OBJECTIVES: In recent years, the increasing incidence of dengue in Argentina has significantly strained both health and economic resources. The TAK-003 vaccine, registered in Argentina since 2023, has demonstrated a balanced safety profile and efficacy in preventing dengue. This study aims to assess the health benefits, costs, and cost-effectiveness of dengue vaccination with TAK-003 in Argentina.

METHODS: We used a static model with a dynamic component to assess the health and economic impact of TAK-003 vaccination over a 20-year time horizon from a payer and societal perspective. The model was populated with local data for demographics, epidemiology, quality of life and cost. Vaccine efficacy data was extrapolated from the DEN-301 trial. We assessed different vaccination strategies at 6, 11, 15 and 20 years-old, with and without catch-up (5 or 10 cohorts) and considered the indirect effect of vaccination. A willingness to pay of one gross domestic product per capita was assumed. Deterministic and probabilistic sensitivity analysis was performed to assess result robustness.

RESULTS: Although vaccine coverage is lower among individuals vaccinated at ages 15 or 20, starting vaccination at these ages provides comparable health benefits to vaccinating during childhood or early adolescence. This is due to the higher incidence of dengue observed in older adolescents and adults. Including 0, 5 or 10 catch-up cohorts would reduce dengue disease burden by 59-61%, 73-75%, or 81-84%, respectively. All strategies were cost-effective or dominant. Starting vaccination at ages 15 or 20, with a 5-cohort catch-up, showed the lowest incremental cost-effectiveness ratio. In terms of uncertainty, the sensitivity analysis confirmed the results.

CONCLUSIONS: Dengue vaccination strategies should be designed based on country-specific epidemiology. In Argentina, while all explored strategies are expected to yield significant health and economic benefits, vaccinating individuals aged 15-20 years, with a 5-cohort catch-up, seems to be the optimal choice.