Background: Increasing the number of vaccine doses may potentially improve overall efficacy. Decision-makers need information about choosing the most efficient dose schedule to maximise the total health gain of a population when operating under a constrained budget. The objective of this study is to identify the most efficient vaccine dosing schedule within a fixed vaccination budget from a healthcare payer perspective.
Methods: An optimisation model is developed in which maximizing the disease reduction is the functional objective and the constraint is the vaccination budget. The model allows variation in vaccination dosing numbers, in cost difference per dose, in vaccine coverage rate, and in vaccine efficacy. We apply the model using the monovalent rotavirus vaccine as an example.
Results: With a fixed budget, a 2-dose schedule for vaccination against rotavirus infection with the monovalent vaccine results in a larger reduction in disease episodes than a 3-dose scheme with the same vaccine under most circumstances. A 3-dose schedule would only be better under certain conditions: a cost reduction of >26% per dose, combined with vaccine efficacy improvement of ≥5% and a target coverage rate of 75%. Substantial interaction is observed between cost reduction per dose, vaccine coverage rate, and increased vaccine efficacy. Sensitivity analysis shows that the conditions required for a 3-dose strategy to be better than a 2-dose strategy may seldom occur when the budget is fixed. The model does not consider vaccine herd effect, precise timing for additional doses, or the effect of natural immunity development.
Conclusions: Under budget constraint, optimisation modelling is a helpful tool for a decision-maker selecting the most efficient vaccination dosing schedule. The low dosing scheme could be the optimal option to consider under the many scenarios tested. The model can be applied under many different circumstances of changing dosing schemes with single or multiple vaccines.
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http://dx.doi.org/10.1186/1478-7547-12-3 | DOI Listing |
J Infect Dis
January 2025
Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland 21218, USA.
Clinical trials that employ human challenge, also known as controlled human infection models (CHIM), have rapidly advanced vaccine development for multiple pathogens, including at least 30 disease models to date. CHIM studies, championed by networks of researchers, regulators, ethicists, technical experts, and other stakeholders, limit exposure of individuals to an investigational product, de-risk product investments, identify correlates of protection, and most importantly provide a prompt readout of vaccine efficacy. While CHIM studies provide multiple advantages, important challenges exist, including strengthening the relevance and comparability of CHIM study results to efficacy trials in endemic areas, particularly in resource-limited settings.
View Article and Find Full Text PDFJ Infect Dis
January 2025
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12A, SE-17177 Stockholm, Sweden.
Background: Sweden introduced HPV vaccination in 2006, administered through opportunistic, subsidized, catch-up and school-based programs. Notably, genital warts (GW) are the first observable clinical outcome following infection by HPV-6/11, targeted by vaccination. We aim to gain knowledge of the incidence of GW in Sweden and evaluate its change throughout vaccination programs.
View Article and Find Full Text PDFClin Infect Dis
January 2025
GSK, Wavre, Belgium.
Background: In this phase 3 trial of an investigational maternal respiratory syncytial virus prefusion F protein-based vaccine (RSVPreF3-Mat), a higher rate of preterm birth was observed in the vaccine (6.8%) versus the placebo group (4.9%).
View Article and Find Full Text PDFCien Saude Colet
January 2025
Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo. São Paulo SP Brasil.
Progressive declines in vaccination coverage have been recorded in Brazil in recent years. The COVID-19 pandemic has introduced even more challenges to this scenario. Considering the pandemic as an event, the scope of this article was to analyze the politicization of vaccines from the perspective of caregivers of young children.
View Article and Find Full Text PDFCien Saude Colet
January 2025
Escola de Enfermagem, Universidade Federal da Bahia. Salvador BA Brasil.
The study aims to explain the discourse of the collective subject of adult and elderly men about the experience of long COVID. Qualitative research, derived from a national multicenter clinical-virtual observatory involving 92 adult men, between 2022 and 2023 in Brazil. IRaMuTeQ software was used (data processing), the Collective Subject Discourse technique (analysis) and socio-anthropological references of the disease experience (interpretation).
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