A forecast of typhoid conjugate vaccine introduction and demand in typhoid endemic low- and middle-income countries to support vaccine introduction policy and decisions

Mogasale, Vittal; Ramani, Enusa; Park, Il Yeon; Lee, Jung Seok

doi:10.1080/21645515.2017.1333681

Cited by 11 publications

(11 citation statements)

References 32 publications

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“…Only 2 studies [11, 12] exclusively looked at public health facilities. An additional 2 studies [9, 10] surveyed both public and private health facilities, and 2 more [8, 13] used modeled costs to estimate the public costs.…”

Section: Resultsmentioning

confidence: 99%

“…A 2008 forecast released by Gavi estimated the total market for all typhoid vaccines in Gavi-eligible countries over the period of 2011 to 2020 to range from 178 million doses to 497 million, depending on the target cohort and delivery platform utilized (2008 presentation produced by Gavi, the Vaccine Alliance, unreferenced, see Acknowledgments). An unpublished study by the Clinton Health Access Initiative estimated the total global market size from 2018 to 2030 will be at 743 million doses (2017 conference presentation by V. Vishwanarayan, unreferenced, see Acknowledgments), while a recent paper by Mogasale and colleagues projected demand for TCVs to range from 40–160 million doses per year, depending on the target population, delivery strategy, and year of introduction for a given country [13]. This paper focused on the public sector and estimated demand across LMICs.…”

Section: Resultsmentioning

confidence: 99%

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A Review of the Economic Evidence of Typhoid Fever and Typhoid Vaccines

Luthra

Watts

Debellut³

et al. 2019

Clinical Infectious Diseases

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Typhoid places a substantial economic burden on low- and middle-income countries. We performed a literature review and critical overview of typhoid-related economic issues to inform vaccine introduction. We searched 4 literature databases, covering 2000–2017, to identify typhoid-related cost-of-illness (COI) studies, cost-of-delivery studies, cost-effectiveness analyses (CEAs), and demand forecast studies. Manual bibliographic searches of reviews revealed studies in the gray literature. Planned studies were identified in conference proceedings and through partner organization outreach. We identified 29 published, unpublished, and planned studies. Published COI studies revealed a substantial burden in Asia, with hospitalization costs alone ranging from $159 to $636 (in 2016 US$) in India, but there was less evidence for the burden in Africa. Cost-of-delivery studies are largely unpublished, but 1 study found that $671 000 in government investments would avert $60 000 in public treatment costs. CEA evidence was limited, but generally found targeted vaccination programs to be cost-effective. This review revealed insufficient economic evidence for vaccine introduction. Countries considering vaccine introduction should have access to relevant economic evidence to aid in decision-making and planning. Planned studies will fill many of the existing gaps in the literature.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

A Review of the Economic Evidence of Typhoid Fever and Typhoid Vaccines

Luthra

Watts

Debellut³

et al. 2019

Clinical Infectious Diseases

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show abstract

“…Computing the excess risk associated with the consumption of unsafe water or unimproved water will help in understanding the additional typhoid risk in certain populations and helps in measuring risk-differential typhoid fever incidence in different communities [ 6 ]. Such characterization of disease burden that can be linked to access to improved water can help in developing risk-based vaccination strategies and forecasting vaccine demand [ 38 ], identifying high-risk populations within countries and targeting vaccination to specific population, estimate its impact, calculate cost-effectiveness, and compare the efficiency of targeted vaccination versus vaccination of whole population.…”

Section: Resultsmentioning

confidence: 99%

Estimating Typhoid Fever Risk Associated with Lack of Access to Safe Water: A Systematic Literature Review

