Modeling comparative cost-effectiveness of SARS-CoV-2 vaccine dose fractionation in India

Du, Zhanwei; Wang, Lin; Pandey, Abhishek; Lim, Wey Wen; Chinazzi, Matteo; Piontti, Ana Pastore y; Lau, Eric H. Y.; Wu, Peng; Malani, Anup; Cobey, Sarah; Cowling, Benjamin J.

doi:10.1038/s41591-022-01736-z

Cited by 33 publications

(27 citation statements)

References 34 publications

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“…The fail-safe number was seven, indicating seven studies or interventions with negative results could change the current results. Of the remaining 15 studies on COVID-19 vaccination, 12 concluded that COVID-19 vaccinations were cost-effective [ 87 - 98 ] and two suggested that parts of the vaccination strategies were optimal [ 99 , 100 ]. Only one study reported the conclusion depended on the primary outcome of interest [ 101 ].…”

Section: Resultsmentioning

confidence: 99%

“…In the younger population with a tendency for higher contact rates, vaccination with relatively lower efficacy and great coverage could reduce the probability of transmission and would be cost-effective [ 101 , 111 ]. Du et al [ 99 ] suggested that dose-sparing strategies could save a large number of lives, even with the emergence of new variants with higher transmissibility in India.…”

Section: Discussionmentioning

confidence: 99%

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Cost-effectiveness of interventions for the prevention and control of COVID-19: Systematic review of 85 modelling studies

Zhou

Yan

et al. 2022

J Glob Health

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Background We aimed to quantitatively summarise the health economic evaluation evidence of prevention and control programs addressing COVID-19 globally. Methods We did a systematic review and meta-analysis to assess the economic and health benefit of interventions for COVID-19. We searched PubMed, Embase, Web of Science, and Cochrane Library of economic evaluation from December 31, 2019, to March 22, 2022, to identify relevant literature. Meta-analyses were done using random-effects models to estimate pooled incremental net benefit (INB). Heterogeneity was assessed using I 2 statistics and publication bias was assessed by Egger’s test. This study is registered with PROSPERO, CRD42021267475. Results Of 16 860 studies identified, 85 articles were included in the systematic review, and 25 articles (10 studies about non-pharmacological interventions (NPIs), five studies about vaccinations and 10 studies about treatments) were included in the meta-analysis. The pooled INB of NPIs, vaccinations, and treatments were $1378.10 (95% CI = $1079.62, $1676.59), $254.80 (95% CI = $169.84, $339.77) and $4115.11 (95% CI = $1631.09, $6599.14), respectively. Sensitivity analyses showed similar findings. Conclusions NPIs, vaccinations, and treatments are all cost-effective in combating the COVID-19 pandemic. However, evidence was mostly from high-income and middle-income countries. Further studies from lower-income countries are needed.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of interventions for the prevention and control of COVID-19: Systematic review of 85 modelling studies

Zhou

Yan

et al. 2022

J Glob Health

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“…In addition, vaccination campaigns are really important in order to induce herd immunity, which could mitigate the threat of COVID-19 pandemic. Hence, rapid production and supply of various vaccines are crucial [103]. Besides, mixing different vaccine to achieve an elevated level of immunity can also be an approach to overcome the shortage of vaccines in poor countries.…”

Section: Discussionmentioning

confidence: 99%

A Review on Immunological Responses to SARS-CoV-2 and Various COVID-19 Vaccine Regimens

Upreti

Samant²

2022

Pharm Res

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The transmission of SARS-CoV-2 has caused serious health crises globally. So far, 7 vaccines that are already being assessed in Phase IV clinical trials are, Comirnaty/ Pfizer; Spikevax/Moderna (m RNA vaccine); Vaxzevria or Covishield; Ad26. COV2.S; Ad5-nCoV (adenoviral vector-based vaccine); CoronaVac and BBIBP-CorV (inactivated virus vaccine). Besides, there are about 280 vaccines that are undergoing preclinical and clinical trials including Sputnik-V, Covaxin or BBV152, and NVX-CoV2373. These vaccines are being studied for their immunological responses and efficiency against COVID-19, and have been reported to demonstrate effective T and B cell responses. However, the long-lasting immunity of these vaccine regimens still needs to be investigated. An in-depth understanding of the vaccine efficacy and immune control mechanism is imperative for the rational purposing and implementation of the vaccines. Hence, in this review, we have comprehensively discussed the immune response induced in COVID-19 patients, as well as in the convalescent individuals to avoid reinfection. Moreover, we have also summarized the immunological responses and prophylactic efficacy of various COVID-19 vaccine regimens. In this context, this review can give insights into the development of effective vaccines against SARS-CoV-2 and its variants in the future.

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“…Only one simple utility function was considered in this work. This could be made more complex by including dose–cost relationships or modelling dose–response curves for multiple different efficacy or toxicity responses [ 11 , 60 , 64 ]. Creating a meaningful utility function is non-trivial [ 65 , 66 ] and is key to effective optimisation.…”

Section: Discussionmentioning

confidence: 99%

Mathematical Modelling for Optimal Vaccine Dose Finding: Maximising Efficacy and Minimising Toxicity

et al. 2022

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Vaccination is a key tool to reduce global disease burden. Vaccine dose can affect vaccine efficacy and toxicity. Given the expense of developing vaccines, optimising vaccine dose is essential. Mathematical modelling has been suggested as an approach for optimising vaccine dose by quantitatively establishing the relationships between dose and efficacy/toxicity. In this work, we performed simulation studies to assess the performance of modelling approaches in determining optimal dose. We found that the ability of modelling approaches to determine optimal dose improved with trial size, particularly for studies with at least 30 trial participants, and that, generally, using a peaking or a weighted model-averaging-based dose–efficacy relationship was most effective in finding optimal dose. Most methods of trial dose selection were similarly effective for the purpose of determining optimal dose; however, including modelling to adapt doses during a trial may lead to more trial participants receiving a more optimal dose. Clinical trial dosing around the predicted optimal dose, rather than only at the predicted optimal dose, may improve final dose selection. This work suggests modelling can be used effectively for vaccine dose finding, prompting potential practical applications of these methods in accelerating effective vaccine development and saving lives.

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Modeling comparative cost-effectiveness of SARS-CoV-2 vaccine dose fractionation in India

Cited by 33 publications

References 34 publications

Cost-effectiveness of interventions for the prevention and control of COVID-19: Systematic review of 85 modelling studies

Cost-effectiveness of interventions for the prevention and control of COVID-19: Systematic review of 85 modelling studies

A Review on Immunological Responses to SARS-CoV-2 and Various COVID-19 Vaccine Regimens

Mathematical Modelling for Optimal Vaccine Dose Finding: Maximising Efficacy and Minimising Toxicity

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