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Comparison of static and dynamic models of maternal immunization to prevent infant pertussis in Brazil
- Source :
- Vaccine
- Publication Year :
- 2021
- Publisher :
- Elsevier Science, 2021.
-
Abstract
- Highlights • Dynamic transmission models of infectious disease capture the herd immunity effects of vaccination. • We compared dynamic and static models of maternal acellular pertussis (aP) immunization built with Brazilian data. • At infant vaccine coverage 90–95%. • The background effect of routine infant vaccination is critical to the cost-effectiveness of maternal aP immunization.<br />Background This paper compares cost-effectiveness results from two models of maternal immunization to prevent pertussis in infants in Brazil, one static, one dynamic, to explore when static models are adequate for public health decisions and when the extra effort required by dynamic models is worthwhile. Methods We defined two scenarios to explore key differences between static and dynamic models, herd immunity and time horizon. Scenario 1 evaluates the incremental cost/DALY of maternal acellular pertussis (aP) immunization as routine infant vaccination coverage ranges from low/moderate up to, and above, the threshold at which herd immunity begins to eliminate pertussis. Scenario 2 compares cost-effectiveness estimates over the models’ different time horizons. Maternal vaccine prices of $9.55/dose (base case) and $1/dose were evaluated. Results The dynamic model shows that maternal immunization could be cost-saving as well as life-saving at low levels of infant vaccination coverage. When infant coverage reaches the threshold range (90–95%), it is expensive: the dynamic model estimates that maternal immunization costs $2 million/DALY at infant coverage > 95% and maternal vaccine price of $9.55/dose; at $1/dose, cost/DALY is $200,000. By contrast, the static model estimates costs/DALY only modestly higher at high than at low infant coverage. When the models’ estimates over their different time horizons are compared at infant coverage
- Subjects :
- Marginal cost
medicine.medical_specialty
Dynamic transmission model
Cost effectiveness
Whooping Cough
animal diseases
Cost-Benefit Analysis
030231 tropical medicine
Population
Context (language use)
chemical and pharmacologic phenomena
Article
Herd immunity
03 medical and health sciences
0302 clinical medicine
Pertussis
Medicine
Humans
030212 general & internal medicine
education
health care economics and organizations
Pertussis Vaccine
education.field_of_study
General Veterinary
General Immunology and Microbiology
business.industry
Immunization Programs
Public health
Vaccination
Public Health, Environmental and Occupational Health
Infant
Immunization (finance)
biochemical phenomena, metabolism, and nutrition
Infectious Diseases
Maternal immunization
Static model
Molecular Medicine
bacteria
Cost-effectiveness
Immunization
Infectious disease model
business
Brazil
Demography
Subjects
Details
- Language :
- English
- ISSN :
- 18732518 and 0264410X
- Volume :
- 39
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Vaccine
- Accession number :
- edsair.doi.dedup.....3f2344d89cb58f6802603fda1a39b514