Number needed to vaccinate with a COVID-19 booster to prevent a COVID-19-associated hospitalization during SARS-CoV-2 Omicron BA.1 variant predominance, December 2021–February 2022, VISION Network: a retrospective cohort study

Adams, Katherine; Riddles, John; Rowley, Elizabeth; Grannis, Shaun J.; Gaglani, Manjusha; Fireman, Bruce; Hartmann, Emily; Naleway, Allison L.; Stenehjem, Edward; Hughes, Alexandria; Dalton, Alexandra F.; Natarajan, Karthik; Dascomb, Kristin; Raiyani, Chandni; Irving, Stephanie A.; Sloan-Aagard, Chantel; Kharbanda, Anupam B.; DeSilva, Malini B.; Dixon, Brian E.; Ong, Toan C.; Keller, J B; Dickerson, Monica; Grisel, Nancy; Murthy, Kempapura; Nañez, Juan; Fadel, William F.; Ball, S; Patel, Palak; Arndorfer, Julie; Mamawala, Mufaddal; Valvi, Nimish R; Dunne, Margaret M.; Griggs, Eric P.; Embi, Peter J.; Thompson, Mark G.; Link‐Gelles, Ruth; Tenforde, Mark W

doi:10.1016/j.lana.2023.100530

Cited by 7 publications

(4 citation statements)

References 28 publications

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“…Specifically, the NNV to prevent one case of COVID-19 would be 142 (range 122-170) for the BNT162b2 injection and 88 (range 76-104) for the mRNA-1273 injection, respectively [ 65 ]. These numbers increase with age and depending on the variant [ 70 ]. The NNV is an interpretable and salient metric for assessing real-world impact, enabling us to gauge the potential benefits derived from vaccination.…”

Section: Reviewmentioning

confidence: 99%

COVID-19 mRNA Vaccines: Lessons Learned from the Registrational Trials and Global Vaccination Campaign

Mead,

Seneff,

Wolfinger

et al. 2024

Cureus

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Our understanding of COVID-19 vaccinations and their impact on health and mortality has evolved substantially since the first vaccine rollouts. Published reports from the original randomized phase 3 trials concluded that the COVID-19 mRNA vaccines could greatly reduce COVID-19 symptoms. In the interim, problems with the methods, execution, and reporting of these pivotal trials have emerged. Re-analysis of the Pfizer trial data identified statistically significant increases in serious adverse events (SAEs) in the vaccine group. Numerous SAEs were identified following the Emergency Use Authorization (EUA), including death, cancer, cardiac events, and various autoimmune, hematological, reproductive, and neurological disorders. Furthermore, these products never underwent adequate safety and toxicological testing in accordance with previously established scientific standards. Among the other major topics addressed in this narrative review are the published analyses of serious harms to humans, quality control issues and process-related impurities, mechanisms underlying adverse events (AEs), the immunologic basis for vaccine inefficacy, and concerning mortality trends based on the registrational trial data. The risk-benefit imbalance substantiated by the evidence to date contraindicates further booster injections and suggests that, at a minimum, the mRNA injections should be removed from the childhood immunization program until proper safety and toxicological studies are conducted. Federal agency approval of the COVID-19 mRNA vaccines on a blanket-coverage population-wide basis had no support from an honest assessment of all relevant registrational data and commensurate consideration of risks versus benefits. Given the extensive, well-documented SAEs and unacceptably high harm-to-reward ratio, we urge governments to endorse a global moratorium on the modified mRNA products until all relevant questions pertaining to causality, residual DNA, and aberrant protein production are answered.

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Section: Reviewmentioning

confidence: 99%

COVID-19 mRNA Vaccines: Lessons Learned from the Registrational Trials and Global Vaccination Campaign

Mead,

Seneff,

Wolfinger

et al. 2024

Cureus

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“…Theoretical and empirical considerations linking vaccine needs, vaccine and disease characteristics, and vaccine delivery difficulties are critical to illustrating how limited government health financing lessens the value of vaccines to protect health. Given the VE of the currently approved vaccines (see range interval of the VEs of both vaccines with associated uncertainty in the “ Background ” section) and the malaria incidence among unvaccinated (IU) in the AFR (WHO estimate of case incidence in 2022: 222.6 per 1000 population at-risk), then the number needed to vaccinate (NNV) can be calculated [ 5 , 6 , 9 , 11 ]: . Applying this equation to the data suggests that between 6 (95% CI: 6–6) and 15 (95% CI: 10–75) children would need to be vaccinated to prevent a malaria adverse outcome.…”

