Informing decision makers seeking to improve vaccination programs: case-study Serbia

Area of Science:

• Public Health
• Health Economics
• Vaccinology

Background:

• Public health decision-makers aim to maximize population health through optimized vaccine policies.
• This case study in Serbia evaluated pneumococcal conjugate vaccination (PCV), rotavirus (RV) vaccination, and varicella zoster virus (VZV) vaccination.
• Vaccine policy optimization is crucial before implementation to maximize health outcomes.

Purpose of the Study:

• To determine the optimal introduction order for PCV, RV, and VZV vaccines in Serbia.
• To minimize deaths, Quality-Adjusted Life Years (QALYs) lost, and hospitalisation days.
• To operate under budget and vaccine coverage constraints.

Main Methods:

• A constrained optimization model using a static multi-cohort decision-tree model for three infectious diseases.
• Linear programming was employed to rank vaccines based on outcome per budget unit.
• Probabilistic decision analysis via Monte Carlo simulation assessed ranking robustness.

Main Results:

• Pneumococcal conjugate vaccination (PCV) ranked first for minimizing deaths.
• Varicella zoster virus (VZV) vaccination ranked first for QALY loss minimization.
• Rotavirus (RV) vaccination ranked first for reducing hospitalisation days.
• Sensitivity analysis confirmed PCV for death minimization as the most robust ranking.

Conclusions:

• Constrained optimization modeling provides a rational framework for vaccine policy decisions.
• The study highlights PCV as a priority for reducing mortality.
• This approach comprehensively evaluates potential public health interventions.