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A multi-country study of dengue vaccination strategies with Dengvaxia and a future vaccine candidate in three dengue-endemic countries: Vietnam, Thailand, and Colombia.
Vaccine. 2018 04 19; 36(17):2346-2355.V

Abstract

BACKGROUND

The dengue vaccination era began when Dengvaxia (CYD-TDV) became available in 2016. In addition, several second-generation vaccine candidates are currently in phase 3 trials, suggesting that a broader availability of dengue vaccines may be possible in the near future. Advancing on the recent WHO-SAGE recommendations for the safe and effective use of CYD-TDV at the regional level on average, this study investigates the vaccination impacts and cost-effectiveness of CYD-TDV and of a hypothetical new vaccine candidate (NVC) in a country-specific manner for three endemic countries: Vietnam, Thailand, and Colombia.

METHODS

The vaccination impacts of CYD-TDV and NVC were derived by fitting the empirical seroprevalence rates of 9 year olds into an individual-based meta-population transmission model, previously used for the WHO-SAGE working group. The disability-adjusted life years were estimated by applying country-specific parametric values. The cost-effectiveness analyses of four intervention strategies in combination with routine and catch-up campaigns were compared for both vaccines to inform decision makers regarding the most suitable immunization program in each of the three countries.

RESULTS AND CONCLUSION

Both CYD-TDV and NVC could be cost-effective at the DALY threshold cost of $2000 depending upon vaccination costs. With CYD-TDV, targeting 9 year olds in routine vaccination programs and 10-29 year olds as a one-off catch-up campaign was the most cost-effective strategy in all three countries. With NVC, while the most cost-effective strategy was to vaccinate 9-29 and 9-18 year olds in Vietnam and Thailand respectively, vaccinating younger age cohorts between 1 and 5 years old in Colombia was more cost-effective than other strategies. Given that three countries will soon face decisions regarding whether and how to incorporate CYD-TDV or future dengue vaccines into their budget-constrained national immunization programs, the current study outcomes can be used to help decision makers understand the expected impacts and cost-effectiveness of such vaccines.

Authors+Show Affiliations

Department of Zoology, University of Oxford, Oxford, UK. Electronic address: jungseok.lee@linacre.ox.ac.uk.Department of Zoology, University of Oxford, Oxford, UK.Department of Zoology, University of Oxford, Oxford, UK.Department of Zoology, University of Oxford, Oxford, UK.

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

29573874

Citation

Lee, Jung-Seok, et al. "A Multi-country Study of Dengue Vaccination Strategies With Dengvaxia and a Future Vaccine Candidate in Three Dengue-endemic Countries: Vietnam, Thailand, and Colombia." Vaccine, vol. 36, no. 17, 2018, pp. 2346-2355.
Lee JS, Lourenço J, Gupta S, et al. A multi-country study of dengue vaccination strategies with Dengvaxia and a future vaccine candidate in three dengue-endemic countries: Vietnam, Thailand, and Colombia. Vaccine. 2018;36(17):2346-2355.
Lee, J. S., Lourenço, J., Gupta, S., & Farlow, A. (2018). A multi-country study of dengue vaccination strategies with Dengvaxia and a future vaccine candidate in three dengue-endemic countries: Vietnam, Thailand, and Colombia. Vaccine, 36(17), 2346-2355. https://doi.org/10.1016/j.vaccine.2018.03.002
Lee JS, et al. A Multi-country Study of Dengue Vaccination Strategies With Dengvaxia and a Future Vaccine Candidate in Three Dengue-endemic Countries: Vietnam, Thailand, and Colombia. Vaccine. 2018 04 19;36(17):2346-2355. PubMed PMID: 29573874.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A multi-country study of dengue vaccination strategies with Dengvaxia and a future vaccine candidate in three dengue-endemic countries: Vietnam, Thailand, and Colombia. AU - Lee,Jung-Seok, AU - Lourenço,José, AU - Gupta,Sunetra, AU - Farlow,Andrew, Y1 - 2018/03/21/ PY - 2017/12/14/received PY - 2018/02/15/revised PY - 2018/03/01/accepted PY - 2018/3/27/pubmed PY - 2018/9/12/medline PY - 2018/3/26/entrez KW - Cost-effectiveness of dengue vaccines KW - Dengue KW - Dengue vaccine KW - Vaccination strategies SP - 2346 EP - 2355 JF - Vaccine JO - Vaccine VL - 36 IS - 17 N2 - BACKGROUND: The dengue vaccination era began when Dengvaxia (CYD-TDV) became available in 2016. In addition, several second-generation vaccine candidates are currently in phase 3 trials, suggesting that a broader availability of dengue vaccines may be possible in the near future. Advancing on the recent WHO-SAGE recommendations for the safe and effective use of CYD-TDV at the regional level on average, this study investigates the vaccination impacts and cost-effectiveness of CYD-TDV and of a hypothetical new vaccine candidate (NVC) in a country-specific manner for three endemic countries: Vietnam, Thailand, and Colombia. METHODS: The vaccination impacts of CYD-TDV and NVC were derived by fitting the empirical seroprevalence rates of 9 year olds into an individual-based meta-population transmission model, previously used for the WHO-SAGE working group. The disability-adjusted life years were estimated by applying country-specific parametric values. The cost-effectiveness analyses of four intervention strategies in combination with routine and catch-up campaigns were compared for both vaccines to inform decision makers regarding the most suitable immunization program in each of the three countries. RESULTS AND CONCLUSION: Both CYD-TDV and NVC could be cost-effective at the DALY threshold cost of $2000 depending upon vaccination costs. With CYD-TDV, targeting 9 year olds in routine vaccination programs and 10-29 year olds as a one-off catch-up campaign was the most cost-effective strategy in all three countries. With NVC, while the most cost-effective strategy was to vaccinate 9-29 and 9-18 year olds in Vietnam and Thailand respectively, vaccinating younger age cohorts between 1 and 5 years old in Colombia was more cost-effective than other strategies. Given that three countries will soon face decisions regarding whether and how to incorporate CYD-TDV or future dengue vaccines into their budget-constrained national immunization programs, the current study outcomes can be used to help decision makers understand the expected impacts and cost-effectiveness of such vaccines. SN - 1873-2518 UR - https://www.unboundmedicine.com/medline/citation/29573874/A_multi_country_study_of_dengue_vaccination_strategies_with_Dengvaxia_and_a_future_vaccine_candidate_in_three_dengue_endemic_countries:_Vietnam_Thailand_and_Colombia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0264-410X(18)30328-1 DB - PRIME DP - Unbound Medicine ER -