Shen Jing, Kharitonova Elizaveta, Tytula Anna, Zawieja Justyna, Aballea Samuel, Biswal Shibadas, Sharma Mayuri, Rungmaitree Supattra, Sruamsiri Rosarin, Wallace Derek, Hanley Riona
Takeda Pharmaceuticals International AG, Zürich, Switzerland.
External Contractor, Putnam, Paris, France.
PLoS Med. 2025 Jun 17;22(6):e1004631. doi: 10.1371/journal.pmed.1004631. eCollection 2025 Jun.
Dengue is an increasing global problem associated with negative health and economic impacts. Vaccination is an important measure to reduce the significant public health and economic burden caused by dengue. Our study assesses the public health impact and cost-effectiveness of a new dengue vaccine, TAK-003, using Thailand as a case study.
We developed a dynamic transmission model with both host and vector populations, 4 serotype-specific infections, seasonality, and other key elements of dengue natural history. We estimated efficacy of TAK-003 from the DEN-301 trial. We first used the model to determine the optimal cohort age for different vaccination strategies with TAK-003, based on Thai dengue epidemiology. Secondly, we assessed the public health impact of a pragmatic strategy integrating TAK-003 into an existing national immunization program in Thailand. Cost-effectiveness was evaluated from a societal perspective using disability-adjusted life-years (DALYs) over a 20-year horizon. TAK-003 is estimated to prevent 41%-57% of symptomatic cases and 47%-70% of hospitalizations, with the greatest impact observed when routinely vaccinating children aged 6 years with 10 additional catch-up cohorts. This strategy resulted in 104,415 fewer DALYs and savings of US$1,786 million. If introduced into the national immunization program at 11 years of age (alongside the existing human papillomavirus vaccine), TAK-003 is estimated to prevent 44% of symptomatic cases and 53% of hospitalizations. This strategy prevented 87,715 DALYs and saved US$1,346 million. Sensitivity analyses demonstrated that the results were robust. The main limitations were inherent to the assumptions and simplifications made in the model, which are unavoidable when approximating the impact of vaccination in the real world.
TAK-003 can considerably reduce dengue burden and lead to cost savings in Thailand. These benefits can be maximized by identifying optimal age cohorts for vaccination and adding catch-up programs. Our model can be used to assess the vaccination impact in other dengue-endemic countries.
登革热是一个日益严重的全球性问题，对健康和经济产生负面影响。疫苗接种是减轻登革热造成的重大公共卫生和经济负担的一项重要措施。我们的研究以泰国为例，评估了一种新型登革热疫苗TAK - 003的公共卫生影响和成本效益。
我们建立了一个包含宿主和病媒种群、4种血清型特异性感染、季节性以及登革热自然史其他关键要素的动态传播模型。我们从DEN - 301试验中估计了TAK - 003的疗效。我们首先使用该模型，根据泰国登革热流行病学情况，确定不同TAK - 003疫苗接种策略的最佳队列年龄。其次，我们评估了将TAK - 003纳入泰国现有国家免疫规划的务实策略的公共卫生影响。从社会角度，使用20年期间的伤残调整生命年（DALYs）评估成本效益。据估计，TAK - 003可预防41% - 57%的有症状病例和47% - 70%的住院病例，在对6岁儿童进行常规接种并增加10个补种队列时观察到最大影响。该策略使伤残调整生命年减少了104,415个，并节省了17.86亿美元。如果在11岁时（与现有人乳头瘤病毒疫苗一起）引入国家免疫规划，据估计TAK - 003可预防44%的有症状病例和53%的住院病例。该策略预防了87,715个伤残调整生命年，并节省了13.46亿美元。敏感性分析表明结果是稳健的。主要局限性在于模型中所作的假设和简化，在近似现实世界中疫苗接种的影响时这是不可避免的。
TAK - 003可大幅减轻泰国的登革热负担并节省成本。通过确定最佳接种年龄队列并增加补种计划，这些益处可最大化。我们的模型可用于评估其他登革热流行国家的疫苗接种影响。
