Colombini Anaïs, Trotter Caroline, Madrid Yvette, Karachaliou Andromachi, Preziosi Marie-Pierre
Independent Consultant, World Health Organization Initiative for Vaccine Research, Geneva, Switzerland.
Disease Dynamics Unit, Department of Veterinary Medicine, University of Cambridge, United Kingdom.
Clin Infect Dis. 2015 Nov 15;61 Suppl 5(Suppl 5):S473-82. doi: 10.1093/cid/civ600.
Five years since the successful introduction of MenAfriVac in a mass vaccination campaign targeting 1- to 29-year-olds in Burkina Faso, consideration must be given to the optimal strategies for sustaining population protection. This study aims to estimate the economic impact of a range of vaccination strategies in Burkina Faso.
We performed a cost-of-illness study, comparing different vaccination scenarios in terms of costs to both households and health systems over a 26-year time horizon. These scenarios are (1) reactive vaccination campaign (baseline comparator); (2) preventive vaccination campaign; (3) routine immunization at 9 months; and (4) a combination of routine and an initial catchup campaign of children under 5. Costs were estimated from a literature review, which included unpublished programmatic documents and peer-reviewed publications. The future disease burden for each vaccination strategy was predicted using a dynamic transmission model of group A Neisseria meningitidis.
From 2010 to 2014, the total costs associated with the preventive campaign targeting 1- to 29-year-olds with MenAfriVac were similar to the estimated costs of the reactive vaccination strategy (approximately 10 million US dollars [USD]). Between 2015 and 2035, routine immunization with or without a catch-up campaign of 1- to 4-year-olds is cost saving compared with the reactive strategy, both with and without discounting costs and cases. Most of the savings are accrued from lower costs of case management and household costs resulting from a lower burden of disease. After the initial investment in the preventive strategy, 1 USD invested in the routine strategy saves an additional 1.3 USD compared to the reactive strategy.
Prevention strategies using MenAfriVac will be significantly cost saving in Burkina Faso, both for the health system and for households, compared with the reactive strategy. This will protect households from catastrophic expenditures and increase the development capacity of the population.
自在布基纳法索针对1至29岁人群成功开展大规模疫苗接种运动引入MenAfriVac疫苗五年以来,必须考虑维持人群保护的最佳策略。本研究旨在评估布基纳法索一系列疫苗接种策略的经济影响。
我们开展了一项疾病成本研究,在26年的时间范围内比较不同疫苗接种方案对家庭和卫生系统的成本。这些方案包括:(1)反应性疫苗接种运动(基线对照);(2)预防性疫苗接种运动;(3)9个月龄时的常规免疫;以及(4)常规免疫与5岁以下儿童初始补种运动相结合。成本通过文献综述进行估算,其中包括未发表的项目文件和同行评审出版物。使用A群脑膜炎奈瑟菌动态传播模型预测每种疫苗接种策略未来的疾病负担。
2010年至2014年,使用MenAfriVac针对1至29岁人群开展预防性运动的总成本与反应性疫苗接种策略的估计成本相似(约1000万美元)。在2015年至2035年期间,无论是否对成本和病例进行贴现,对1至4岁儿童进行常规免疫(无论有无补种运动)与反应性策略相比均具有成本节约效果。大部分节约来自病例管理成本降低以及疾病负担减轻带来的家庭成本降低。在预防性策略进行初始投资后,与反应性策略相比,每投入1美元用于常规策略可额外节省1.3美元。
与反应性策略相比,在布基纳法索使用MenAfriVac的预防策略对卫生系统和家庭而言都将显著节省成本。这将保护家庭免于灾难性支出,并提高人群的发展能力。