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Evaluating the cost-effectiveness of maternal pertussis immunization in low- and middle-income countries: A review of lessons learnt
- Source :
- Vaccine
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- This issue of Vaccine is devoted to papers from a research project that developed two types of simulation models, static and dynamic transmission, to evaluate the cost-effectiveness of maternal immunization to prevent pertussis in infants in low- and middle-income countries (LMICs). The research was conducted by a multinational team of investigators and funded by the Bill & Melinda Gates Foundation to gain an understanding of when and where maternal immunization might be a good public health investment for LMICs. Here we review the project’s central lessons for vaccine policy and research. Models require a lot of data. As most LMICs lack good data, the models were built using pertussis disease burden data from Brazil, a middle-income country with three long-established, independent information systems (disease surveillance, hospitalization, and mortality), on the hypothesis that the disease process is similar across countries. Values for key parameters, particularly infant mortality, infant vaccine coverage, and costs of vaccination and treatment, were then varied to represent other LMICs. The results show that coverage levels of infant whole cell pertussis (wP) vaccine are key to the cost-effectiveness of maternal pertussis immunization. In settings where infant wP coverage is below the threshold thought necessary to eliminate pertussis in the population, 90–95%, maternal immunization is cost-effective, even cost-saving. By contrast, it is very expensive in countries capable of maintaining infant vaccination in or above the threshold range. The research also suggests that, while static models may serve to explore an intervention’s cost-effectiveness initially, dynamic transmission models are essential for more accurate estimates. These findings can help guide policies toward maternal pertussis immunization, but also show that developing better data on neonatal pertussis mortality burden and infant vaccine coverage in LMICs, and on the duration of immunity of currently available pertussis vaccines, are key priorities to support better vaccine policy.
- Subjects :
- Dynamic transmission model
medicine.medical_specialty
Whooping Cough
Cost effectiveness
Cost-Benefit Analysis
030231 tropical medicine
Population
03 medical and health sciences
0302 clinical medicine
Pertussis
Environmental health
Vaccine policy
medicine
Humans
Infant vaccination
030212 general & internal medicine
education
Developing Countries
Disease burden
Pertussis Vaccine
education.field_of_study
Disease surveillance
General Veterinary
General Immunology and Microbiology
Immunization Programs
business.industry
Public health
Vaccination
Public Health, Environmental and Occupational Health
Infant
Infant mortality
Editorial
Infectious Diseases
Immunization
Maternal immunization
Molecular Medicine
Cost-effectiveness
business
Brazil
Subjects
Details
- ISSN :
- 0264410X
- Volume :
- 39
- Database :
- OpenAIRE
- Journal :
- Vaccine
- Accession number :
- edsair.doi.dedup.....76ed0de3279a3eace5832e41b4525660