Epidemiological impact and cost-effectiveness analysis of COVID-19 vaccination in Kenya
Background A few studies have assessed the epidemiological impact and the cost-effectiveness of COVID-19 vaccines in settings where most of the population had been exposed to SARS-CoV-2 infection.Methods We conducted a cost-effectiveness analysis of COVID-19 vaccine in Kenya from a societal perspect...
Ausführliche Beschreibung
Autor*in: |
Morris Ogero [verfasserIn] Edwine Barasa [verfasserIn] Ambrose Agweyu [verfasserIn] Matt J Keeling [verfasserIn] Philip Bejon [verfasserIn] Angela Kairu [verfasserIn] Wangari Ng'ang'a [verfasserIn] Mercy Mwangangi [verfasserIn] Stefan Flasche [verfasserIn] John Ojal [verfasserIn] Stacey Orangi [verfasserIn] J Anthony G Scott [verfasserIn] Patrick Amoth [verfasserIn] Samuel PC Brand [verfasserIn] Cameline Orlendo [verfasserIn] Rabia Aziza [verfasserIn] George M Warimwe [verfasserIn] Sophie Uyoga [verfasserIn] Edward Otieno [verfasserIn] Lynette I Ochola-Oyier [verfasserIn] Charles N Agoti [verfasserIn] Kadondi Kasera [verfasserIn] Rashid Aman [verfasserIn] Ifedayo MO Adetifa [verfasserIn] D James Nokes [verfasserIn] |
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Format: |
E-Artikel |
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Sprache: |
Englisch |
Erschienen: |
2022 |
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Übergeordnetes Werk: |
In: BMJ Global Health - BMJ Publishing Group, 2018, 7(2022), 8 |
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Übergeordnetes Werk: |
volume:7 ; year:2022 ; number:8 |
Links: |
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DOI / URN: |
10.1136/bmjgh-2022-009430 |
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Katalog-ID: |
DOAJ040085171 |
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520 | |a Background A few studies have assessed the epidemiological impact and the cost-effectiveness of COVID-19 vaccines in settings where most of the population had been exposed to SARS-CoV-2 infection.Methods We conducted a cost-effectiveness analysis of COVID-19 vaccine in Kenya from a societal perspective over a 1.5-year time frame. An age-structured transmission model assumed at least 80% of the population to have prior natural immunity when an immune escape variant was introduced. We examine the effect of slow (18 months) or rapid (6 months) vaccine roll-out with vaccine coverage of 30%, 50% or 70% of the adult (>18 years) population prioritising roll-out in those over 50-years (80% uptake in all scenarios). Cost data were obtained from primary analyses. We assumed vaccine procurement at US$7 per dose and vaccine delivery costs of US$3.90–US$6.11 per dose. The cost-effectiveness threshold was US$919.11.Findings Slow roll-out at 30% coverage largely targets those over 50 years and resulted in 54% fewer deaths (8132 (7914–8373)) than no vaccination and was cost saving (incremental cost-effectiveness ratio, ICER=US$−1343 (US$−1345 to US$−1341) per disability-adjusted life-year, DALY averted). Increasing coverage to 50% and 70%, further reduced deaths by 12% (810 (757–872) and 5% (282 (251–317) but was not cost-effective, using Kenya’s cost-effectiveness threshold (US$919.11). Rapid roll-out with 30% coverage averted 63% more deaths and was more cost-saving (ICER=US$−1607 (US$−1609 to US$−1604) per DALY averted) compared with slow roll-out at the same coverage level, but 50% and 70% coverage scenarios were not cost-effective.Interpretation With prior exposure partially protecting much of the Kenyan population, vaccination of young adults may no longer be cost-effective. | ||
