Data_Sheet_1_One vaccine to counter many diseases? Modeling the economics of oral polio vaccine against child mortality and COVID-19.docx
Recent reviews summarize evidence that some vaccines have heterologous or non-specific effects (NSE), potentially offering protection against multiple pathogens. Numerous economic evaluations examine vaccines' pathogen-specific effects, but less than a handful focus on NSE. This paper addresses that gap by reporting economic evaluations of the NSE of oral polio vaccine (OPV) against under-five mortality and COVID-19.
Materials and methodsWe studied two settings: (1) reducing child mortality in a high-mortality setting (Guinea-Bissau) and (2) preventing COVID-19 in India. In the former, the intervention involves three annual campaigns in which children receive OPV incremental to routine immunization. In the latter, a susceptible-exposed-infectious-recovered model was developed to estimate the population benefits of two scenarios, in which OPV would be co-administered alongside COVID-19 vaccines. Incremental cost-effectiveness and benefit-cost ratios were modeled for ranges of intervention effectiveness estimates to supplement the headline numbers and account for heterogeneity and uncertainty.
ResultsFor child mortality, headline cost-effectiveness was $650 per child death averted. For COVID-19, assuming OPV had 20% effectiveness, incremental cost per death averted was $23,000–65,000 if it were administered simultaneously with a COVID-19 vaccine <200 days into a wave of the epidemic. If the COVID-19 vaccine availability were delayed, the cost per averted death would decrease to $2600–6100. Estimated benefit-to-cost ratios vary but are consistently high.
DiscussionEconomic evaluation suggests the potential of OPV to efficiently reduce child mortality in high mortality environments. Likewise, within a broad range of assumed effect sizes, OPV (or another vaccine with NSE) could play an economically attractive role against COVID-19 in countries facing COVID-19 vaccine delays.
FundingThe contribution by DTJ was supported through grants from Trond Mohn Foundation (BFS2019MT02) and Norad (RAF-18/0009) through the Bergen Center for Ethics and Priority Setting.
History
Usage metrics
Categories
- Aboriginal and Torres Strait Islander Health
- Aged Health Care
- Care for Disabled
- Community Child Health
- Environmental and Occupational Health and Safety
- Epidemiology
- Family Care
- Health and Community Services
- Health Care Administration
- Health Counselling
- Health Information Systems (incl. Surveillance)
- Health Promotion
- Preventive Medicine
- Primary Health Care
- Public Health and Health Services not elsewhere classified
- Medicine, Nursing and Health Curriculum and Pedagogy
- Nanotoxicology, Health and Safety
- Mental Health Nursing
- Midwifery
- Nursing not elsewhere classified