or health ministries in low- and middle-income countries. To determine whether there is a compelling public health value proposition for a Shigella vaccine, we used the World Health Organization's Full Value of Vaccine Assessment analytic framework and formulated five broad scientific, policy, economic and commercial-related propositions regarding the development of a Shigella vaccine. We also explored the current regulatory, clinical, policy and commercial challenges to a Shigella-containing combination vaccine development and adoption. Through a series of literature reviews, expert consultations, social science field studies and model-based analyses, we addressed each of these propositions. As described in a series of separate publications that are synthesized here, we concluded that the economic and public health value of a Shigella vaccine may be greater than previously recognized, particularly if it is found to also be effective against less severe forms of diarrheal disease and childhood stunting. The decision by pharmaceutical companies to develop a standalone vaccine or a multipathogen combination will be a key factor in determining its relative prioritization by various stakeholders in low- and middle-income countries.
Collapse
Affiliation(s)
- William P Hausdorff
- Center for Vaccine Innovation and Access, PATH, 455 Massachusetts Avenue NW, Washington, D.C.20001, United States of America (USA)
| | | | - A Louis Bourgeois
- Center for Vaccine Innovation and Access, PATH, 455 Massachusetts Avenue NW, Washington, D.C.20001, United States of America (USA)
| | - Allison Clifford
- Center for Vaccine Innovation and Access, PATH, 455 Massachusetts Avenue NW, Washington, D.C.20001, United States of America (USA)
| | | | - Farzana Muhib
- Center for Vaccine Innovation and Access, PATH, 455 Massachusetts Avenue NW, Washington, D.C.20001, United States of America (USA)
| | | | - Chloe Puett
- Stony Brook University, Stony Brook, New York, USA
| | | | - Suzanne Scheele
- Center for Vaccine Innovation and Access, PATH, 455 Massachusetts Avenue NW, Washington, D.C.20001, United States of America (USA)
| | | |
Collapse
|
14
|
Espinal C, Becerra-Posada F, Torres JR. Improving Middle-Income Countries Access to Vaccines. A Blueprint to Overcome Current Challenges. Ann Glob Health 2023; 89:80. [PMID: 38025920 PMCID: PMC10668881 DOI: 10.5334/aogh.4151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 10/20/2023] [Indexed: 12/01/2023] Open
Abstract
The Global Health Consortium at Florida International University developed an end-to-end solution framework based on the input of a diverse panel of experts from middle-income country (MIC) government agencies, public health think tanks, academia, and nonprofit organizations to identify mechanisms to help MIC governments and stakeholders increase access to novel vaccines for infectious diseases. The resultant layout can be deployed to improve vaccine discovery and development, strengthen regulatory processes, and boost vaccine production, access, and implementation. Mechanisms include policies and incentives MIC governments can use to stimulate vaccine investment and activity, as well as actions government agencies can take together with other stakeholders to coordinate efforts or build capabilities. Through a series of individual virtual interviews, we engaged diverse experts from MIC government agencies, public health think tanks, academia, and nonprofit organizations who understand the vaccine ecosystem, immunization policies, and population health financing at global, regional, and country levels. Responses were mapped, and in-depth questions were prepared for a group virtual discussion. This paper is the result of such a group discussion. The panel identified clear opportunities for MICs to improve locally-driven innovations and future access to novel vaccines. It proposes a solution framework for countries considering investing in vaccine research and development and innovation to use as a guide to evaluate the steps they could take to improve such an environment and incentivize innovation in vaccine development. It is hoped that this end-to-end solution framework will become a key resource to help MICs strengthen policies and take more actions to make such improvements.
Collapse
Affiliation(s)
- Carlos Espinal
- Global Health Consortium (GHC), Department of Global Health - Robert Stempel College of Public Health & Social Work - Florida International University, US
| | - Francisco Becerra-Posada
- Global Health Consortium (GHC), Department of Global Health - Robert Stempel College of Public Health & Social Work - Florida International University, US
| | - Jaime R. Torres
- Infectious Diseases Section, Tropical Medicine Institute, Universidad Central de Venezuela, Venezuela
| |
Collapse
|
15
|
den Boon S, Ahmed S, Sarker AR. Economic evaluations of immunization programs as an indispensable tool for policymakers. BMC Health Serv Res 2023; 23:1284. [PMID: 37993890 PMCID: PMC10666433 DOI: 10.1186/s12913-023-10071-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 09/26/2023] [Indexed: 11/24/2023] Open
Abstract
Introducing new vaccines within national immunization programs requires careful consideration of disease- and vaccine-related issues as well as of the strength of the program and the affected health system. Economic evaluations play an essential role in this process. In this editorial, we set the context and invite contributions for a BMC Health Services Research Collection of articles titled 'Economic Evaluations of Vaccine Programs'.
Collapse
Affiliation(s)
| | - Sayem Ahmed
- Health Economics and Health Technology Assessment, School of Health and Wellbeing, University of Glasgow, Glasgow, UK.
| | - Abdur Razzaque Sarker
- Health Economics and Financing Research, Bangladesh Institute of Development Studies, Dhaka, Bangladesh.