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10.1136/bmjgh-2022-009430 doi (DE-627)DOAJ040085171 (DE-599)DOAJc1192928f85547ea96b8178d08dc5f89 DE-627 ger DE-627 rakwb eng R5-920 RC109-216 Morris Ogero verfasserin aut Epidemiological impact and cost-effectiveness analysis of COVID-19 vaccination in Kenya 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background A few studies have assessed the epidemiological impact and the cost-effectiveness of COVID-19 vaccines in settings where most of the population had been exposed to SARS-CoV-2 infection.Methods We conducted a cost-effectiveness analysis of COVID-19 vaccine in Kenya from a societal perspective over a 1.5-year time frame. An age-structured transmission model assumed at least 80% of the population to have prior natural immunity when an immune escape variant was introduced. We examine the effect of slow (18 months) or rapid (6 months) vaccine roll-out with vaccine coverage of 30%, 50% or 70% of the adult (>18 years) population prioritising roll-out in those over 50-years (80% uptake in all scenarios). Cost data were obtained from primary analyses. We assumed vaccine procurement at US$7 per dose and vaccine delivery costs of US$3.90–US$6.11 per dose. The cost-effectiveness threshold was US$919.11.Findings Slow roll-out at 30% coverage largely targets those over 50 years and resulted in 54% fewer deaths (8132 (7914–8373)) than no vaccination and was cost saving (incremental cost-effectiveness ratio, ICER=US$−1343 (US$−1345 to US$−1341) per disability-adjusted life-year, DALY averted). Increasing coverage to 50% and 70%, further reduced deaths by 12% (810 (757–872) and 5% (282 (251–317) but was not cost-effective, using Kenya’s cost-effectiveness threshold (US$919.11). Rapid roll-out with 30% coverage averted 63% more deaths and was more cost-saving (ICER=US$−1607 (US$−1609 to US$−1604) per DALY averted) compared with slow roll-out at the same coverage level, but 50% and 70% coverage scenarios were not cost-effective.Interpretation With prior exposure partially protecting much of the Kenyan population, vaccination of young adults may no longer be cost-effective. Medicine (General) Infectious and parasitic diseases Edwine Barasa verfasserin aut Ambrose Agweyu verfasserin aut Matt J Keeling verfasserin aut Philip Bejon verfasserin aut Angela Kairu verfasserin aut Wangari Ng'ang'a verfasserin aut Mercy Mwangangi verfasserin aut Stefan Flasche verfasserin aut John Ojal verfasserin aut Stacey Orangi verfasserin aut J Anthony G Scott verfasserin aut Patrick Amoth verfasserin aut Samuel PC Brand verfasserin aut Cameline Orlendo verfasserin aut Rabia Aziza verfasserin aut George M Warimwe verfasserin aut Sophie Uyoga verfasserin aut Edward Otieno verfasserin aut Lynette I Ochola-Oyier verfasserin aut Charles N Agoti verfasserin aut Kadondi Kasera verfasserin aut Rashid Aman verfasserin aut Ifedayo MO Adetifa verfasserin aut D James Nokes verfasserin aut In BMJ Global Health BMJ Publishing Group, 2018 7(2022), 8 (DE-627)85645365X (DE-600)2851843-3 20597908 nnns volume:7 year:2022 number:8 https://doi.org/10.1136/bmjgh-2022-009430 kostenfrei https://doaj.org/article/c1192928f85547ea96b8178d08dc5f89 kostenfrei https://gh.bmj.com/content/7/8/e009430.full kostenfrei https://doaj.org/toc/2059-7908 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 7 2022 8 |
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10.1136/bmjgh-2022-009430 doi (DE-627)DOAJ040085171 (DE-599)DOAJc1192928f85547ea96b8178d08dc5f89 DE-627 ger DE-627 rakwb eng R5-920 RC109-216 Morris Ogero verfasserin aut Epidemiological impact and cost-effectiveness analysis of COVID-19 vaccination in Kenya 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background A few studies have assessed the epidemiological impact and the cost-effectiveness of COVID-19 vaccines in settings where most of the population had been exposed to SARS-CoV-2 infection.Methods We conducted a cost-effectiveness analysis of COVID-19 vaccine in Kenya from a societal