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Coudeville L, Gomez GB, Jollivet O, Harris RC, Thommes E, Druelles S, Chit A, Chaves SS, Mahé C. Exploring uncertainty and risk in the accelerated response to a COVID-19 vaccine: Perspective from the pharmaceutical industry. Vaccine 2020; 38:7588-7595. [PMID: 33097312 PMCID: PMC7552977 DOI: 10.1016/j.vaccine.2020.10.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/29/2020] [Accepted: 10/11/2020] [Indexed: 12/21/2022]
Affiliation(s)
- L Coudeville
- Vaccine Epidemiology and Modeling, Sanofi Pasteur, 14 Espace Henry Vallée, 69007 Lyon, France.
| | - G B Gomez
- Vaccine Epidemiology and Modeling, Sanofi Pasteur, 14 Espace Henry Vallée, 69007 Lyon, France; Department of Global Health and Development, London School of Hygiene and Tropical Medicine, UK
| | - O Jollivet
- Vaccine Epidemiology and Modeling, Sanofi Pasteur, 14 Espace Henry Vallée, 69007 Lyon, France
| | - R C Harris
- Vaccine Epidemiology and Modeling. Sanofi Pasteur, 38 Beach Road, 189767, Singapore; Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, UK
| | - E Thommes
- Vaccine Epidemiology and Modeling, Sanofi Pasteur, Discovery Drive, Swiftwater, PA 18370, USA; Department of Mathematics and Statistics, University of Guelph, Canada
| | - S Druelles
- Vaccine Epidemiology and Modeling, Sanofi Pasteur, 14 Espace Henry Vallée, 69007 Lyon, France
| | - A Chit
- Vaccine Epidemiology and Modeling, Sanofi Pasteur, Discovery Drive, Swiftwater, PA 18370, USA; Leslie Dan Faculty of Pharmacy, University of Toronto, Canada
| | - S S Chaves
- Vaccine Epidemiology and Modeling, Sanofi Pasteur, 14 Espace Henry Vallée, 69007 Lyon, France.
| | - C Mahé
- Vaccine Epidemiology and Modeling, Sanofi Pasteur, 14 Espace Henry Vallée, 69007 Lyon, France
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Espul C, Cuello H, Lo Castro I, Bravo C, Thollot Y, Voznica J, Vigne C, Coudeville L. Statistical modeling alongside observational data predicts long-term immunogenicity of one dose and two doses of pediatric hepatitis A vaccine in the Mendoza province of Argentina. Vaccine 2020; 38:1715-1722. [PMID: 31928855 DOI: 10.1016/j.vaccine.2019.12.049] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 12/19/2019] [Accepted: 12/20/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Follow-up for anti-hepatitis A (HA) antibody persistence up to 10 years was conducted after implementation of universal vaccination against HA virus (HAV) in Mendoza, Argentina. Based on these data, statistical modeling was used to predict the antibody persistence to 30 years. METHODS A non-interventional study evaluated long-term immunogenicity (geometric mean concentrations [GMCs] and seroprotection rate) following routine vaccination with 1 dose (Group 1: N = 436) or 2 doses (Group 2: N = 108) of HA vaccine. Associated statistical modeling based on a Bayesian approach of mixed effects models on log transformed titers evaluated three models (linear, piecewise linear, and exponential decay, with and without a natural boosting effect). RESULTS From the initial cohort, 9 participants (Group 1) and 1 participant (Group 2) showed antibody titers below the seroprotective threshold and received a booster. At Year 10, 190 (Group 1) and 51 (Group 2) participants remained in the study without a booster dose and all were seroprotected. Regarding statistical modeling, the piecewise linear model showed the best fit and demonstrated high and similar seroprotection for each schedule up to 30 years (89% [1-dose schedule], 85% [2-dose schedule]). The 2-dose schedule showed higher GMC (95% CI) than the 1-dose schedule (Year 10: 352 [271-456] versus 78 [69.8-87.6] mIU/mL) and Year 30 (predicted) (37 [13-97] versus 19 [11-34] mIU/mL). Natural boosting had little impact on predicted seroprotection rates at 30 years for the 1-dose schedule (89% [0.8-0.96] and 84% [0.73-0.94] with and without a natural booster, respectively). CONCLUSIONS Long-term persistence of anti-HAV antibodies was observed up to 10 years with 1-dose and 2-dose vaccine schedules, supporting booster flexibility. Statistical modeling predicted good persistence of seroprotection for each schedule up to 30 years. Natural boosting had a limited impact on seroprotection rate predictions, enabling extrapolation of these results to non-endemic settings for traveler vaccination.
