Forecasting dengue vaccine demand in disease endemic and non-endemic countries
Forecasting dengue vaccine demand in disease endemic and non-endemic countries
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DOI：
10.4161/hv.6.9.12587
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发表时间：
2010-09-01
期刊：
影响因子：
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通讯作者：
Mahoney, Richard T.
中科院分区：
文献类型：
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作者：
Amarasinghe, Ananda;Wichmann, Ole;Mahoney, Richard T.
背景：大规模临床试验中的登革热疫苗可能在几年内获得许可。我们估计了54个登革热流行国家和来自非登革热流行国家的旅行者对不同引进策略的潜在疫苗需求，使疫苗生产商和公共卫生机构能够更好地为疫苗的及时利用做好准备。结果：根据我们的假设，在引进登革热疫苗后的头五年，将需要24 - 35亿剂登革热疫苗，其中公共部门提供的疫苗数量为75%。在20个潜在的“早期采用”国家中，估计需要9- 14亿剂疫苗来采用相同的引进方法。对于私营部门，估计需要为10%的儿童和30%的成人接种4.43 - 6.64亿剂疫苗。在非流行国家，旅行者估计可以使用5900万至8900万剂疫苗，尽管目前的产品概况使其不太可能及时接种疫苗。方法：计算基于亚洲和美洲流行国家2015-2020年人口预测，人口为10万。对于登革热流行国家，我们假设在全国范围内常规接种12-23个月疫苗，并在2-14岁儿童中采用2或3剂接种计划进行补种。对预期疫苗接种覆盖率的假设基于具体国家公共、私营和旅行者部门的免疫接种绩效。结论：我们的结果预测了疫苗需求的上限估计，实际需求取决于国家优先事项、成本和产品概况。鉴于登革热疫苗的潜力，登革热流行国家和非登革热流行国家的决策者应在发放许可证之前考虑适当的实施战略。
Background: A dengue vaccine in large-scale clinical trials could be licensed in several years. We estimated the potential vaccine demand for different introduction strategies in 54 dengue-endemic countries and for travelers from non-endemic countries to enable vaccine producers and public health agencies to better prepare for timely utilization of the vaccine.Results: Under our assumptions, 2.4-3.5 billion dengue vaccine doses would be needed in the first five years after introduction with >75% delivered in the public sector. Among 20 potential 'early-adopter' countries, an estimated 0.9-1.4 billion doses would be needed for the same introduction approach. For the private sector, covering 10% of children and 30% of adults an estimated 443-664 million doses would be required. In non-endemic countries, travelers could use an estimated 59-89 million vaccine doses, although the present product profile would make it unlikely to be able to administer vaccine in a timely manner.Methods: Calculations were based on 2015-2020 population projections for endemic countries in Asia and the Americas with populations >100,000. For dengue-endemic countries we assumed country-wide routine 12-23 month-old vaccination and catch-up vaccination among 2-14 year-old children employing a 2 or 3-dose schedule. Assumptions on expected vaccination coverage were based on country-specific public, private and travelers' sectors immunization performance.Conclusions: Our results project an upper-limit estimate of vaccine demand, with actual demand depending on country priorities, cost and product profile. Given the potential for a dengue vaccine, policymakers in endemic and non-endemic countries should consider appropriate implementation strategies in advance of licensure.