perspective over a 1.5-year time frame. An age-structured transmission model assumed at least 80% of the population to have prior natural immunity when an immune escape variant was introduced. We examine the effect of slow (18 months) or rapid (6 months) vaccine roll-out with vaccine coverage of 30%, 50% or 70% of the adult (>18 years) population prioritising roll-out in those over 50-years (80% uptake in all scenarios). Cost data were obtained from primary analyses. We assumed vaccine procurement at US$7 per dose and vaccine delivery costs of US$3.90–US$6.11 per dose. The cost-effectiveness threshold was US$919.11.Findings Slow roll-out at 30% coverage largely targets those over 50 years and resulted in 54% fewer deaths (8132 (7914–8373)) than no vaccination and was cost saving (incremental cost-effectiveness ratio, ICER=US$−1343 (US$−1345 to US$−1341) per disability-adjusted life-year, DALY averted). Increasing coverage to 50% and 70%, further reduced deaths by 12% (810 (757–872) and 5% (282 (251–317) but was not cost-effective, using Kenya’s cost-effectiveness threshold (US$919.11). Rapid roll-out with 30% coverage averted 63% more deaths and was more cost-saving (ICER=US$−1607 (US$−1609 to US$−1604) per DALY averted) compared with slow roll-out at the same coverage level, but 50% and 70% coverage scenarios were not cost-effective.Interpretation With prior exposure partially protecting much of the Kenyan population, vaccination of young adults may no longer be cost-effective. Medicine (General) Infectious and parasitic diseases Edwine Barasa verfasserin aut Ambrose Agweyu verfasserin aut Matt J Keeling verfasserin aut Philip Bejon verfasserin aut Angela Kairu verfasserin aut Wangari Ng'ang'a verfasserin aut Mercy Mwangangi verfasserin aut Stefan Flasche verfasserin aut John Ojal verfasserin aut Stacey Orangi verfasserin aut J Anthony G Scott verfasserin aut Patrick Amoth verfasserin aut Samuel PC Brand verfasserin aut Cameline Orlendo verfasserin aut Rabia Aziza verfasserin aut George M Warimwe verfasserin aut Sophie Uyoga verfasserin aut Edward Otieno verfasserin aut Lynette I Ochola-Oyier verfasserin aut Charles N Agoti verfasserin aut Kadondi Kasera verfasserin aut Rashid Aman verfasserin aut Ifedayo MO Adetifa verfasserin aut D James Nokes verfasserin aut In BMJ Global Health BMJ Publishing Group, 2018 7(2022), 8 (DE-627)85645365X (DE-600)2851843-3 20597908 nnns volume:7 year:2022 number:8 https://doi.org/10.1136/bmjgh-2022-009430 kostenfrei https://doaj.org/article/c1192928f85547ea96b8178d08dc5f89 kostenfrei https://gh.bmj.com/content/7/8/e009430.full kostenfrei https://doaj.org/toc/2059-7908 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 7 2022 8 |
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10.1136/bmjgh-2022-009430 doi (DE-627)DOAJ040085171 (DE-599)DOAJc1192928f85547ea96b8178d08dc5f89 DE-627 ger DE-627 rakwb eng R5-920 RC109-216 Morris Ogero verfasserin aut Epidemiological impact and cost-effectiveness analysis of COVID-19 vaccination in Kenya 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background A few studies have assessed the epidemiological impact and the cost-effectiveness of COVID-19 vaccines in settings where most of the population had been exposed to SARS-CoV-2 infection.Methods We conducted a cost-effectiveness analysis of COVID-19 vaccine in Kenya from a societal perspective over a 1.5-year time frame. An age-structured transmission model assumed at least 80% of the population to have prior natural immunity when an immune escape variant was introduced. We examine the effect of slow (18 months) or rapid (6 months) vaccine roll-out with vaccine coverage of 30%, 50% or 70% of the adult (>18 years) population prioritising roll-out in those over 50-years (80% uptake in all scenarios). Cost data were obtained from