Mogasale

Ramani

Park

et al. 2018

Journal of Environmental and Public Health

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Background Unsafe water is a well-known risk for typhoid fever, but a pooled estimate of the population-level risk of typhoid fever resulting from exposure to unsafe water has not been quantified. An accurate estimation of the risk from unsafe water will be useful in demarcating high-risk populations, modeling typhoid disease burden, and targeting prevention and control activities. Methods We conducted a systematic literature review and meta-analysis of observational studies that measured the risk of typhoid fever associated with drinking unimproved water as per WHO-UNICEF's definition or drinking microbiologically unsafe water. The mean value for the pooled odds ratio from case-control studies was calculated using a random effects model. In addition to unimproved water and unsafe water, we also listed categories of other risk factors from the selected studies. Results The search of published studies from January 1, 1990, to December 31, 2013 in PubMed, Embase, and World Health Organization databases provided 779 publications, of which 12 case-control studies presented the odds of having typhoid fever for those exposed to unimproved or unsafe versus improved drinking water sources. The odds of typhoid fever among those exposed to unimproved or unsafe water ranged from 1.06 to 9.26 with case weighted mean of 2.44 (95% CI: 1.65–3.59). Besides water-related risk, the studies also identified other risk factors related to socioeconomic aspects, type of food consumption, knowledge and awareness about typhoid fever, and hygiene practices. Conclusions In this meta-analysis, we have quantified the pooled risk of typhoid fever among people exposed to unimproved or unsafe water which is almost two and a half times more than people who were not exposed to unimproved or unsafe water. However, caution should be exercised in applying the findings from this study in modeling typhoid fever disease burden at country, regional, and global levels as improved water does not always equate to safe water.

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“…There is only 1 other published article projecting demand for TCVs in low- and middle-income countries [23]. Mogasale et al also project an eventual leveling off of demand near 100 million annual doses; however, unlike our model, theirs did not suggest that introduction was likely to occur in geographically defined phases.…”

Section: Discussionmentioning

confidence: 70%

Forecasting Demand for the Typhoid Conjugate Vaccine in Low- and Middle-income Countries

Debellut¹,

Hendrix

Pitzer

et al. 2019

Clinical Infectious Diseases

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Background The World Health Organization (WHO) released a position paper in March 2018 calling for integration of a novel typhoid conjugate vaccine (TCV) into routine immunization along with catch-up campaigns for children up to age 15. Gavi, the Vaccine Alliance, has committed funding to help resource-constrained countries introduce this vaccine. In this article, the Typhoid Vaccine Acceleration Consortium forecasts demand if WHO recommendations are followed. Methods We built a model of global TCV introductions between 2020 and 2040 to estimate the demand of the vaccine for 133 countries. We estimated each country’s year of introduction by examining its estimated incidence of typhoid fever, its history of introducing new vaccines, and any knowledge we have of its engagement with typhoid prevention, including intention to apply for Gavi funding. Our model predicted use in routine infant vaccination as well as campaigns targeting varying proportions of the unvaccinated population up to 15 years of age. Results Between 2020 and 2025, demand will predominantly come from African countries, many receiving Gavi support. After that, Asian countries generate most demand until 2030, when campaigns are estimated to end. Demand will then track the birth cohort of participating countries, suggesting an annual routine demand between 90 and 100 million doses. Peak demand is likely to occur between 2023 and 2026, approaching 300 million annual doses if campaign implementation is high. Conclusions In our analysis, target population for catch-up campaigns is the main driver of uncertainty. At peak demand, there is some risk of exceeding presently estimated peak production capacity. Therefore, it will be important to carefully coordinate introductions, especially when accompanied by campaigns targeting large proportions of the eligible population.

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A forecast of typhoid conjugate vaccine introduction and demand in typhoid endemic low- and middle-income countries to support vaccine introduction policy and decisions

Cited by 11 publications

References 32 publications

A Review of the Economic Evidence of Typhoid Fever and Typhoid Vaccines

A Review of the Economic Evidence of Typhoid Fever and Typhoid Vaccines

Estimating Typhoid Fever Risk Associated with Lack of Access to Safe Water: A Systematic Literature Review

Forecasting Demand for the Typhoid Conjugate Vaccine in Low- and Middle-income Countries

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