What Is the Value of Different Zika Vaccination Strategies to Prevent and Mitigate Zika Outbreaks?

Sarah Bartsch, Lindsey Asti, Sarah N. Cox, David P. Durham, Samuel Randall, Peter J. Hotez, Alison P. Galvani, Bruce Lee

Research output: Contribution to journalArticle

Abstract

BACKGROUND: While the 2015-2016 Zika epidemics prompted accelerated vaccine development, decision makers need to know the potential economic value of vaccination strategies. METHODS: We developed models of Honduras, Brazil, and Puerto Rico, simulated targeting different populations for Zika vaccination (women of childbearing age, school-aged children, young adults, and everyone) and then introduced various Zika outbreaks. Sensitivity analyses varied vaccine characteristics. RESULTS: With a 2% attack rate ($5 vaccination), compared to no vaccination, vaccinating women of childbearing age cost $314-$1664 per case averted ($790-$4221/disability-adjusted life-year [DALY] averted) in Honduras, and saved $847-$1644/case averted in Brazil, and $3648-$4177/case averted in Puerto Rico, varying with vaccination coverage and efficacy (societal perspective). Vaccinating school-aged children cost $718-$1849/case averted (≤$5002/DALY averted) in Honduras, saved $819-$1609/case averted in Brazil, and saved $3823-$4360/case averted in Puerto Rico. Vaccinating young adults cost $310-$1666/case averted ($731-$4017/DALY averted) in Honduras, saved $953-$1703/case averted in Brazil, and saved $3857-$4372/case averted in Puerto Rico. Vaccinating everyone averted more cases but cost more, decreasing cost savings per case averted. Vaccination resulted in more cost savings and better outcomes at higher attack rates. CONCLUSIONS: When considering transmission, while vaccinating everyone naturally averted the most cases, specifically targeting women of childbearing age or young adults was the most cost-effective.

Original languageEnglish (US)
Pages (from-to)920-931
Number of pages12
JournalThe Journal of infectious diseases
Volume220
Issue number6
DOIs
StatePublished - Aug 9 2019

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Honduras
Disease Outbreaks
Puerto Rico
Vaccination
Brazil
Quality-Adjusted Life Years
Costs and Cost Analysis
Young Adult
Cost Savings
Vaccines
Economics
Population

Keywords

  • cost-effectiveness
  • vaccine
  • Zika

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

Cite this

What Is the Value of Different Zika Vaccination Strategies to Prevent and Mitigate Zika Outbreaks? / Bartsch, Sarah; Asti, Lindsey; Cox, Sarah N.; Durham, David P.; Randall, Samuel; Hotez, Peter J.; Galvani, Alison P.; Lee, Bruce.

In: The Journal of infectious diseases, Vol. 220, No. 6, 09.08.2019, p. 920-931.

Research output: Contribution to journalArticle

Bartsch, Sarah ; Asti, Lindsey ; Cox, Sarah N. ; Durham, David P. ; Randall, Samuel ; Hotez, Peter J. ; Galvani, Alison P. ; Lee, Bruce. / What Is the Value of Different Zika Vaccination Strategies to Prevent and Mitigate Zika Outbreaks?. In: The Journal of infectious diseases. 2019 ; Vol. 220, No. 6. pp. 920-931.
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