primary analyses. We assumed vaccine procurement at US$7 per dose and vaccine delivery costs of US$3.90–US$6.11 per dose. The cost-effectiveness threshold was US$919.11.Findings Slow roll-out at 30% coverage largely targets those over 50 years and resulted in 54% fewer deaths (8132 (7914–8373)) than no vaccination and was cost saving (incremental cost-effectiveness ratio, ICER=US$−1343 (US$−1345 to US$−1341) per disability-adjusted life-year, DALY averted). Increasing coverage to 50% and 70%, further reduced deaths by 12% (810 (757–872) and 5% (282 (251–317) but was not cost-effective, using Kenya’s cost-effectiveness threshold (US$919.11). Rapid roll-out with 30% coverage averted 63% more deaths and was more cost-saving (ICER=US$−1607 (US$−1609 to US$−1604) per DALY averted) compared with slow roll-out at the same coverage level, but 50% and 70% coverage scenarios were not cost-effective.Interpretation With prior exposure partially protecting much of the Kenyan population, vaccination of young adults may no longer be cost-effective. Medicine (General) Infectious and parasitic diseases Edwine Barasa verfasserin aut Ambrose Agweyu verfasserin aut Matt J Keeling verfasserin aut Philip Bejon verfasserin aut Angela Kairu verfasserin aut Wangari Ng'ang'a verfasserin aut Mercy Mwangangi verfasserin aut Stefan Flasche verfasserin aut John Ojal verfasserin aut Stacey Orangi verfasserin aut J Anthony G Scott verfasserin aut Patrick Amoth verfasserin aut Samuel PC Brand verfasserin aut Cameline Orlendo verfasserin aut Rabia Aziza verfasserin aut George M Warimwe verfasserin aut Sophie Uyoga verfasserin aut Edward Otieno verfasserin aut Lynette I Ochola-Oyier verfasserin aut Charles N Agoti verfasserin aut Kadondi Kasera verfasserin aut Rashid Aman verfasserin aut Ifedayo MO Adetifa verfasserin aut D James Nokes verfasserin aut In BMJ Global Health BMJ Publishing Group, 2018 7(2022), 8 (DE-627)85645365X (DE-600)2851843-3 20597908 nnns volume:7 year:2022 number:8 https://doi.org/10.1136/bmjgh-2022-009430 kostenfrei https://doaj.org/article/c1192928f85547ea96b8178d08dc5f89 kostenfrei https://gh.bmj.com/content/7/8/e009430.full kostenfrei https://doaj.org/toc/2059-7908 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 7 2022 8 |
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10.1136/bmjgh-2022-009430 doi (DE-627)DOAJ040085171 (DE-599)DOAJc1192928f85547ea96b8178d08dc5f89 DE-627 ger DE-627 rakwb eng R5-920 RC109-216 Morris Ogero verfasserin aut Epidemiological impact and cost-effectiveness analysis of COVID-19 vaccination in Kenya 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background A few studies have assessed the epidemiological impact and the cost-effectiveness of COVID-19 vaccines in settings where most of the population had been exposed to SARS-CoV-2 infection.Methods We conducted a cost-effectiveness analysis of COVID-19 vaccine in Kenya from a societal perspective over a 1.5-year time frame. An age-structured transmission model assumed at least 80% of the population to have prior natural immunity when an immune escape variant was introduced. We examine the effect of slow (18 months) or rapid (6 months) vaccine roll-out with vaccine coverage of 30%, 50% or 70% of the adult (>18 years) population prioritising roll-out in those over 50-years (80% uptake in all scenarios). Cost data were obtained from primary analyses. We assumed vaccine procurement at US$7 per dose and vaccine delivery costs of US$3.90–US$6.11 per dose. The cost-effectiveness threshold was US$919.11.Findings Slow roll-out at 30% coverage largely targets those over 50 years and resulted in 54% fewer deaths (8132 (7914–8373)) than no vaccination and was cost saving (incremental cost-effectiveness ratio, ICER=US$−1343 (US$−1345 to US$−1341) per disability-adjusted life-year, DALY