Quantifying relative health impact across Gavi, the Vaccine Alliance's portfolio in 117 countries at the subregional level: a modelling study.
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Gaythorpe Katy A M, Li Xiang, Shankar Manjari, Hartner Anna-Maria, Gibney Zoë, Abbas Kaja, Abeysuriya Romesh, Alam Christina, Auzenbergs Megan, Azman Andrew S, Barasa Edwine, Costello Alan, Ferrari Matthew J, Fraser Keith, Fu Han, Haile Lydia, Kakaï Romain Glèlè, Karachaliou-Prasinou Andromachi, Lee Elizabeth C, Katama Esther Nyadzua, Kim Jong-Hoon, Jit Mark, Liu Yang, Malinga Josephine, Moore Sean, Nayagam Shevanthi, Nedjati-Gilani Gemma, Okell Lucy C, Onifade Akindele Akano, Papadopoulos Timos, Penny Melissa A, Perkins T Alex, Pitzer Virginia E, Portnoy Allison, Procter Simon R, Saraswati Chitra Maharani, Scott Nick, Seaman Chris, Shattock Andrew J, Sim So Yoon, Tran Quan, Vynnycky Emilia, Winter Amy K, Hinsley Wes, Ferguson Neil M, Trotter Caroline L
Аннотация
METHODS: In this modelling study, we have presented Vaccine Impact Modelling Consortium estimates of vaccine impact ratios, defined as deaths or disability-adjusted life-years averted per 1000 vaccinations, for the Gavi portfolio of vaccines. Modelling groups used standardised inputs for demographic data and vaccination coverage assumptions, including a no-vaccination counterfactual, and accounted for structural, parameter, and stochastic uncertainty to produce burden estimates. These estimates were then compared to calculate vaccine impact ratios, disaggregated by immunisation activity type and geographical subregions for vaccinations given between 2000 and 2030 (or 2000 and 2040 for cholera).
FINDINGS: Overall, we observed human papillomavirus (11·24 [95% uncertainty interval 10·88-11·64]) and measles (6·09 [4·90-7·07])vaccines averting a higher number of deaths per 1000 vaccinations than others. For other vaccines, the impact ratios varied across subregions and activity types. Due to parameter, structural, and stochastic uncertainty, the ranges of these ratios often overlap.
INTERPRETATION: Decisions around which vaccines to use are increasingly important in the context of Gavi's country vaccine budgets. Robust metrics that allow comparison between vaccines are thus essential to inform discussions. The vaccine impact ratios presented in this study can be used to complement other evidence to support effective planning and prioritisation in national immunisation programmes.
FUNDING: Gavi, the Vaccine Alliance, Gates Foundation, and Wellcome Trust.