One vaccine to counter many diseases? Modelling the economics of oral polio vaccine against child mortality and COVID-19

  1. Angela Y. Chang
  2. Peter Aaby
  3. Michael S. Avidan
  4. Christine S. Benn
  5. Stefano M. Bertozzi
  6. Lawrence Blatt
  7. Konstantin Chumakov
  8. Shabaana A. Khader
  9. Shyam Kottilil
  10. Madhav Nekkar
  11. Mihai G. Netea
  12. Annie Sparrow
  13. Dean T. Jamison
1 evaluations Published on
Read the full article Related papers
This article on Sciety

Abstract

Background

Recent reviews summarize evidence that some vaccines have heterologous or non-specific effects (NSE), potentially offering protection against multiple pathogens. Numerous economic evaluations examine vaccines’ pathogen-specific effects, but we have found only two economic evaluations of NSE. This paper starts to fill this gap by reporting economic evaluations of the NSE of oral polio vaccine (OPV) against under-five mortality and COVID-19.

Methods

We studied two settings: (1) reducing child mortality in a high-mortality setting (Guinea-Bissau) and (2) preventing COVID-19 in India. In the former, the intervention involves three annual campaigns in which children receive OPV incremental to routine immunization. In the latter, a susceptible-exposed-infectious-recovered model was developed to estimate the population benefits of two scenarios, in which OPV would be co-administered alongside COVID-19 vaccines. Incremental cost-effectiveness and benefit-cost ratios were modelled for ranges of intervention effectiveness estimates to supplement the headline numbers and account for heterogeneity and uncertainty.

Results

For child mortality, headline cost-effectiveness was $650 per child death averted. For COVID-19, assuming OPV had 20% effectiveness, incremental cost per death averted was $23,000-65,000 if it were administered simultaneously with a COVID-19 vaccine less than 200 days into a wave of the epidemic. If the COVID-19 vaccine availability were delayed, the cost per averted death would decrease to $2600-6100. Estimated benefit-to-cost ratios vary but are consistently high.

Conclusion

Economic evaluation suggests the potential of OPV to efficiently reduce child mortality in high mortality environments. Likewise, within a broad range of assumed effect sizes OPV could play an economically attractive role against COVID-19.

Related articles

Related articles are currently not available for this article.