Budget constraint and vaccine dosing: a mathematical modelling exercise.

Area of Science:

• Health economics
• Vaccinology
• Public health policy

Background:

• Vaccine efficacy can be influenced by the number of doses administered.
• Budgetary constraints necessitate efficient vaccine scheduling for maximizing population health benefits.

Purpose of the Study:

• To identify the optimal vaccine dosing schedule within a fixed budget from a healthcare payer's viewpoint.
• To guide decision-makers in selecting cost-effective vaccination strategies.

Main Methods:

• Developed an optimization model to maximize disease reduction under a vaccination budget constraint.
• Varied parameters including dosing numbers, cost per dose, coverage rates, and vaccine efficacy.
• Applied the model to the monovalent rotavirus vaccine for illustrative purposes.

Main Results:

• A 2-dose schedule generally yields greater disease reduction than a 3-dose schedule for rotavirus vaccine under a fixed budget.
• A 3-dose schedule may be superior only under specific conditions: >26% cost reduction per dose, ≥5% efficacy increase, and 75% coverage.
• Significant interactions exist between cost reduction, coverage rates, and vaccine efficacy, influencing optimal dosing.

Conclusions:

• Optimization modeling is a valuable tool for determining efficient vaccine dosing schedules under budget constraints.
• Lower-dose vaccination strategies often represent the optimal choice in various tested scenarios.
• The model's framework is adaptable for evaluating diverse dosing schemes with single or multiple vaccines.