REFINED ESTIMATES OF THE PERSISTENCE OF VACCINE EFFECTIVENESS INCREASE THE VALUE AND IMPACT OF 4CMENB ADOLESCENT VACCINATION
Author(s)
Irshaad R. Jansen1, Pavo Marijic, MSc2, Phil Watson, PhD3, Nicolas Jamet, MSc, PharmD4, Zeki Kocaata, PhD2.
1Associate Director Value Evidence, GSK, Elsene, Belgium, 2GSK, München, Germany, 3GSK, London, United Kingdom, 4GSK, Rueil-Malmaison, France.
1Associate Director Value Evidence, GSK, Elsene, Belgium, 2GSK, München, Germany, 3GSK, London, United Kingdom, 4GSK, Rueil-Malmaison, France.
OBJECTIVES: Vaccine effectiveness (VE) waning is a critical parameter when modeling potential impacts of immunisation. In the context of invasive meningococcal disease (IMD), recent data suggest that existing assumptions for adolescent 4CMenB vaccination may overestimate VE waning, hence undervaluing vaccine benefits. This analysis evaluated the influence of different VE waning assumptions on the public health impact and cost-effectiveness of adolescent 4CMenB booster vaccination in England.
METHODS: We considered two 4CMenB VE waning curves: (1) an existing curve derived from Australian post-programme implementation VE data at discrete time points, with exponential trends applied to approximate waning (Kuylens; 2024); and (2) a novel stepwise curve, extrapolated from long-term immunogenicity data which modelled antibody persistence data integrated with circulating serogroup B (MenB) strain data (Argante; 2024). Differential impacts were assessed via an established health economic model (DyVICE) over a 30-year time horizon; assuming age-specific IMD incidence, single 4CMenB booster dosing at 14 years (73% coverage) in primed subjects (i.e., prior infant 4CMenB vaccination). We estimated IMD cases and deaths avoided with each VE waning assumption compared with no adolescent vaccine booster, and the differential impact on case reductions and resultant incremental cost-effectiveness ratios (ICERs).
RESULTS: Using existing VE waning assumptions, booster adolescent 4CMenB vaccination was estimated to avert 675 MenB cases (overall population) and avert 656 MenB cases and avert 34 IMD deaths in 15-24-year-olds. When modelling with novel stepwise curve VE waning assumptions, vaccination would avert 951 MenB cases in the overall population (a 40.9% increase in cases prevented), 950 MenB cases in 15-24-year-olds (+44.8%) and avert 49 IMD deaths (+44.1%). The resultant ICERs were approximately 30% lower with the novel VE waning inputs.
CONCLUSIONS: Incorporating stepwise exponential VE waning based on immunogenicity-derived estimates can help provide robust predictions of the clinical and economic value of booster adolescent 4CMenB vaccination.
METHODS: We considered two 4CMenB VE waning curves: (1) an existing curve derived from Australian post-programme implementation VE data at discrete time points, with exponential trends applied to approximate waning (Kuylens; 2024); and (2) a novel stepwise curve, extrapolated from long-term immunogenicity data which modelled antibody persistence data integrated with circulating serogroup B (MenB) strain data (Argante; 2024). Differential impacts were assessed via an established health economic model (DyVICE) over a 30-year time horizon; assuming age-specific IMD incidence, single 4CMenB booster dosing at 14 years (73% coverage) in primed subjects (i.e., prior infant 4CMenB vaccination). We estimated IMD cases and deaths avoided with each VE waning assumption compared with no adolescent vaccine booster, and the differential impact on case reductions and resultant incremental cost-effectiveness ratios (ICERs).
RESULTS: Using existing VE waning assumptions, booster adolescent 4CMenB vaccination was estimated to avert 675 MenB cases (overall population) and avert 656 MenB cases and avert 34 IMD deaths in 15-24-year-olds. When modelling with novel stepwise curve VE waning assumptions, vaccination would avert 951 MenB cases in the overall population (a 40.9% increase in cases prevented), 950 MenB cases in 15-24-year-olds (+44.8%) and avert 49 IMD deaths (+44.1%). The resultant ICERs were approximately 30% lower with the novel VE waning inputs.
CONCLUSIONS: Incorporating stepwise exponential VE waning based on immunogenicity-derived estimates can help provide robust predictions of the clinical and economic value of booster adolescent 4CMenB vaccination.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE597
Topic
Economic Evaluation, Epidemiology & Public Health, Methodological & Statistical Research
Disease
Infectious Disease (non-vaccine), Vaccines