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Affiliation(s)
- C Espul
- Ministerio de Salud/Hospital Central de Mendoza, Mendoza, Argentina.
| | - H Cuello
- Seccíon Virología, Hospital Central de Mendoza, Mendoza, Argentina
| | - I Lo Castro
- Seccíon Virología, Hospital Central de Mendoza, Mendoza, Argentina
| | - C Bravo
- Sanofi Pasteur, Lyon, France.
| | | | - J Voznica
- Sanofi Pasteur, Lyon, France; Department of Biology, École Normale Supérieure Paris-Saclay, Cachan, France.
| | - C Vigne
- Sanofi Pasteur, Lyon, France.
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Dorigatti I, Donnelly CA, Laydon DJ, Small R, Jackson N, Coudeville L, Ferguson NM. Refined efficacy estimates of the Sanofi Pasteur dengue vaccine CYD-TDV using machine learning. Nat Commun 2018; 9:3644. [PMID: 30194294 PMCID: PMC6128884 DOI: 10.1038/s41467-018-06006-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 08/03/2018] [Indexed: 01/08/2023] Open
Abstract
CYD-TDV is the first licensed dengue vaccine for individuals 9-45 (or 60) years of age. Using 12% of the subjects enroled in phase-2b and phase-3 trials for which baseline serostatus was measured, the vaccine-induced protection against virologically confirmed dengue during active surveillance (0-25 months) was found to vary with prior exposure to dengue. Because age and dengue exposure are highly correlated in endemic settings, refined insight into how efficacy varies by serostatus and age is essential to understand the increased risk of hospitalisation observed among vaccinated individuals during the long-term follow-up and to develop safe and effective vaccination strategies. Here we apply machine learning to impute the baseline serostatus for subjects with post-dose 3 titres but missing baseline serostatus. We find evidence for age dependence in efficacy independent of serostatus and estimate that among 9-16 year olds, CYD-TDV is protective against serotypes 1, 3 and 4 regardless of baseline serostatus.
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Affiliation(s)
- I Dorigatti
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, Norfolk Place, London,, W2 1PG, UK.
| | - C A Donnelly
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, Norfolk Place, London,, W2 1PG, UK
| | - D J Laydon
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, Norfolk Place, London,, W2 1PG, UK
| | - R Small
- Sanofi Pasteur, 2501 Discovery Dr, Orlando, FL, 32826, USA
| | - N Jackson
- Sanofi Pasteur, 1541 Avenue Marcel Mérieux, 69280, Marcy l'Étoile, France
| | - L Coudeville
- Sanofi Pasteur, 14, Espace Henry Vallee, 690077, Lyon, France
| | - N M Ferguson
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, Norfolk Place, London,, W2 1PG, UK
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Coudeville L, Baurin N, Shepard D, Halasa Y. Potential impact and economic value of dengue vaccination in 10 endemic countries. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.02.386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Bailleux F, Coudeville L, Kolenc-Saban A, Bevilacqua J, Barreto L, André P. Predicted long-term persistence of pertussis antibodies in adolescents after an adolescent and adult formulation combined tetanus, diphtheria, and 5-component acellular pertussis vaccine, based on mathematical modeling and 5-year observed data. Vaccine 2008; 26:3903-8. [DOI: 10.1016/j.vaccine.2008.04.089] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2007] [Revised: 04/21/2008] [Accepted: 04/28/2008] [Indexed: 11/17/2022]
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Coudeville L, van Rie A, Andre P. Adult pertussis vaccination strategies and their impact on pertussis in the United States: evaluation of routine and targeted (cocoon) strategies. Epidemiol Infect 2008; 136:604-20. [PMID: 17612417 PMCID: PMC2870855 DOI: 10.1017/s0950268807009041] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2007] [Indexed: 11/05/2022] Open
Abstract
A compartmental, age-structured mathematical model was developed and recent US pertussis epidemiology data were used to evaluate the impact on pertussis infection rates of routine and targeted adult immunization strategies. Model simulations predict that the implementation of adolescent immunization only could reverse the current rise in pertussis infection rates but may lead to a resurgence of pertussis in subsequent decades. In contrast, inclusion of a routine adult strategy is likely to lead to sustained control of pertussis. Routine adult vaccination could control the disease even with relatively low coverage rates of 40% for routine vaccination of all adults every 10 years, or 65% for a targeted vaccination of close contacts of newborns completed by one booster dose for all adults. The model also predicts that the optimal age for this booster dose is 40 years. These results support the 2006 American Academy of Immunization Practices' recommendations for adolescent and adult vaccination against pertussis.
