| dc.creator | Durham, David P. | |
| dc.creator | Mbah, Martial L. Ndeffo | |
| dc.creator | Medlock, Jan | |
| dc.creator | Luz, Paula M. | |
| dc.creator | Meyers, Lauren A. | |
| dc.creator | Paltiel, A. David | |
| dc.creator | Galvani, Alison P. | |
| dc.date | 2019-10-10T12:42:51Z | |
| dc.date | 2019-10-10T12:42:51Z | |
| dc.date | 2013 | |
| dc.date.accessioned | 2023-09-26T22:47:49Z | |
| dc.date.available | 2023-09-26T22:47:49Z | |
| dc.identifier | DURHAM, David P. et al. Dengue dynamics and vaccine cost-effectiveness in Brazil. Vaccine, v. 31, n. 37, p. 3957-3961, Aug. 2013. | |
| dc.identifier | 0264-410X | |
| dc.identifier | https://www.arca.fiocruz.br/handle/icict/36318 | |
| dc.identifier | 10.1016/j.vaccine.2013.06.036 | |
| dc.identifier.uri | https://repositorioslatinoamericanos.uchile.cl/handle/2250/8883299 | |
| dc.description | Recent Phase 2b dengue vaccine trials have demonstrated the safety of the vaccine and estimated the vaccine efficacy with further trials underway. In anticipation of vaccine roll-out, costeffectiveness analysis of potential vaccination policies that quantify the dynamics of disease transmission are fundamental to the optimal allocation of available doses. We developed a dengue transmission and vaccination model and calculated, for a range of vaccination costs and willingness-to-pay thresholds, the level of vaccination coverage necessary to sustain herd-immunity, the price at which vaccination is cost-effective and is cost-saving, and the sensitivity of our results to parameter uncertainty. We compared two vaccine efficacy scenarios, one a more optimistic scenario and another based on the recent lower-than-expected efficacy from the latest clinical trials. We found that herd-immunity may be achieved by vaccinating 82% (95% CI 58–100%) of the population at a vaccine efficacy of 70%. At this efficacy, vaccination may be cost-effective for vaccination costs up to US $534 (95% CI $369–1008) per vaccinated individual and cost-saving up to $204 (95% CI $39–678). At the latest clinical trial estimates of an average of 30% vaccine efficacy, vaccination may be cost-effective and cost-saving at costs of up to $237 (95% CI $159–512) and $93 (95% CI $15–368), respectively. Our model provides an assessment of the cost-effectiveness of dengue vaccination in Brazil and incorporates the effect of herd immunity into dengue vaccination cost-effectiveness. Our results demonstrate that at the relatively low vaccine efficacy from the recent Phase 2b dengue vaccine trials, age-targeted vaccination may still be cost-effective provided the total vaccination cost is sufficiently low. | |
| dc.format | application/pdf | |
| dc.language | eng | |
| dc.publisher | Elsevier | |
| dc.rights | restricted access | |
| dc.subject | Dengue | |
| dc.subject | Vaccine | |
| dc.subject | Modeling | |
| dc.subject | Cost-effectiveness | |
| dc.title | Dengue dynamics and vaccine cost-effectiveness in Brazil | |
| dc.type | Article | |
