Modeling the impact and cost-effectiveness of next-generation rotavirus vaccine strategies in low- and middle-income countries

模拟低收入和中等收入国家下一代轮状病毒疫苗策略的影响和成本效益

基本信息

批准号：
10468747
负责人：
VIRGINIA E PITZER
金额：
$ 42.65万
依托单位：
YALE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-02-01 至 2025-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10468747
关键词：
Accounting Adopted Age Benchmarking Cessation of life Child Clinical Trials Collaborations Collection Cost Analysis Cost Effectiveness Analysis Costs and Benefits Country Data Data Collection Decision Making Development Diarrhea Disease Economic Models Funding Future Gastroenteritis Ghana Health Heterogeneity Immune response Immunity Immunization Programs Incidence Income Individual Inpatients Intussusception Light Malawi Measures Modeling Morbidity - disease rate Neonatal Oral Outpatients Population Positioning Attribute Predisposition Price Randomized Clinical Trials Research Personnel Risk Rotavirus Rotavirus Vaccines Rotavirus disease Serious Adverse Event Site Source Statistical Models Structural Models Subunit Vaccines Time Translating Uncertainty Vaccination Vaccines Virus base clinical predictors cost effective cost effectiveness cost-effectiveness evaluation economic evaluation health economics immunogenicity low and middle-income countries low income country mathematical model mortality next generation novel novel strategies novel vaccines oral vaccine response success surveillance data transmission process vaccination strategy vaccine candidate vaccine effectiveness vaccine response vaccine strategy willingness to pay

项目摘要

PROJECT SUMMARY/ABSTRACT Despite the introduction of live oral rotavirus vaccines into more than 90 countries worldwide, rotavirus remains a leading cause of severe diarrhea in children and a major source of morbidity and mortality in low- and middle-income countries (LMICs). Rotavirus vaccination has been effective at controlling the burden of rotavirus-associated gastroenteritis (RVGE) in high-income countries, but the response, efficacy, and impact of current live oral rotavirus vaccines is lower in LMICs for multiple reasons that are still not fully understood. New vaccines and approaches may be needed to overcome the poor immune response to current live oral rotavirus vaccines in LMICs. Next-generation rotavirus vaccines, including neonatal and parenteral subunit vaccines, are currently in development and undergoing clinical trials at our field sites in Malawi and Ghana. Models are needed to extrapolate the results of these trials to the population level. We will use mathematical models to predict the potential impact of different rotavirus vaccination strategies, accounting for both the direct and indirect effects of vaccination. We will then conduct economic evaluations to determine the most cost-effective approach to reducing the burden of diarrhea due to rotavirus. We will begin by focusing on Malawi and Ghana, where we have previously developed models and have good pre- and post-vaccination surveillance data. We will then extend our approach to predict vaccine impact and cost-effectiveness across all LMICs. Our analyses will help to better define the vaccine response, duration of immunity, and price at which next-generation rotavirus vaccines are likely to be cost-effective, and will provide a validated platform that decision-makers in LMICs can use to weigh the costs and benefits of different rotavirus vaccination strategies in their country.

项目摘要/摘要尽管将现场口服轮状病毒疫苗引入了全球90多个国家，但轮状病毒仍然存在儿童严重腹泻的主要原因，以及低 - 和中等收入国家（LMIC）。轮状病毒疫苗已有效控制高收入国家的轮状病毒相关胃炎（RVGE），但的反应，功效和影响目前的LMIC中，当前的现场口服轮状病毒疫苗较低，原因是尚未完全了解的多种原因。新的可能需要采取疫苗和方法来克服对当前活体轮状病毒的不良免疫反应 LMICS中的疫苗。下一代轮状病毒疫苗，包括新生儿和肠胃外亚基疫苗，是目前正在马拉维和加纳的现场开发并正在进行临床试验。模型是需要将这些试验的结果推送到人群水平。我们将使用数学模型预测不同轮状病毒疫苗接种策略的潜在影响，对直接和疫苗接种的间接影响。然后，我们将进行经济评估，以确定最具成本效益的减轻轮状病毒引起的腹泻负担的方法。我们将首先关注马拉维和加纳，我们以前已经开发了模型，并具有良好的疫苗发生前监视数据。我们然后，将扩展我们的方法，以预测所有LMIC的疫苗影响和成本效益。我们的分析将有助于更好地定义疫苗反应，免疫持续时间和下一代的价格轮状病毒疫苗可能具有成本效益，并将提供一个经过验证的平台，决策者 LMIC可以用来权衡其国家不同轮状病毒疫苗策略的成本和收益。