No abstract

No abstract

Entering vaccine data into immunization records through barcode scanning led to improved data quality, and was generally well received. Further work is needed to improve barcode readability, particularly for unit-dose vials.

BackgroundResults of phase III vaccine clinical trials against COVID-19, although encouraging and well above initial expectations, have only reported on efficacy against disease and its severity. We evaluated the impact of vaccination on COVID-19 outbreak and disease outcomes in Ontario, Canada.MethodsWe used an agent-based transmission model and parameterized it with COVID-19 characteristics, demographics of Ontario, and age-specific clinical outcomes derived from outbreak data. We implemented a two-dose vaccination program, prioritizing healthcare workers and high-risk individuals, with 40% vaccine coverage and vaccine efficacy of 95% against disease. Vaccines were distributed at a rate of 30 doses per day per 10,000 population with a 6-day schedule per week. We projected the impact of vaccination on attack rates, hospitalizations, and deaths. For scenario analyses, we varied the vaccine efficacy against infection, under the assumption of 5% pre-existing population immunity.ResultsWith no protection against infection, a two-dose vaccination campaign with a time interval of 21 days between doses reduced attack rate, hospitalizations, and deaths by 44.6% (95% CrI: 34.5% - 54.3%), 63.4% (95% CrI: 56.1% - 69.9%), and 70.0% (95% CrI: 62.6% - 75.8%), respectively. These reductions were improved with increased vaccine efficacy against infection, with similar estimated ranges in the corresponding scenarios with a 28-day time interval between vaccine doses.ConclusionsVaccination can substantially mitigate ongoing COVID-19 outbreaks, even when vaccines offer limited protection against infection. This impact is founded upon a relatively strong vaccine efficacy against disease and severe outcomes.

Background: Economic evaluations should form part of the basis for public health decision making on new vaccine programs. While Canada's national immunization advisory committee does not systematically include economic evaluations in immunization decision making, there is increasing interest in adopting them. We therefore sought to examine the extent and quality of economic evaluations of vaccines in Canada. Objective: We conducted a systematic review of economic evaluations of vaccines in Canada to determine and summarize: comprehensiveness across jurisdictions, studied vaccines, funding sources, study designs, research quality, and changes over time. Methods: Searches in multiple databases were conducted using the terms “vaccine,” “economics” and “Canada.” Descriptive data from eligible manuscripts was abstracted and three authors independently evaluated manuscript quality using a 7-point Likert-type scale scoring tool based on criteria from the International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Results: 42/175 articles met the search criteria. Of these, Canada-wide studies were most common (25/42), while provincial studies largely focused on the three populous provinces of Ontario, Quebec and British Columbia. The most common funding source was industry (17/42), followed by government (7/42). 38 studies used mathematical models estimating expected economic benefit while 4 studies examined post-hoc data on established programs. Studies covered 10 diseases, with 28/42 addressing pediatric vaccines. Many studies considered cost-utility (22/42) and the majority of these studies reported favorable economic results (16/22). The mean quality score was 5.9/7 and was consistent over publication date, funding sources, and disease areas. Conclusions: We observed diverse approaches to evaluate vaccine economics in Canada. Given the increased complexity of economic studies evaluating vaccines and the impact of results on public health practice, Canada needs improved, transparent and consistent processes to review and assess the findings of the economic evaluations of vaccines.