Economic impact of a maternal Klebsiella pneumoniae vaccine: estimates for 107 low- and middle-income countries.

Sepsis is a leading cause of morbidity and mortality among newborns in low- and middle-income countries, and its treatment is further complicated by high rates of antimicrobial resistance to current antibiotics. We assessed the economic impact of a proposed maternal vaccine to protect neonates against sepsis caused by Klebsiella pneumoniae in 107 low- and middle-income countries. We estimated vaccine-avertable medical expenditures, vaccine-avertable productivity losses owing to caregiver absenteeism from work, and vaccine-avertable monetized disability-adjusted life-years using a country-specific value of statistical life-year estimate. Implementing a maternal K. pneumoniae vaccine could avert US$6.9 billion (95% CI 5.6-8.3) in monetized disability-adjusted life-years annually across 107 countries. Countries in the African region displayed the highest median vaccine-avertable medical costs and productivity losses per capita associated with resistance to first- and second-line treatments compared with other regions. Low-income countries were disproportionately impacted by the increased medical expenditures associated with antimicrobial resistance, with the median price of third-line antibiotic treatment in these countries being 23.9 days of income. Our estimates indicate that a maternal K. pneumoniae vaccine could significantly reduce the societal economic burden and catastrophic health expenditures for families affected by neonatal sepsis and antimicrobial resistance in low- and middle-income countries. This article is part of the Royal Society Science+ meeting issue 'Vaccines and antimicrobial resistance: from science to policy'.