What Drives the Value of a Shigella Vaccine?

Abstract

The development and licensure of a safe and highly efficacious Shigella vaccine has been a priority in international public health circles for decades and would represent a great scientific achievement. Nonetheless, in the context of increasingly crowded and costly childhood immunization programs, and with a myriad of other new and improved vaccines currently or soon on the market, there is no guarantee that even a highly effective Shigella vaccine would become a priority for adoption and introduction by the low- and middle-income countries that could benefit from it the most. We discuss here some of the major determinants and questions regarding the introduction of Shigella vaccines and the importance of developing a succinct, compelling public health value proposition.

Incidence of Asymptomatic Shigella Infection and Association with the Composite Index of Anthropometric Failure among Children Aged 1–24 Months in Low-Resource Settings

“…Currently, there is no vaccine against Shigella infection [ 16 , 17 , 40 ]. Based on the severity, disease burden, and emergence of antimicrobial resistance, Shigella has long been a priority for the WHO and other international organizations and the potential to prevent the disease in children would be a huge scientific breakthrough with substantial public health implications [ 17 , 18 ]. McQuade et al reported that when the latest technique (qPCR) was used compared to culture, there was an 11-fold increase in Shigella detection compared to previous reports [ 1 , 16 , 17 ].…”

“…Based on the severity, disease burden, and emergence of antimicrobial resistance, Shigella has long been a priority for the WHO and other international organizations and the potential to prevent the disease in children would be a huge scientific breakthrough with substantial public health implications [ 17 , 18 ]. McQuade et al reported that when the latest technique (qPCR) was used compared to culture, there was an 11-fold increase in Shigella detection compared to previous reports [ 1 , 16 , 17 ]. In this study, it was reported that traditional culture methods may have missed the majority of Shigella cases; the lowest sensitivity was found in young children, who are the most vulnerable to adverse outcomes [ 1 ].…”

“…Vaccines are one of the most effective ways to prevent illnesses, and Shigella vaccines are now being tested in clinical trials [ 16 , 17 ]. A multi-centric study reported that 85% of cases occurring in LMIC could be attributable to S. flexneri 2a, 3a and 6, together with S. sonnei , and, therefore, a quadrivalent vaccine targeting these strains is expected to provide significant protection in endemic regions [ 18 ].…”

Healthcare provider perspectives on delivering next generation rotavirus vaccines in five low-to-middle-income countries

“…Findings from this study add to the existing literature on vaccine assessments, value propositions, and investment cases [ 34 – 37 ], including a complementary paper reporting on national stakeholder findings regarding NGRVs [ 21 ]. Interviews with HPs on vaccine preferences elucidated potential barriers and facilitators for NGRV delivery, which align with previously published findings around vaccine feasibility and acceptability in LMIC settings [ 23 , 38 ].…”

Potential impact and cost-effectiveness of Shigella vaccination in 102 low-income and middle-income countries in children aged 5 years or younger: a modelling study

“…Our findings also enhance the estimated value of Shigella vaccination, which is important as policy makers consider a multiplicity of other public health interventions. 35 These findings require assessment by large-scale vaccine trials in populations at high risk, ideally showing that non-acute health effects, such as linear growth faltering and stunting, even from less severe disease, can be ameliorated by vaccination .…”