A DYNAMIC MODEL FOR ASSESSING THE IMPACT OF EMERGING VACCINE TECHNOLOGIES ON MEASLES DISEASE BURDEN IN DEVELOPING COUNTRIES
Author(s)
Christopher T Bauch, PhD, Associate Professor1, Emily Szusz, N/A, Research Assistant1, Brian Bresnahan, PhD, Research Assistant Professor2, Thomas K. Hazlet, PharmD, DrPH, Associate Professor2, Srikanth Kadiyala, PhD, Assistant Professor2, David L. Veenstra, PharmD, PhD, Research Associate Professor2, Lou Garrison, PhD, Professor, Pharmaceutical Outcomes Research and Policy Program21University of Guelph, Guelph, ON, Canada; 2 University of Washington, Seattle, WA, USA
Objectives: Measles continues to cause considerable morbidity and mortality worldwide. The current measles vaccine is administered in developing countries through a combination of routine immunization (RI) at nine months of age plus a second opportunity (SO)--either another routine injection after one year of age or via large-scale campaigns. Although these strategies have proven successful in eliminating measles in the Americas, measles continues to prove intractable in much of Asia and Africa due to challenges with vaccine delivery and effectiveness in current settings. However, several potential measles vaccine technologies are presently in R&D with the aim to further reduce measles disease burden compared to the conventional approach alone. Examples of such technologies include needle-free devices, DNA vaccines, and/or thermostable vaccines. Methods: We developed an age-structured compartmental (dynamic) model of measles transmission in Nigeria, Uganda and Bihar, parameterized with available demographic, clinical, incidence and seroprevalence data. We thus projected future measles cases and deaths under scenarios of (1) RI alone with current technology; (2) RI with SO using current technology; (3) RI with new technologies; and (4) RI and SO with new technologies. We investigated the impact of new technologies under various alternative assumptions regarding how much they would increase vaccine coverage and/or vaccine efficacy. A dynamic model was used so that herd immunity effects can be captured and the estimated benefits of vaccine innovations thus better estimated. Results: The effectiveness of RI and SO is enhanced with some of the new measles vaccine technologies. According to model projections, new technologies would further reduce the burden of disease in all three populations, especially at younger ages. Conclusion: New immunization technologies could help reduce the measles disease burden in developing countries. However, the potential cost-effectiveness of using these new technologies and strategies, including the likelihood of uptake, remains to be determined.
Conference/Value in Health Info
2008-05, ISPOR 2008, Toronto, Ontario, Canada
Value in Health, Vol. 11, No. 3 (May/June 2008)
Code
PIN33
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Infectious Disease (non-vaccine)