期刊
JOURNAL OF INFECTIOUS DISEASES
卷 220, 期 6, 页码 920-931出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/infdis/jiy688
关键词
Zika; cost-effectiveness; vaccine
资金
- Bill & Melinda Gates Foundation [OPP1139051]
- Instituto Carlos Slim de la Salud
- National Institutes of Health [U01 GM087719, U01 GM105627, U54HD070725, U01 HD086861]
- Agency for Healthcare Research and Quality [R01HS023317]
- US Agency for International Development [AID-OAA-A-15-00064]
- Bill and Melinda Gates Foundation [OPP1139051] Funding Source: Bill and Melinda Gates Foundation
Background. While the 2015-2016 Zika epidemics prompted accelerated vaccine development, decision makers need to know the potential economic value of vaccination strategies. Methods. We developed models of Honduras, Brazil, and Puerto Rico, simulated targeting different populations for Zika vaccination (women of childbearing age, school-aged children, young adults, and everyone) and then introduced various Zika outbreaks. Sensitivity analyses varied vaccine characteristics. Results. With a 2% attack rate ($5 vaccination), compared to no vaccination, vaccinating women of childbearing age cost $314-$1664 per case averted ($790-$4221/disability-adjusted life-year [DALY] averted) in Honduras, and saved $847-$1644/case averted in Brazil, and $3648-$4177/case averted in Puerto Rico, varying with vaccination coverage and efficacy (societal perspective). Vaccinating school-aged children cost $718-$1849/case averted (<=$5002/DALY averted) in Honduras, saved $819-$1609/case averted in Brazil, and saved $3823-$4360/case averted in Puerto Rico. Vaccinating young adults cost $310-$1666/case averted ($731-$4017/DALY averted) in Honduras, saved $953-$1703/case averted in Brazil, and saved $3857-$4372/case averted in Puerto Rico. Vaccinating everyone averted more cases but cost more, decreasing cost savings per case averted. Vaccination resulted in more cost savings and better outcomes at higher attack rates. Conclusions. When considering transmission, while vaccinating everyone naturally averted the most cases, specifically targeting women of childbearing age or young adults was the most cost-effective.
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