Dataset Information

What Is the Value of Different Zika Vaccination Strategies to Prevent and Mitigate Zika Outbreaks?

ABSTRACT:

Background

While the 2015-2016 Zika epidemics prompted accelerated vaccine development, decision makers need to know the potential economic value of vaccination strategies.

Methods

We developed models of Honduras, Brazil, and Puerto Rico, simulated targeting different populations for Zika vaccination (women of childbearing age, school-aged children, young adults, and everyone) and then introduced various Zika outbreaks. Sensitivity analyses varied vaccine characteristics.

Results

With a 2% attack rate ($5 vaccination), compared to no vaccination, vaccinating women of childbearing age cost $314-$1664 per case averted ($790-$4221/disability-adjusted life-year [DALY] averted) in Honduras, and saved $847-$1644/case averted in Brazil, and $3648-$4177/case averted in Puerto Rico, varying with vaccination coverage and efficacy (societal perspective). Vaccinating school-aged children cost $718-$1849/case averted (≤$5002/DALY averted) in Honduras, saved $819-$1609/case averted in Brazil, and saved $3823-$4360/case averted in Puerto Rico. Vaccinating young adults cost $310-$1666/case averted ($731-$4017/DALY averted) in Honduras, saved $953-$1703/case averted in Brazil, and saved $3857-$4372/case averted in Puerto Rico. Vaccinating everyone averted more cases but cost more, decreasing cost savings per case averted. Vaccination resulted in more cost savings and better outcomes at higher attack rates.

Conclusions

When considering transmission, while vaccinating everyone naturally averted the most cases, specifically targeting women of childbearing age or young adults was the most cost-effective.

SUBMITTER: Bartsch SM

PROVIDER: S-EPMC6688058 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature

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Publications

What Is the Value of Different Zika Vaccination Strategies to Prevent and Mitigate Zika Outbreaks?

Bartsch Sarah M SM Asti Lindsey L Cox Sarah N SN Durham David P DP Randall Samuel S Hotez Peter J PJ Galvani Alison P AP Lee Bruce Y BY

The Journal of infectious diseases 20190801 6

<h4>Background</h4>While the 2015-2016 Zika epidemics prompted accelerated vaccine development, decision makers need to know the potential economic value of vaccination strategies.<h4>Methods</h4>We developed models of Honduras, Brazil, and Puerto Rico, simulated targeting different populations for Zika vaccination (women of childbearing age, school-aged children, young adults, and everyone) and then introduced various Zika outbreaks. Sensitivity analyses varied vaccine characteristics.<h4>Resul ...[more]

PMID: 30544164

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Project description:BackgroundMosquito-borne and sexually transmitted Zika virus has become widespread across Central and South America and the Caribbean. Many Zika vaccine candidates are under active development.ObjectiveTo quantify the effect of Zika vaccine prioritization of females aged 9 to 49 years, followed by males aged 9 to 49 years, on incidence of prenatal Zika infections.DesignA compartmental model of Zika transmission between mosquitoes and humans was developed and calibrated to empirical estimates of country-specific mosquito density. Mosquitoes were stratified into susceptible, exposed, and infected groups; humans were stratified into susceptible, exposed, infected, recovered, and vaccinated groups. Age-specific fertility rates, Zika sexual transmission, and country-specific demographics were incorporated.Setting34 countries and territories in the Americas with documented Zika outbreaks.Target populationMales and females aged 9 to 49 years.InterventionAge- and sex-targeted immunization using a Zika vaccine with 75% efficacy.MeasurementsAnnual prenatal Zika infections.ResultsFor a base-case vaccine efficacy of 75% and vaccination coverage of 90%, immunizing females aged 9 to 49 years (the World Health Organization target population) would reduce the incidence of prenatal infections by at least 94%, depending on the country-specific Zika attack rate. In regions where an outbreak is not expected for at least 10 years, vaccination of women aged 15 to 29 years is more efficient than that of women aged 30 years or older.LimitationPopulation-level modeling may not capture all local and neighborhood-level heterogeneity in mosquito abundance or Zika incidence.ConclusionA Zika vaccine of moderate to high efficacy may virtually eliminate prenatal infections through a combination of direct protection and transmission reduction. Efficiency of age-specific targeting of Zika vaccination depends on the timing of future outbreaks.Primary funding sourceNational Institutes of Health.

Project description:BackgroundThe monkeypox outbreak in non-endemic countries in recent months has led the World Health Organization (WHO) to declare a public health emergency of international concern (PHEIC). It is thought that festivals, parties, and other gatherings may have contributed to the outbreak.MethodsWe considered a hypothetical metropolitan city and modeled the transmission of the monkeypox virus in humans in a high-risk group (HRG) and a low-risk group (LRG) using a Susceptible-Exposed-Infectious-Recovered (SEIR) model and incorporated gathering events. Model simulations assessed how the vaccination strategies combined with other public health measures can contribute to mitigating or halting outbreaks from mass gathering events.ResultsThe risk of a monkeypox outbreak was high when mass gathering events occurred in the absence of public health control measures. However, the outbreaks were controlled by isolating cases and vaccinating their close contacts. Furthermore, contact tracing, vaccinating, and isolating close contacts, if they can be implemented, were more effective for the containment of monkeypox transmission during summer gatherings than a broad vaccination campaign among HRG, when accounting for the low vaccination coverage in the overall population, and the time needed for the development of the immune responses. Reducing the number of attendees and effective contacts during the gathering could also prevent a burgeoning outbreak, as could restricting attendance through vaccination requirements.ConclusionMonkeypox outbreaks following mass gatherings can be made less likely with some restrictions on either the number and density of attendees in the gathering or vaccination requirements. The ring vaccination strategy inoculating close contacts of confirmed cases may not be enough to prevent potential outbreaks; however, mass gatherings can be rendered less risky if that strategy is combined with public health measures, including identifying and isolating cases and contact tracing. Compliance with the community and promotion of awareness are also indispensable to containing the outbreak.

Dataset Information

What Is the Value of Different Zika Vaccination Strategies to Prevent and Mitigate Zika Outbreaks?

Background

Methods

Results

Conclusions

Publications

What Is the Value of Different Zika Vaccination Strategies to Prevent and Mitigate Zika Outbreaks?

Similar Datasets

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