Cost-effectiveness analysis of typhoid conjugate vaccines in five endemic low- and middle-income settings

Vaccine
Marina AntillónVirginia E Pitzer

Abstract

Typhoid fever remains endemic in low- and middle-income countries. Programmatic use of existing vaccines is limited, but upcoming typhoid conjugate vaccines (TCVs) could warrant wider use. We evaluated the cost-effectiveness of five TCV delivery strategies in three urban areas (Delhi and Kolkata, India and Nairobi, Kenya) and two rural settings (Lwak, Kenya and Dong Thap, Vietnam) with varying incidence. We evaluated routine infant vaccination with and without catch-up campaigns among older individuals. We used a dynamic model of typhoid transmission to simulate cases, hospitalizations, deaths, disability-adjusted life-years (DALY) lost, treatment and intervention costs. We estimated cost-effectiveness (in terms of cost in international dollars (I$) per DALY averted) from the healthcare payer perspective, and assessed how it was influenced by uncertain model parameters. Compared to no vaccination, routine infant vaccination at I$1/dose was cost-saving in Delhi and Dong Thap, "very cost-effective" in Kolkata and Nairobi, and "cost-effective" in Lwak according to World Health Organization thresholds. However, routine vaccination was not the optimal strategy compared to strategies that included a catch-up campaign, which yielded t...Continue Reading

Citations

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Mar 8, 2019·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Samantha KaufholdVirginia E Pitzer
Apr 3, 2020·Expert Review of Vaccines·Peter J O'ReillyAndrew J Pollard
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Jun 15, 2021·Vaccine·Akashdeep Singh ChauhanShankar Prinja

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