Modelling the impact of maternal pneumococcal vaccination on infant pneumococcal disease in low-income settings

Bilgin, Gizem; Lokuge, Kamalini; Glass, Kathryn M.

doi:10.1016/j.vaccine.2022.05.066

Cited by 2 publications

(7 citation statements)

References 65 publications

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“…In this study, we quantify the incremental cost-effectiveness of introducing a maternal PPV vaccine alongside an infant PCV schedule compared to continuing with infant PCV vaccination only. The impacts of a maternal pneumococcal vaccine on health outcomes have been quantified in a previous paper [ 10 ]; a summary of key characteristics of the dynamic transmission model is provided in the S1 Text . Here, we estimate the costs of introducing a maternal pneumococcal vaccine, and the healthcare costs averted through the novel use of this vaccine.…”

Section: Methodsmentioning

confidence: 99%

“…Our transmission model focused on examining the effects of a maternal vaccine on children under one year of age since maternally derived immunity is expected to wane after one year [ 23 ]. We did not consider indirect effects of a maternal vaccine on older age groups since previous modelling suggested that a maternal pneumococcal vaccine would not cause widespread or ongoing reduction in transmission in the community [ 10 ]. No adverse events related to the vaccine were included in the model since such events have not been documented in existing trial data [ 6 ].…”

Section: Methodsmentioning

confidence: 99%

“…These studies have observed no adverse outcomes of PPVs in pregnancy but have yielded inconclusive results regarding the efficacy of PPV as a maternal vaccine due to their small-scale. In a previous paper, we constructed a dynamic transmission model which demonstrated that a maternal pneumococcal vaccine could reduce incidence by 73% (range 49–88%) in children <1 month, and 55% (range 36–66%) in children 1–2 months old [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Cost-effectiveness analysis of a maternal pneumococcal vaccine in low-income, high-burden settings such as Sierra Leone

Bilgin,

Munira,

Lokuge

et al. 2023

PLOS Glob Public Health

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Maternal pneumococcal vaccines have been proposed as a method of protecting infants in the first few months of life. In this paper, we use results from a dynamic transmission model to assess the cost-effectiveness of a maternal pneumococcal polysaccharide vaccine from both healthcare and societal perspectives. We estimate the costs of delivering a maternal pneumococcal polysaccharide vaccine, the healthcare costs averted, and productivity losses avoided through the prevention of severe pneumococcal outcomes such as pneumonia and meningitis. Our model estimates that a maternal pneumococcal program would cost $606 (2020 USD, 95% prediction interval 437 to 779) from a healthcare perspective and $132 (95% prediction interval -1 to 265) from a societal perspective per DALY averted for one year of vaccine delivery. Hence, a maternal pneumococcal vaccine would be cost-effective from a societal perspective but not cost-effective from a healthcare perspective using Sierra Leone’s GDP per capita of $527 as a cost-effectiveness threshold. Sensitivity analysis demonstrates how the choice to discount ongoing health benefits determines whether the maternal pneumococcal vaccine was deemed cost-effective from a healthcare perspective. Without discounting, the cost per DALY averted would be $292 (55% of Sierra Leone’s GDP per capita) from a healthcare perspective. Further, the cost per DALY averted would be $142 (27% GDP per capita) from a healthcare perspective if PPV could be procured at the same cost relative to PCV in Sierra Leone as on the PAHO reference price list. Overall, our paper demonstrates that maternal pneumococcal vaccines have the potential to be cost-effective in low-income settings; however, the likelihood of low-income countries self-financing this intervention will depend on negotiations with vaccine providers on vaccine price. Vaccine price is the largest program cost driving the cost-effectiveness of a future maternal pneumococcal vaccine.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cost-effectiveness analysis of a maternal pneumococcal vaccine in low-income, high-burden settings such as Sierra Leone

Bilgin,

Munira,

Lokuge

et al. 2023

PLOS Glob Public Health

Self Cite

View full text Add to dashboard Cite

show abstract

“…In this study, we quantify the incremental cost-effectiveness of introducing a maternal PPV vaccine into a setting with existing infant PCV. The impacts of a maternal pneumococcal vaccine on health outcomes have been quantified in a previous paper [10]. Here, we estimate the costs of introducing a maternal pneumococcal vaccine, and the healthcare costs averted through the novel use of this vaccine.…”

Section: Methodsmentioning

confidence: 99%

“…These studies have observed no adverse outcomes of PPVs in pregnancy but have yielded inconclusive results regarding the efficacy of PPV as a maternal vaccine due to their small-scale. In a previous paper, we demonstrated that a maternal pneumococcal vaccine could reduce incidence by 73% (range 49-88%) in children <1 month, and 55% (range 36-66%) in children 1-2 months old [10].…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness analysis of a maternal pneumococcal vaccine in low-income, high-burden settings such as Sierra Leone

Bilgin

Munira

Lokuge

et al. 2022

Preprint

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Maternal pneumococcal vaccines have been proposed as a method of protecting infants in the first few months of life. In this paper, we assess the cost-effectiveness of a maternal pneumococcal polysaccharide vaccine using a health sector perspective. We estimate the costs of delivering a maternal pneumococcal polysaccharide vaccine, and the healthcare costs averted through the prevention of severe pneumococcal outcomes such as pneumonia and meningitis, with estimates of vaccine effectiveness based on previous research. Our model estimates that a maternal pneumococcal program would cost $570 per DALY averted (2020 USD, range $558-582), and hence not be cost-effective in our study setting of Sierra Leone using the nation’s GDP per capita of $527 as a benchmark. However, the choice of discounting rates for health outcomes determines whether the maternal pneumococcal vaccine was deemed cost-effective. Without discounting, the cost per DALY averted would be $277 (53% of Sierra Leone’s GDP per capita). Further, the cost per DALY averted would be $128 (24% GDP per capita) if PPV could be procured at the same cost relative to PCV in Sierra Leone as on the PAHO reference price list. Overall, our paper demonstrates that maternal pneumococcal vaccines have the potential to be cost-effective in low-income settings; however, their cost-effectiveness depends on the choice of discounting rates determined by social values, and negotiations with vaccine providers on vaccine price. Vaccine price is the largest cost driving the cost-effectiveness of a future maternal pneumococcal vaccine.

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Modelling the impact of maternal pneumococcal vaccination on infant pneumococcal disease in low-income settings

Cited by 2 publications

References 65 publications

Cost-effectiveness analysis of a maternal pneumococcal vaccine in low-income, high-burden settings such as Sierra Leone

Cost-effectiveness analysis of a maternal pneumococcal vaccine in low-income, high-burden settings such as Sierra Leone

Cost-effectiveness analysis of a maternal pneumococcal vaccine in low-income, high-burden settings such as Sierra Leone

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