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Caro JJ, Möller J, Getsios D, Coudeville L, El-Hadi W, Chevat C, Nguyen VH, Caro I. Invasive meningococcal disease epidemiology and control measures: a framework for evaluation. BMC Public Health 2007; 7:130. [PMID: 17603880 PMCID: PMC1925079 DOI: 10.1186/1471-2458-7-130] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2006] [Accepted: 06/29/2007] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Meningococcal disease can have devastating consequences. As new vaccines emerge, it is necessary to assess their impact on public health. In the absence of long-term real world data, modeling the effects of different vaccination strategies is required. Discrete event simulation provides a flexible platform with which to conduct such evaluations. METHODS A discrete event simulation of the epidemiology of invasive meningococcal disease was developed to quantify the potential impact of implementing routine vaccination of adolescents in the United States with a quadrivalent conjugate vaccine protecting against serogroups A, C, Y, and W-135. The impact of vaccination is assessed including both the direct effects on individuals vaccinated and the indirect effects resulting from herd immunity. The simulation integrates a variety of epidemiologic and demographic data, with core information on the incidence of invasive meningococcal disease and outbreak frequency derived from data available through the Centers for Disease Control and Prevention. Simulation of the potential indirect benefits of vaccination resulting from herd immunity draw on data from the United Kingdom, where routine vaccination with a conjugate vaccine has been in place for a number of years. Cases of disease are modeled along with their health consequences, as are the occurrence of disease outbreaks. RESULTS When run without a strategy of routine immunization, the simulation accurately predicts the age-specific incidence of invasive meningococcal disease and the site-specific frequency of outbreaks in the Unite States. 2,807 cases are predicted annually, resulting in over 14,000 potential life years lost due to invasive disease. In base case analyses of routine vaccination, life years lost due to infection are reduced by over 45% (to 7,600) when routinely vaccinating adolescents 12 years of age at 70% coverage. Sensitivity analyses indicate that herd immunity plays an important role when this population is targeted for vaccination. While 1,100 cases are avoided annually when herd immunity effects are included, in the absence of any herd immunity, the number of cases avoided with routine vaccination falls to 380 annually. The duration of vaccine protection also strongly influences results. CONCLUSION In the absence of appropriate real world data on outcomes associated with large-scale vaccination programs, decisions on optimal immunization strategies can be aided by discrete events simulations such as the one described here. Given the importance of herd immunity on outcomes associated with routine vaccination, published estimates of the economic efficiency of routine vaccination with a quadrivalent conjugate vaccine in the United States may have considerably underestimated the benefits associated with a policy of routine immunization of adolescents.
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Affiliation(s)
- J Jaime Caro
- Caro Research Institute, 336 Baker, Concord, MA, USA
- Division of General Internal Medicine and Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Jörgen Möller
- Caro Research Institute, Vaggarpsvagen 11, SE24193 Eslov, Sweden
| | - Denis Getsios
- Caro Research Institute, 6415 Seaforth Street, Halifax, NS B3L 1R4, Canada
| | - L Coudeville
- sanofi pasteur, 2 Ave du Pont Pasteur, 69367 Lyon cedex 07, Lyon, France
| | | | - Catherine Chevat
- sanofi pasteur, 2 Ave du Pont Pasteur, 69367 Lyon cedex 07, Lyon, France
| | - Van Hung Nguyen
- sanofi pasteur, 2 Ave du Pont Pasteur, 69367 Lyon cedex 07, Lyon, France
| | - Ingrid Caro
- Caro Research Institute, 185 Dorval Ave., Montreal, Quebec, H9S 5J9, Canada
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Getsios D, Caro J, Caro I, El-Hadi W, O’Brien JA, Chevat C, Coudeville L, Nguyen VH. 393: Health Economic Burden of Invasive Meningococcal Disease in the Us. J MöLler,. Am J Epidemiol 2005. [DOI: 10.1093/aje/161.supplement_1.s99] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- D Getsios
- Caro Research Institute, Eslov, SWEDEN
| | - J Caro
- Caro Research Institute, Eslov, SWEDEN
| | - I Caro
- Caro Research Institute, Eslov, SWEDEN
| | - W El-Hadi
- Caro Research Institute, Eslov, SWEDEN
| | | | - C Chevat
- Caro Research Institute, Eslov, SWEDEN
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Yazdanpanah Y, Goldie SJ, Paltiel AD, Losina E, Coudeville L, Weinstein MC, Gerard Y, Kimmel AD, Zhang H, Salamon R, Mouton Y, Freedberg KA. Prevention of human immunodeficiency virus-related opportunistic infections in France: a cost-effectiveness analysis. Clin Infect Dis 2003; 36:86-96. [PMID: 12491207 DOI: 10.1086/344902] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2002] [Accepted: 09/17/2002] [Indexed: 11/03/2022] Open