averted). Increasing coverage to 50% and 70%, further reduced deaths by 12% (810 (757–872) and 5% (282 (251–317) but was not cost-effective, using Kenya’s cost-effectiveness threshold (US$919.11). Rapid roll-out with 30% coverage averted 63% more deaths and was more cost-saving (ICER=US$−1607 (US$−1609 to US$−1604) per DALY averted) compared with slow roll-out at the same coverage level, but 50% and 70% coverage scenarios were not cost-effective.Interpretation With prior exposure partially protecting much of the Kenyan population, vaccination of young adults may no longer be cost-effective. Medicine (General) Infectious and parasitic diseases Edwine Barasa verfasserin aut Ambrose Agweyu verfasserin aut Matt J Keeling verfasserin aut Philip Bejon verfasserin aut Angela Kairu verfasserin aut Wangari Ng'ang'a verfasserin aut Mercy Mwangangi verfasserin aut Stefan Flasche verfasserin aut John Ojal verfasserin aut Stacey Orangi verfasserin aut J Anthony G Scott verfasserin aut Patrick Amoth verfasserin aut Samuel PC Brand verfasserin aut Cameline Orlendo verfasserin aut Rabia Aziza verfasserin aut George M Warimwe verfasserin aut Sophie Uyoga verfasserin aut Edward Otieno verfasserin aut Lynette I Ochola-Oyier verfasserin aut Charles N Agoti verfasserin aut Kadondi Kasera verfasserin aut Rashid Aman verfasserin aut Ifedayo MO Adetifa verfasserin aut D James Nokes verfasserin aut In BMJ Global Health BMJ Publishing Group, 2018 7(2022), 8 (DE-627)85645365X (DE-600)2851843-3 20597908 nnns volume:7 year:2022 number:8 https://doi.org/10.1136/bmjgh-2022-009430 kostenfrei https://doaj.org/article/c1192928f85547ea96b8178d08dc5f89 kostenfrei https://gh.bmj.com/content/7/8/e009430.full kostenfrei https://doaj.org/toc/2059-7908 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 7 2022 8 |
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10.1136/bmjgh-2022-009430 doi (DE-627)DOAJ040085171 (DE-599)DOAJc1192928f85547ea96b8178d08dc5f89 DE-627 ger DE-627 rakwb eng R5-920 RC109-216 Morris Ogero verfasserin aut Epidemiological impact and cost-effectiveness analysis of COVID-19 vaccination in Kenya 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background A few studies have assessed the epidemiological impact and the cost-effectiveness of COVID-19 vaccines in settings where most of the population had been exposed to SARS-CoV-2 infection.Methods We conducted a cost-effectiveness analysis of COVID-19 vaccine in Kenya from a societal perspective over a 1.5-year time frame. An age-structured transmission model assumed at least 80% of the population to have prior natural immunity when an immune escape variant was introduced. We examine the effect of slow (18 months) or rapid (6 months) vaccine roll-out with vaccine coverage of 30%, 50% or 70% of the adult (>18 years) population prioritising roll-out in those over 50-years (80% uptake in all scenarios). Cost data were obtained from primary analyses. We assumed vaccine procurement at US$7 per dose and vaccine delivery costs of US$3.90–US$6.11 per dose. The cost-effectiveness threshold was US$919.11.Findings Slow roll-out at 30% coverage largely targets those over 50 years and resulted in 54% fewer deaths (8132 (7914–8373)) than no vaccination and was cost saving (incremental cost-effectiveness ratio, ICER=US$−1343 (US$−1345 to US$−1341) per disability-adjusted life-year, DALY averted). Increasing coverage to 50% and 70%, further reduced deaths by 12% (810 (757–872) and 5% (282 (251–317) but was not cost-effective, using Kenya’s cost-effectiveness threshold (US$919.11). Rapid roll-out with 30% coverage averted 63% more deaths and was more cost-saving (ICER=US$−1607 (US$−1609 to US$−1604) per DALY averted) compared with slow roll-out at the same coverage level, but 50% and 70% coverage scenarios were not cost-effective.Interpretation