- Health Economics Unit, Centre for Health Policy, The University of Melbourne, Melbourne, Australia.
| |
Collapse
|
16
|
Bresee J, Koh M, Chadwick C, Jit M, Soble A, Lambach P. The need and ongoing efforts to understand the full value of improved influenza vaccines. Vaccine 2023; 41:7044-7046. [PMID: 37872012 DOI: 10.1016/j.vaccine.2023.10.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/26/2023] [Accepted: 10/17/2023] [Indexed: 10/25/2023]
Affiliation(s)
| | - Mitsuki Koh
- Immunization, Vaccines and Biologicals Department, World Health Organization, Geneva, Switzerland
| | - Christopher Chadwick
- Epidemic and Pandemic Preparedness and Prevention Department, World Health Organization, Geneva, Switzerland
| | - Mark Jit
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Tropical Hygiene and Medicine, London, UK
| | - Adam Soble
- MMGH Consulting GmbH, Zurich, Switzerland
| | - Philipp Lambach
- Immunization, Vaccines and Biologicals Department, World Health Organization, Geneva, Switzerland
| |
Collapse
|
17
|
Giersing B, Karron R, Tufet-Bayona M, Trotter C, Lambach P, Jit M. Vaccine Value Profiles. Vaccine 2023; 41 Suppl 2:S1-S2. [PMID: 37455159 DOI: 10.1016/j.vaccine.2023.06.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Affiliation(s)
- Birgitte Giersing
- Team Lead, Vaccine Prioritization & Platforms, WHO Department of Immunization, Vaccines and Biologicals, Secretariat for WHO PDVAC, Switzerland
| | - Ruth Karron
- Professor of International Health, Johns Hopkins University, Chair of WHO PDVAC, United States
| | | | - Caroline Trotter
- Professor of Global Health, University of Cambridge, United Kingdom
| | - Philipp Lambach
- Team Lead, a.i, Value of Vaccines, WHO Department of Immunization, Vaccines and Biologicals, Secretariat for WHO Immunization and Vaccines Related Implementation Research Advisory Committee (IVIR-AC), Switzerland
| | - Mark Jit
- Professor of Vaccine Epidemiology, London School of Hygiene & Tropical Medicine (LSHTM) and visiting professor at the School of Public Health, University of Hong Kong, WHO PDVAC Member, United Kingdom
| |
Collapse
|
18
|
Fu H, Abbas K, Malvolti S, Gregory C, Ko M, Amorij JP, Jit M. Impact and cost-effectiveness of measles vaccination through microarray patches in 70 low-income and middle-income countries: mathematical modelling and early-stage economic evaluation. BMJ Glob Health 2023; 8:e012204. [PMID: 37949503 PMCID: PMC10649680 DOI: 10.1136/bmjgh-2023-012204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 10/01/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Microarray patches (MAPs) are a promising technology being developed to reduce barriers to vaccine delivery based on needles and syringes (N&S). To address the evidence gap on the public health value of applying this potential technology to immunisation programmes, we evaluated the health impact on measles burden and cost-effectiveness of introducing measles-rubella MAPs (MR-MAPs) in 70 low-income and middle-income countries (LMICs). METHODS We used an age-structured dynamic model of measles transmission and vaccination to project measles cases, deaths and disability-adjusted life-years during 2030-2040. Compared with the baseline scenarios with continuing current N&S-based practice, we evaluated the introduction of MR-MAPs under different measles vaccine coverage projections and MR-MAP introduction strategies. Costs were calculated based on the ingredients approach, including direct cost of measles treatment, vaccine procurement and vaccine delivery. Model-based burden and cost estimates were derived for individual countries and country income groups. We compared the incremental cost-effectiveness ratios of introducing MR-MAPs to health opportunity costs. RESULTS MR-MAP introduction could prevent 27%-37% of measles burden between 2030 and 2040 in 70 LMICs, compared with the N&S-only immunisation strategy. The largest health impact could be achieved under lower coverage projection and accelerated introduction strategy, with 39 million measles cases averted. Measles treatment cost is a key driver of the net cost of introduction. In countries with a relatively higher income, introducing MR-MAPs could be a cost-saving intervention due to reduced treatment costs. Compared with country-specific health opportunity costs, introducing MR-MAPs would be cost-effective in 16%-81% of LMICs, depending on the MR-MAPs procurement prices and vaccine coverage projections. CONCLUSIONS Introducing MR-MAPs in LMICs can be a cost-effective strategy to revitalise measles immunisation programmes with stagnant uptake and reach undervaccinated children. Sustainable introduction and uptake of MR-MAPs has the potential to improve vaccine equity within and between countries and accelerate progress towards measles elimination.
Collapse
Affiliation(s)
- Han Fu
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Kaja Abbas
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
- Public Health Foundation of India, New Delhi, India
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | | | | | - Melissa Ko
- MMGH Consulting GmbH, Zurich, Switzerland
| | | | - Mark Jit
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
- School of Public Health, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| |
Collapse
|
19
|
Waterlow NR, Procter SR, Eggo RM, Jit M. Correspondence to: Estimating the full health and economic benefits of current and future influenza vaccines. BMC Med 2023; 21:301. [PMID: 37559086 PMCID: PMC10411004 DOI: 10.1186/s12916-023-02996-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 07/20/2023] [Indexed: 08/11/2023] Open
Abstract
We recently published an article in BMC Medicine looking at the potential health and economic impact of paediatric vaccination using next-generation influenza vaccines in Kenya: a modelling study. In their commentary on our article, Lafond et al. highlight the potential importance of the wider benefits of vaccination on cost-effectiveness. Whilst we agree with many points raised in the commentary, we think it raises further interesting discussion points, specifically around model complexity, model assumptions and data availability. These points are both relevant to this manuscript but have wider implications for vaccine cost-effectiveness studies.
Collapse
Affiliation(s)
- Naomi R Waterlow
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, London, UK.
| | - Simon R Procter
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, London, UK
| | - Rosalind M Eggo
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, London, UK
| | - Mark Jit
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, London, UK
| |
Collapse
|