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Potential health and economic impact of paediatric vaccination using next-generation influenza vaccines in Kenya: a modelling study
BACKGROUND: Influenza is a major year-round cause of respiratory illness in Kenya, particularly in children under 5. Current influenza vaccines result in short-term, strain-specific immunity and were found in a previous study not to be cost-effective in Kenya. However, next-generation vaccines are i...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10032252/ https://www.ncbi.nlm.nih.gov/pubmed/36949456 http://dx.doi.org/10.1186/s12916-023-02830-w |
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author | Waterlow, Naomi R. Radhakrishnan, Sreejith Dawa, Jeanette van Leeuwen, Edwin Procter, Simon R. Lambach, Philipp Bresee, Joseph Mazur, Marie Eggo, Rosalind M. Jit, Mark |
author_facet | Waterlow, Naomi R. Radhakrishnan, Sreejith Dawa, Jeanette van Leeuwen, Edwin Procter, Simon R. Lambach, Philipp Bresee, Joseph Mazur, Marie Eggo, Rosalind M. Jit, Mark |
author_sort | Waterlow, Naomi R. |
collection | PubMed |
description | BACKGROUND: Influenza is a major year-round cause of respiratory illness in Kenya, particularly in children under 5. Current influenza vaccines result in short-term, strain-specific immunity and were found in a previous study not to be cost-effective in Kenya. However, next-generation vaccines are in development that may have a greater impact and cost-effectiveness profile. METHODS: We expanded a model previously used to evaluate the cost-effectiveness of seasonal influenza vaccines in Kenya to include next-generation vaccines by allowing for enhanced vaccine characteristics and multi-annual immunity. We specifically examined vaccinating children under 5 years of age with improved vaccines, evaluating vaccines with combinations of increased vaccine effectiveness, cross-protection between strains (breadth) and duration of immunity. We evaluated cost-effectiveness using incremental cost-effectiveness ratios (ICERs) and incremental net monetary benefits (INMBs) for a range of values for the willingness-to-pay (WTP) per DALY averted. Finally, we estimated threshold per-dose vaccine prices at which vaccination becomes cost-effective. RESULTS: Next-generation vaccines can be cost-effective, dependent on the vaccine characteristics and assumed WTP thresholds. Universal vaccines (assumed to provide long-term and broad immunity) are most cost-effective in Kenya across three of four WTP thresholds evaluated, with the lowest median value of ICER per DALY averted ($263, 95% Credible Interval (CrI): $ − 1698, $1061) and the highest median INMBs. At a WTP of $623, universal vaccines are cost-effective at or below a median price of $5.16 per dose (95% CrI: $0.94, $18.57). We also show that the assumed mechanism underlying infection-derived immunity strongly impacts vaccine outcomes. CONCLUSIONS: This evaluation provides evidence for country-level decision makers about future next-generation vaccine introduction, as well as global research funders about the potential market for these vaccines. Next-generation vaccines may offer a cost-effective intervention to reduce influenza burden in low-income countries with year-round seasonality like Kenya. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12916-023-02830-w. |
format | Online Article Text |
id | pubmed-10032252 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-100322522023-03-23 Potential health and economic impact of paediatric vaccination using next-generation influenza vaccines in Kenya: a modelling study Waterlow, Naomi R. Radhakrishnan, Sreejith Dawa, Jeanette van Leeuwen, Edwin Procter, Simon R. Lambach, Philipp Bresee, Joseph Mazur, Marie Eggo, Rosalind M. Jit, Mark BMC Med Research Article BACKGROUND: Influenza is a major year-round cause of respiratory illness in Kenya, particularly in children under 5. Current influenza vaccines result in short-term, strain-specific immunity and were found in a previous study not to be cost-effective in Kenya. However, next-generation vaccines are in development that may have a greater impact and cost-effectiveness profile. METHODS: We expanded a model previously used to evaluate the cost-effectiveness of seasonal influenza vaccines in Kenya to include next-generation vaccines by allowing for enhanced vaccine characteristics and multi-annual immunity. We specifically examined vaccinating children under 5 years of age with improved vaccines, evaluating vaccines with combinations of increased vaccine effectiveness, cross-protection between strains (breadth) and duration of immunity. We evaluated cost-effectiveness using incremental cost-effectiveness ratios (ICERs) and incremental net monetary benefits (INMBs) for a range of values for the willingness-to-pay (WTP) per DALY averted. Finally, we estimated threshold per-dose vaccine prices at which vaccination becomes cost-effective. RESULTS: Next-generation vaccines can be cost-effective, dependent on the vaccine characteristics and assumed WTP thresholds. Universal vaccines (assumed to provide long-term and broad immunity) are most cost-effective in Kenya across three of four WTP thresholds evaluated, with the lowest median value of ICER per DALY averted ($263, 95% Credible Interval (CrI): $ − 1698, $1061) and the highest median INMBs. At a WTP of $623, universal vaccines are cost-effective at or below a median price of $5.16 per dose (95% CrI: $0.94, $18.57). We also show that the assumed mechanism underlying infection-derived immunity strongly impacts vaccine outcomes. CONCLUSIONS: This evaluation provides evidence for country-level decision makers about future next-generation vaccine introduction, as well as global research funders about the potential market for these vaccines. Next-generation vaccines may offer a cost-effective intervention to reduce influenza burden in low-income countries with year-round seasonality like Kenya. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12916-023-02830-w. BioMed Central 2023-03-22 /pmc/articles/PMC10032252/ /pubmed/36949456 http://dx.doi.org/10.1186/s12916-023-02830-w Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Waterlow, Naomi R. Radhakrishnan, Sreejith Dawa, Jeanette van Leeuwen, Edwin Procter, Simon R. Lambach, Philipp Bresee, Joseph Mazur, Marie Eggo, Rosalind M. Jit, Mark Potential health and economic impact of paediatric vaccination using next-generation influenza vaccines in Kenya: a modelling study |
title | Potential health and economic impact of paediatric vaccination using next-generation influenza vaccines in Kenya: a modelling study |
title_full | Potential health and economic impact of paediatric vaccination using next-generation influenza vaccines in Kenya: a modelling study |
title_fullStr | Potential health and economic impact of paediatric vaccination using next-generation influenza vaccines in Kenya: a modelling study |
title_full_unstemmed | Potential health and economic impact of paediatric vaccination using next-generation influenza vaccines in Kenya: a modelling study |
title_short | Potential health and economic impact of paediatric vaccination using next-generation influenza vaccines in Kenya: a modelling study |
title_sort | potential health and economic impact of paediatric vaccination using next-generation influenza vaccines in kenya: a modelling study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10032252/ https://www.ncbi.nlm.nih.gov/pubmed/36949456 http://dx.doi.org/10.1186/s12916-023-02830-w |
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