With prior exposure partially protecting much of the Kenyan population, vaccination of young adults may no longer be cost-effective. Medicine (General) Infectious and parasitic diseases Edwine Barasa verfasserin aut Ambrose Agweyu verfasserin aut Matt J Keeling verfasserin aut Philip Bejon verfasserin aut Angela Kairu verfasserin aut Wangari Ng'ang'a verfasserin aut Mercy Mwangangi verfasserin aut Stefan Flasche verfasserin aut John Ojal verfasserin aut Stacey Orangi verfasserin aut J Anthony G Scott verfasserin aut Patrick Amoth verfasserin aut Samuel PC Brand verfasserin aut Cameline Orlendo verfasserin aut Rabia Aziza verfasserin aut George M Warimwe verfasserin aut Sophie Uyoga verfasserin aut Edward Otieno verfasserin aut Lynette I Ochola-Oyier verfasserin aut Charles N Agoti verfasserin aut Kadondi Kasera verfasserin aut Rashid Aman verfasserin aut Ifedayo MO Adetifa verfasserin aut D James Nokes verfasserin aut In BMJ Global Health BMJ Publishing Group, 2018 7(2022), 8 (DE-627)85645365X (DE-600)2851843-3 20597908 nnns volume:7 year:2022 number:8 https://doi.org/10.1136/bmjgh-2022-009430 kostenfrei https://doaj.org/article/c1192928f85547ea96b8178d08dc5f89 kostenfrei https://gh.bmj.com/content/7/8/e009430.full kostenfrei https://doaj.org/toc/2059-7908 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 7 2022 8 |
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Morris Ogero @@aut@@ Edwine Barasa @@aut@@ Ambrose Agweyu @@aut@@ Matt J Keeling @@aut@@ Philip Bejon @@aut@@ Angela Kairu @@aut@@ Wangari Ng'ang'a @@aut@@ Mercy Mwangangi @@aut@@ Stefan Flasche @@aut@@ John Ojal @@aut@@ Stacey Orangi @@aut@@ J Anthony G Scott @@aut@@ Patrick Amoth @@aut@@ Samuel PC Brand @@aut@@ Cameline Orlendo @@aut@@ Rabia Aziza @@aut@@ George M Warimwe @@aut@@ Sophie Uyoga @@aut@@ Edward Otieno @@aut@@ Lynette I Ochola-Oyier @@aut@@ Charles N Agoti @@aut@@ Kadondi Kasera @@aut@@ Rashid Aman @@aut@@ Ifedayo MO Adetifa @@aut@@ D James Nokes @@aut@@ |
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Epidemiological impact and cost-effectiveness analysis of COVID-19 vaccination in Kenya |
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Background A few studies have assessed the epidemiological impact and the cost-effectiveness of COVID-19 vaccines in settings where most of the population had been exposed to SARS-CoV-2 infection.Methods We conducted a cost-effectiveness analysis of COVID-19 vaccine in Kenya from a societal perspective over a 1.5-year time frame. An age-structured transmission model assumed at least 80% of the population to have prior natural immunity when an immune escape variant was introduced. We examine the effect of slow (18 months) or rapid (6 months) vaccine roll-out with vaccine coverage of 30%, 50% or 70% of the adult (>18 years) population prioritising roll-out in those over 50-years (80% uptake in all scenarios). Cost data were obtained from primary analyses. We assumed vaccine procurement at US$7 per dose and vaccine delivery costs of US$3.90–US$6.11 per dose. The cost-effectiveness threshold was US$919.11.Findings Slow roll-out at 30% coverage largely targets those over 50 years and resulted in 54% fewer deaths (8132 (7914–8373)) than no vaccination and was cost saving (incremental cost-effectiveness ratio, ICER=US$−1343 (US$−1345 to US$−1341) per disability-adjusted life-year, DALY averted). Increasing coverage to 50% and 70%, further reduced deaths by 12% (810 (757–872) and 5% (282 (251–317) but was not cost-effective, using Kenya’s cost-effectiveness threshold (US$919.11). Rapid roll-out with 30% coverage averted 63% more deaths and was more cost-saving (ICER=US$−1607 (US$−1609 to US$−1604) per DALY averted) compared with slow roll-out at the same coverage level, but 50% and 70% coverage scenarios were not cost-effective.Interpretation With prior exposure partially protecting much of the Kenyan population, vaccination of young adults may no longer be cost-effective. |
