PIN33 - A DYNAMIC TRANSMISSION MODEL TO ESTIMATE THE PUBLIC HEALTH IMPACT AND COST-EFFECTIVENESS OF TRIVALENT INFLUENZA VACCINE HIGH DOSE FOR THE ELDERLY POPULATION IN ENGLAND AND WALES

The worldwide endeavour to develop safe and effective COVID-19 vaccines has been extraordinary, and vaccination is now underway in many countries. However, the doses available in 2021 are likely to be limited. We extended a mathematical model of SARS-CoV-2 transmission across different country settings to evaluate the public health impact of potential vaccines using WHO-developed target product profiles. We identified optimal vaccine allocation strategies within- and between-countries to maximise averted deaths under constraints on dose supply. We found that the health impact of SARS-CoV-2 vaccination depends on the cumulative population-level infection incidence when vaccination begins, the duration of natural immunity, the trajectory of the epidemic prior to vaccination, and the level of healthcare available to effectively treat those with disease. Within a country we find that for a limited supply (doses for <20% of the population) the optimal strategy is to target the elderly. However, with a larger supply, if vaccination can occur while other interventions are maintained, the optimal strategy switches to targeting key transmitters to indirectly protect the vulnerable. As supply increases, vaccines that reduce or block infection have a greater impact than those that prevent disease alone due to the indirect protection provided to high-risk groups. Given a 2 billion global dose supply in 2021, we find that a strategy in which doses are allocated to countries proportional to population size is close to optimal in averting deaths and aligns with the ethical principles agreed in pandemic preparedness planning.

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The Public Health Impact and Cost-Effectiveness of School-Based Nine-Valent Human Papillomavirus Female Vaccination Compared with BI-Valent and Quadrivalent Vaccination in Malaysia

Value in Health ◽

10.1016/j.jval.2018.07.047 ◽

2018 ◽

Vol 21 ◽

pp. S7

Author(s):

Y Woo ◽

T Hsu ◽

A Pavelyev ◽

R LeVan ◽

VS Prabhu

Keyword(s):

Public Health ◽

Human Papillomavirus ◽

Cost Effectiveness ◽

Health Impact ◽

Public Health Impact ◽

The Public ◽

School Based

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Cost-effectiveness of alternative strategies for vaccination of adolescents against serogroup B IMD with the MenB-FHbp vaccine in Canada

Can J Public Health ◽

10.17269/s41997-019-00275-4 ◽

2020 ◽

Vol 111 (2) ◽

pp. 182-192 ◽

Cited By ~ 1

Author(s):

Marie-Claude Breton ◽

Liping Huang ◽

Sonya J. Snedecor ◽

Noelle Cornelio ◽

Fiorella Fanton-Aita

Keyword(s):

Cost Effectiveness ◽

Disease Incidence ◽

Health Impact ◽

Population Based ◽

Quality Adjusted Life Year ◽

Transmission Model ◽

Immunization Strategies ◽

Dynamic Transmission Model ◽

Significant Public Health ◽

The Impact

Abstract Objective Serogroup B meningococci (MnB) are now the largest cause of invasive meningococcal disease (IMD) in Canada. We assessed the clinical and economic impact of 3 adolescent MenB-FHbp immunization strategies. Methods A population-based dynamic transmission model was developed to simulate the transmission of MnB among the entire Canadian population over a 30-year time horizon. Age group-based IMD incidence, bacterial carriage and transmission, disease outcomes, costs, and impact on quality of life were obtained from Canadian surveillance data and published literature. The vaccine was assumed to provide 85% protection against IMD and 26.6% against carriage acquisition. The model estimated the impact of routine vaccination with MenB-FHbp in 3 strategies: (1) age 14, along with existing school-based programs, with 75% uptake; (2) age 17 with 75% uptake, assuming school vaccination; and (3) age 17 with 30% uptake, assuming vaccination outside of school. Costs were calculated from the Canadian societal perspective. Results With no vaccination, an estimated 3974 MnB cases would be expected over 30 years. Vaccination with strategies 1–3 were estimated to avert 688, 1033, and 575 cases, respectively. These outcomes were associated with incremental costs per quality-adjusted life-year of $976,000, $685,000, and $490,000. Conclusions Our model indicated that if the vaccine reduces risk of carriage acquisition, vaccination of older adolescents, even at lower uptake, could have a significant public health impact. Due to low disease incidence, MnB vaccination is unlikely to meet widely accepted cost-effectiveness thresholds, but evaluations of new programs should consider the overall benefits of the vaccination.

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