Agha Sohail, Zeng Wu
Department of Epidemiology, University of Washington, Seattle, WA, USA.
Research, Behavioral Insights Lab, Mercer Island, WA, USA.
Hum Vaccin Immunother. 2025 Dec;21(1):2500264. doi: 10.1080/21645515.2025.2500264. Epub 2025 May 5.
Digital platforms like social media are increasingly used to promote vaccine uptake in low- and middle-income countries (LMICs), yet limited evidence exists on their economic value. This study estimates the cost-effectiveness of a behavioral insights-informed social media campaign designed to increase HPV vaccine uptake among adolescent girls ages 9-14 in Bangladesh. A static cost-effectiveness analysis was conducted from the health system perspective. Inputs included campaign delivery costs, vaccine procurement and distribution, and treatment costs averted through cervical cancer prevention. Disability-adjusted life years (DALYs) averted per vaccinated girl were modeled using global burden-of-disease parameters. Effectiveness estimates were drawn from a quasi-experimental evaluation of the campaign, which reported a 9.5 percentage-point increase in vaccine uptake in one study arm and a 5.3 percentage-point increase in another, relative to a control group. These findings were preceded by a posttest study in Dhaka Division, which showed a strong association between campaign exposure and vaccination behavior. The incremental cost per vaccinated girl was $6.02, and the cost per DALY averted - i.e. the Incremental Cost-Effectiveness Ratio (ICER) - was $39.57. This falls well below established cost-effectiveness thresholds, including 40% of GDP per capita, commonly applied in LMICs. The findings suggest that digital campaigns guided by behavioral insights can represent a highly cost-effective approach to addressing persistent immunization coverage gaps. These results support the integration of such strategies into national immunization programs, particularly in contexts where traditional outreach methods may face financial constraints.
社交媒体等数字平台越来越多地被用于在低收入和中等收入国家（LMICs）推广疫苗接种，但关于其经济价值的证据有限。本研究估计了一项基于行为洞察的社交媒体活动的成本效益，该活动旨在提高孟加拉国9至14岁少女的人乳头瘤病毒（HPV）疫苗接种率。从卫生系统的角度进行了静态成本效益分析。投入包括活动开展成本、疫苗采购和分发，以及通过预防宫颈癌避免的治疗成本。使用全球疾病负担参数对每个接种疫苗女孩避免的残疾调整生命年（DALYs）进行了建模。有效性估计来自对该活动的准实验评估，该评估报告称，与对照组相比，一个研究组的疫苗接种率提高了9.5个百分点，另一个研究组提高了5.3个百分点。在这些发现之前，达卡专区进行了一项事后测试研究，该研究表明活动曝光与疫苗接种行为之间存在密切关联。每个接种疫苗女孩的增量成本为6.02美元，避免每个DALY的成本，即增量成本效益比（ICER）为39.57美元。这远低于低收入和中等收入国家通常采用的既定成本效益阈值，包括人均国内生产总值的40%。研究结果表明，以行为洞察为指导的数字活动可能是解决持续存在的免疫接种覆盖率差距的一种极具成本效益的方法。这些结果支持将此类策略纳入国家免疫规划，特别是在传统外展方法可能面临资金限制的情况下。