Abstract
A simulation model of human immunodeficiency virus (HIV) disease, which incorporated French data on the progression of HIV disease in the absence of antiretroviral therapy and on cost, was used to determine the clinical impact and cost-effectiveness of different strategies for the prevention of opportunistic infections in French patients who receive highly active antiretroviral therapy (HAART). Compared with use of no prophylaxis, use of trimethoprim-sulfamethoxazole (TMP-SMZ) increased per-person lifetime costs from euro 185,600 to euro 187,900 and quality-adjusted life expectancy from 112.2 to 113.7 months, for an incremental cost-effectiveness ratio of euro 18,700 per quality-adjusted life-year (euro/QALY) gained. Compared with use of TMP-SMZ alone, use of TMP-SMZ plus azithromycin cost euro 23,900/QALY gained; adding fluconazole cost an additional euro 54,500/QALY gained. All strategies that included oral ganciclovir had cost-effectiveness ratios that exceeded euro 100,000/QALY gained. In the era of HAART, on the basis of French data, prophylaxis against Pneumocystis carinii pneumonia, toxoplasmic encephalitis, and Mycobacterium avium complex bacteremia is cost-effective. Prophylaxis against fungal and cytomegalovirus infections is less cost-effective than are other therapeutic options for HIV disease and should remain of lower priority.
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Affiliation(s)
- Y Yazdanpanah
- Service Universitaire des Maladies Infectieuses et du Voyageur, Centre Hospitalier de Tourcoing, Faculté de Médecine de Lille, Lille, France.
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Abstract
The purpose of the cost-benefit analysis described in this article is to determine the economic value of vaccination of healthy children against varicella in France. It is based on the results of two specific investigations--an epidemiological model and a prospective observational study (1832 cases studied) of the socio-economic consequences of varicella. This cost-benefit analysis was conducted from the viewpoint of the society and that of the patient, for vaccination coverage rates ranging from 10 to 90%. This analysis demonstrates the value of varicella vaccination when associated with measles-mumps-rubella (MMR) vaccination: if varicella and MMR vaccines are co-administered, the vaccination of 80% of the children against varicella leads to a reduction in medical costs associated with varicella including that of vaccination, ranging from 10 to 77% according to the values adopted for vaccination costs, varicella treatment costs, discount rate and vaccine efficacy. The results of this study also underline the benefits of a vaccination policy that aims to achieve a high rate of coverage, thereby reaping the highest benefit from vaccination, and also avoiding potential negative consequences.
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Affiliation(s)
- L Coudeville
- Centre de Recherches Economiques, Sociologiques et de Gestion (CRESGE-LABORES, URA-CNRS 362), Lille, France
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Sailly JC, Lebrun T, Coudeville L. [Cost-effective approach to the screening of HIV, HBV, HCV, HTLV in blood donors in France]. Rev Epidemiol Sante Publique 1997; 45:131-41. [PMID: 9221442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
In order to provide greater safety in blood transfusions, public health authorities have imposed the use of screening tests. The purpose of this paper is to estimate the cost-effectiveness ratios of the screening test used in France. Four risks were studied: HIV, HBV, HCV and HTLV. Two efficiency measures were used: cost per positive blood donation detected and cost per case of prevented infection transmission. Moreover, for HTLV alone, the efficiency was estimated by the cost per prevented pathology. Data concerning the costs were provided by the French Blood Agency; those concerning the results of the screening campaigns were provided by the official health authorities, the other data used in the calculations were drawn either from the French Blood Agency data or from a review of international literature. Results gave information about the expenditure devoted to the screening of virologic risks associated with blood transfusion in France (250 million francs per year for the four viruses studied). They stressed the differences in screening efficiency according to the test studied (the cost by prevented seroconversion varied from 31,795 francs for HBV, 72,180 francs for HCV, 676,596 francs for HIV to 6,137,346 francs for HTLV screening test in the base case) and especially the very low efficiency of the systematic screening of the HTLV virus (from 34 to 307 million francs per prevented leukemia).
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