Comparison of model predictions of typhoid conjugate vaccine public health impact and cost-effectiveness.
Comparison of model predictions of typhoid conjugate vaccine public health impact and cost-effectiveness.
复制标题
伤寒结合疫苗公共卫生影响和成本效益的模型预测的比较。
DOI：
10.1016/j.vaccine.2022.12.032
复制
发表时间：
2023-01-23
期刊：
影响因子：
5.5
通讯作者：
Pitzer, Virginia E.
中科院分区：
文献类型：
--
作者：
Burrows, Holly;Antillon, Marina;Gauld, Jillian S.;Kim, Jong-Hoon;Mogasale, Vittal;Ryckman, Theresa;Andrews, Jason R.;Lo, Nathan C.;Pitzer, Virginia E.
关键词：
虽然模型预测各不相同，但伤寒结合疫苗可能具有成本效益。
不同的结构假设可以解释模型预测中的差异。
疫苗影响的静态模型估计不一定保守。
慢性携带者的贡献增加会降低预测的疫苗影响。
模型对于在流行地区部署伤寒结合疫苗（TCV）的政策决策是有用的。然而，方法的选择会影响模型预测的结果。为了对考虑到结构模型差异的TCV潜在公共卫生影响提供可靠的估计，我们比较了四种伤寒传播和疫苗影响的动态数学模型以及一种静态数学模型。所有模型都根据印度加尔各答特定年龄伤寒病例的一个通用数据集进行了拟合。我们评估了三种TCV策略：不接种疫苗、9个月龄时常规接种以及9个月龄时常规接种并开展一次性补种活动（9个月龄至15岁）。主要结果是接种疫苗后10年内有症状伤寒病例预测的减少百分比。对于进行了经济分析的三个模型（模型A - C），我们还比较了增量成本效益比（ICER），其计算方法是每避免一个伤残调整生命年（DALY）的增量成本（美元）。在乐观情景下（初始疫苗效力为95%，平均保护期为19年），常规接种预计在10年时间范围内使有症状病例减少10 - 46%，在悲观情景下（初始效力为82%，平均保护期为6年）减少2 - 16%。增加补种活动预计在乐观和悲观情景下分别使发病率降低36 - 90%和6 - 35%。随着慢性携带者对传播的相对贡献增加，疫苗影响预计会降低。模型A - C都预测，与不接种疫苗相比，有或没有补种活动的常规接种都具有成本效益，ICER在每避免一个DALY 95 - 789美元之间；两个模型预测单独常规接种的ICER大于增加补种活动的情况。尽管模型预测的疫苗影响和成本效益存在差异，但在加尔各答等高发病率地区，常规接种加上补种活动可能是有影响且具有成本效益的。
While model predictions varied, typhoid conjugate vaccines are likely cost-effective. Differing structural assumptions can explain discrepancies in model predictions. Static model estimates of vaccine impact are not necessarily conservative. Increasing the contribution of chronic carriers decreased predicted vaccine impact. Models are useful to inform policy decisions on typhoid conjugate vaccine (TCV) deployment in endemic settings. However, methodological choices can influence model-predicted outcomes. To provide robust estimates for the potential public health impact of TCVs that account for structural model differences, we compared four dynamic and one static mathematical model of typhoid transmission and vaccine impact. All models were fitted to a common dataset of age-specific typhoid fever cases in Kolkata, India. We evaluated three TCV strategies: no vaccination, routine vaccination at 9 months of age, and routine vaccination at 9 months with a one-time catch-up campaign (ages 9 months to 15 years). The primary outcome was the predicted percent reduction in symptomatic typhoid cases over 10 years after vaccine introduction. For three models with economic analyses (Models A-C), we also compared the incremental cost-effectiveness ratios (ICERs), calculated as the incremental cost (US$) per disability-adjusted life-year (DALY) averted. Routine vaccination was predicted to reduce symptomatic cases by 10–46 % over a 10-year time horizon under an optimistic scenario (95 % initial vaccine efficacy and 19-year mean duration of protection), and by 2–16 % under a pessimistic scenario (82 % initial efficacy and 6-year mean protection). Adding a catch-up campaign predicted a reduction in incidence of 36–90 % and 6–35 % in the optimistic and pessimistic scenarios, respectively. Vaccine impact was predicted to decrease as the relative contribution of chronic carriers to transmission increased. Models A-C all predicted routine vaccination with or without a catch-up campaign to be cost-effective compared to no vaccination, with ICERs varying from $95–789 per DALY averted; two models predicted the ICER of routine vaccination alone to be greater than with the addition of catch-up campaign. Despite differences in model-predicted vaccine impact and cost-effectiveness, routine vaccination plus a catch-up campaign is likely to be impactful and cost-effective in high incidence settings such as Kolkata.
登录
查看更多内容
DOI：
10.1093/infdis/jiab476
发表时间：
2021-12-20
期刊：
The Journal of infectious diseases
影响因子：
--
作者：
Khanam F;Darton TC;Meiring JE;Kumer Sarker P;Kumar Biswas P;Bhuiyan MAI;Hasan Rajib N;Tonks S;Pollard AJ;Clemens JD;Qadri F
通讯作者：
Qadri F
DOI：
10.1093/cid/ciy670
发表时间：
2019-04-08
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Gibani MM;Voysey M;Jin C;Jones C;Thomaides-Brears H;Jones E;Baker P;Morgan M;Simmons A;Gordon MA;Cerundolo V;Pitzer VE;Angus B;Levine MM;Darton TC;Pollard AJ
通讯作者：
Pollard AJ
DOI：
10.1073/pnas.0706849105
发表时间：
2008-03-25
影响因子：
11.1
作者：
Halloran, M. Elizabeth;Ferguson, Neil M.;Cooley, Philip
通讯作者：
Cooley, Philip
影响因子：
3.8
作者：
Gauld, Jillian S.;Hu, Hao;Levine, Myron M.
通讯作者：
Levine, Myron M.
DOI：
10.4269/ajtmh.2000.62.644
发表时间：
2000-05-01
影响因子：
3.3
作者：
Lin, FYC;Ho, VA;Robbins, JB
通讯作者：
Robbins, JB