Section: Main Textmentioning

confidence: 99%

Malaria vaccination: hurdles to reach high-risk children

Amimo

2024

BMC Med

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Ensuring that malaria vaccines deliver maximum public health impact is non-trivial. Drawing on current research, this article examines hurdles that malaria immunization may face to reach high-risk children and explores the policy implications. The analysis finds health system related risks with the potential to reduce the ability of malaria vaccines to provide equitable protection. Deployment of effective frameworks to tackle these risks so as to strengthen within-country equity and progress tracking should be entangled with the deployment of the vaccines. To capture more comprehensively disease- and system-related risks to child health and survival, vaccine allocation criteria should expand their data and indicator breadth. Factoring molecular, clinical, and epidemiological features of antimalarial drug resistance into vaccine allocation frameworks is critical to effectively reflect current and future risks to malaria control interventions. It is proposed that approximately 6–15 children would need to be vaccinated to prevent a malaria adverse outcome. Vaccine purchasing and delivery costs may overwhelm endemic countries’ health systems given the sizeable number needed to vaccinate, the population of at-risk children, and limited government financing of the health sector. Innovations in health financing are pivotal to ensuring the cost-effectiveness and sustainability of immunization programs aiming to attain and maintain universal and equitable protection.

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“…Three years after the emergence of COVID-19, vaccines supplies have been sufficient for primary doses and partial booster dose coverage to reach low-and middle-income nations [2]. Still, older adults and individuals with comorbidities remain at considerable risk of severe outcomes associated with COVID-19 [3][4][5]. The World Health Organization (WHO) Strategic Advisory Group of Experts on Immunization (SAGE) roadmap for the use of COVID-19 vaccines (updated March 2023) urges policymakers in low-and middle-income countries to reevaluate the funding of COVID-19 interventions in the context of substantial population immunity against COVID-19 [3].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness analysis of COVID-19 booster doses and oral antivirals in the Indo-Pacific

Bilgin,

Munira,

Lokuge

et al. 2023

Preprint

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Background: Decision-makers in middle-income countries need evidence on the cost-effectiveness of COVID-19 booster doses and oral antivirals to appropriately prioritise these healthcare interventions. Methods: We used a dynamic transmission model to assess the cost-effectiveness of COVID-19 booster doses and oral antivirals in Fiji, Indonesia, Papua New Guinea, and Timor-Leste. We conducted cost-effectiveness analysis from both healthcare and societal perspectives using 3% discounting for ongoing costs and health benefits. We developed an interactive R Shiny which allows the user to vary key model assumptions, such as the choice of discounting rate, and view how these assumptions affect model results. Findings: Booster doses were cost saving and therefore cost-effective in all four middle-income settings from both healthcare and societal perspectives using 3% discounting. Providing oral antivirals was cost-effective from a healthcare perspective if procured at a low generic ($25 United States Dollars) or middle-income reference price ($250 United States Dollars); however, their cost-effectiveness was strongly influenced by rates of wastage or misuse, and the ongoing costs of care for patients hospitalised with COVID-19. Interestingly, the cost or wastage of rapid antigen tests did not appear strongly influential over the cost-effectiveness of oral antivirals in any of the four study settings. Conclusions: Our results support that government funded COVID-19 booster programs continue to be cost-effective in middle-income settings. Oral antivirals demonstrate the potential to be cost-effective if procured at or below a middle-income reference price of $250 USD per schedule. Further research should quantify the rates of wastage or misuse of oral COVID-19 antivirals in middle-income settings.

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Number needed to vaccinate with a COVID-19 booster to prevent a COVID-19-associated hospitalization during SARS-CoV-2 Omicron BA.1 variant predominance, December 2021–February 2022, VISION Network: a retrospective cohort study

Cited by 7 publications

References 28 publications

COVID-19 mRNA Vaccines: Lessons Learned from the Registrational Trials and Global Vaccination Campaign

COVID-19 mRNA Vaccines: Lessons Learned from the Registrational Trials and Global Vaccination Campaign

Malaria vaccination: hurdles to reach high-risk children

Cost-effectiveness analysis of COVID-19 booster doses and oral antivirals in the Indo-Pacific

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