abstractGer |
Background A few studies have assessed the epidemiological impact and the cost-effectiveness of COVID-19 vaccines in settings where most of the population had been exposed to SARS-CoV-2 infection.Methods We conducted a cost-effectiveness analysis of COVID-19 vaccine in Kenya from a societal perspective over a 1.5-year time frame. An age-structured transmission model assumed at least 80% of the population to have prior natural immunity when an immune escape variant was introduced. We examine the effect of slow (18 months) or rapid (6 months) vaccine roll-out with vaccine coverage of 30%, 50% or 70% of the adult (>18 years) population prioritising roll-out in those over 50-years (80% uptake in all scenarios). Cost data were obtained from primary analyses. We assumed vaccine procurement at US$7 per dose and vaccine delivery costs of US$3.90–US$6.11 per dose. The cost-effectiveness threshold was US$919.11.Findings Slow roll-out at 30% coverage largely targets those over 50 years and resulted in 54% fewer deaths (8132 (7914–8373)) than no vaccination and was cost saving (incremental cost-effectiveness ratio, ICER=US$−1343 (US$−1345 to US$−1341) per disability-adjusted life-year, DALY averted). Increasing coverage to 50% and 70%, further reduced deaths by 12% (810 (757–872) and 5% (282 (251–317) but was not cost-effective, using Kenya’s cost-effectiveness threshold (US$919.11). Rapid roll-out with 30% coverage averted 63% more deaths and was more cost-saving (ICER=US$−1607 (US$−1609 to US$−1604) per DALY averted) compared with slow roll-out at the same coverage level, but 50% and 70% coverage scenarios were not cost-effective.Interpretation With prior exposure partially protecting much of the Kenyan population, vaccination of young adults may no longer be cost-effective. |
abstract_unstemmed |
Background A few studies have assessed the epidemiological impact and the cost-effectiveness of COVID-19 vaccines in settings where most of the population had been exposed to SARS-CoV-2 infection.Methods We conducted a cost-effectiveness analysis of COVID-19 vaccine in Kenya from a societal perspective over a 1.5-year time frame. An age-structured transmission model assumed at least 80% of the population to have prior natural immunity when an immune escape variant was introduced. We examine the effect of slow (18 months) or rapid (6 months) vaccine roll-out with vaccine coverage of 30%, 50% or 70% of the adult (>18 years) population prioritising roll-out in those over 50-years (80% uptake in all scenarios). Cost data were obtained from primary analyses. We assumed vaccine procurement at US$7 per dose and vaccine delivery costs of US$3.90–US$6.11 per dose. The cost-effectiveness threshold was US$919.11.Findings Slow roll-out at 30% coverage largely targets those over 50 years and resulted in 54% fewer deaths (8132 (7914–8373)) than no vaccination and was cost saving (incremental cost-effectiveness ratio, ICER=US$−1343 (US$−1345 to US$−1341) per disability-adjusted life-year, DALY averted). Increasing coverage to 50% and 70%, further reduced deaths by 12% (810 (757–872) and 5% (282 (251–317) but was not cost-effective, using Kenya’s cost-effectiveness threshold (US$919.11). Rapid roll-out with 30% coverage averted 63% more deaths and was more cost-saving (ICER=US$−1607 (US$−1609 to US$−1604) per DALY averted) compared with slow roll-out at the same coverage level, but 50% and 70% coverage scenarios were not cost-effective.Interpretation With prior exposure partially protecting much of the Kenyan population, vaccination of young adults may no longer be cost-effective. |
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