Related Experiment Video
Updated: Mar 12, 2026
Evaluation of Host-Pathogen Responses and Vaccine Efficacy in Mice
Published on: February 22, 2019
What Pertussis Mortality Rates Make Maternal Acellular Pertussis Immunization Cost-Effective in Low- and
Louise B Russell1, Sri Ram Pentakota2, Cristiana Maria Toscano3
1Department of Economics and Institute for Health, New Brunswick.
Insights
Maternal acellular pertussis (aP) vaccination could save infant lives in low- and middle-income countries (LMICs). However, it is only cost-effective if the vaccine price is low, below $1-$2 per dose, according to common benchmarks.
Area of Science:
- Public Health
- Vaccinology
- Health Economics
Background:
- Pertussis (whooping cough) remains a significant cause of infant mortality in low- and middle-income countries (LMICs), despite existing vaccination programs.
- A new monovalent acellular pertussis (aP) vaccine for maternal administration is under development to protect young infants.
Purpose of the Study:
- To estimate the infant pertussis mortality rates at which maternal aP vaccination would be a cost-effective public health intervention in LMICs.
- To assess the economic viability of maternal immunization strategies compared to routine infant vaccination alone.
Main Methods:
- A decision-analytic model was employed to evaluate cost-effectiveness in Bangladesh, Nigeria, and Brazil.
- Sensitivity analyses explored the impact of varying maternal aP vaccine prices and different cost-effectiveness benchmarks (e.g., GDP per capita per DALY).
Main Results:
- Achieving cost-effectiveness for maternal aP immunization generally requires higher infant pertussis mortality rates than currently observed, except under specific conditions.
- Low vaccine prices (e.g., $0.50/dose) and high-end cost-effectiveness benchmarks are crucial for demonstrating economic value.
- For instance, in Nigeria, a mortality rate of 0.018 per 1000 infants is needed at $0.50/dose to meet the 0.5 GDP per capita per DALY benchmark.
Conclusions:
- Maternal aP immunization is likely to be cost-effective in many LMICs only if the vaccine price is maintained below $1-$2 per dose.
- The economic feasibility is highly dependent on vaccine pricing and the chosen cost-effectiveness threshold.
Background:
Despite longstanding infant vaccination programs in low- and middle-income countries (LMICs), pertussis continues to cause deaths in the youngest infants. A maternal monovalent acellular pertussis (aP) vaccine, in development, could prevent many of these deaths. We estimated infant pertussis mortality rates at which maternal vaccination would be a cost-effective use of public health resources in LMICs.
Methods:
We developed a decision model to evaluate the cost-effectiveness of maternal aP immunization plus routine infant vaccination vs routine infant vaccination alone in Bangladesh, Nigeria, and Brazil. For a range of maternal aP vaccine prices, one-way sensitivity analyses identified the infant pertussis mortality rates required to make maternal immunization cost-effective by alternative benchmarks ($100, 0.5 gross domestic product [GDP] per capita, and GDP per capita per disability-adjusted life-year [DALY]). Probabilistic sensitivity analysis provided uncertainty intervals for these mortality rates.
Results:
Infant pertussis mortality rates necessary to make maternal aP immunization cost-effective exceed the rates suggested by current evidence except at low vaccine prices and/or cost-effectiveness benchmarks at the high end of those considered in this report. For example, at a vaccine price of $0.50/dose, pertussis mortality would need to be 0.051 per 1000 infants in Bangladesh, and 0.018 per 1000 in Nigeria, to cost 0.5 per capita GDP per DALY. In Brazil, a middle-income country, at a vaccine price of $4/dose, infant pertussis mortality would need to be 0.043 per 1000 to cost 0.5 per capita GDP per DALY.
Conclusions:
For commonly used cost-effectiveness benchmarks, maternal aP immunization would be cost-effective in many LMICs only if the vaccine were offered at less than $1-$2/dose.
More Related Videos
06:26Author Spotlight: Optimizing CFU Determination for Efficient Assessment of TB Vaccine Efficacy and Antigen Presentation Analysis
Published on: July 28, 2023
10:26Author Spotlight: A Cost-Effective Genomic Workflow for Advancing Rabies Control in Resource-Limited Settings
Published on: August 18, 2023
