Comparison of Strategies for Typhoid Conjugate Vaccine Introduction in India: A Cost-Effectiveness Modeling Study
| Autor: | Gagandeep Kang, Nathan Lo, Jacob John, Dilesh Kumar, Yanjia Cao, Theresa Ryckman, Arun S Karthikeyan, Jason R. Andrews, Jeremy D. Goldhaber-Fiebert |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Vaccines Conjugate Immunization Programs business.industry Cost effectiveness Cost-Benefit Analysis Typhoid-Paratyphoid Vaccines Vaccination India medicine.disease Typhoid fever Infectious Diseases Conjugate vaccine Humans Immunology and Allergy Medicine Typhoid Fever Child business Intensive care medicine Enteric fever |
| Zdroj: | The Journal of Infectious Diseases. 224:S612-S624 |
| ISSN: | 1537-6613 0022-1899 |
| Popis: | Background Typhoid fever causes substantial global mortality, with almost half occurring in India. New typhoid vaccines are highly effective and recommended by the World Health Organization for high-burden settings. There is a need to determine whether and which typhoid vaccine strategies should be implemented in India. Methods We assessed typhoid vaccination using a dynamic compartmental model, parameterized by and calibrated to disease and costing data from a recent multisite surveillance study in India. We modeled routine and 1-time campaign strategies that target different ages and settings. The primary outcome was cost-effectiveness, measured by incremental cost-effectiveness ratios (ICERs) benchmarked against India’s gross national income per capita (US$2130). Results Both routine and campaign vaccination strategies were cost-saving compared to the status quo, due to averted costs of illness. The preferred strategy was a nationwide community-based catchup campaign targeting children aged 1–15 years alongside routine vaccination, with an ICER of $929 per disability-adjusted life-year averted. Over the first 10 years of implementation, vaccination could avert 21–39 million cases and save $1.6–$2.2 billion. These findings were broadly consistent across willingness-to-pay thresholds, epidemiologic settings, and model input distributions. Conclusions Despite high initial costs, routine and campaign typhoid vaccination in India could substantially reduce mortality and was highly cost-effective. |
| Databáze: | OpenAIRE |
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