Setting priorities for the Children's Vaccine Initiative: a cost-effectiveness approach

Area of Science:

• Public Health
• Health Economics
• Vaccinology

Background:

• The Children's Vaccine Initiative (CVI) aims to develop new and improved vaccines for children globally.
• Prioritizing vaccine development requires robust methods to assess both health impact and economic feasibility.
• Existing health infrastructure and financial constraints in developing countries necessitate careful resource allocation.

Purpose of the Study:

• To develop and apply a cost-effectiveness model for prioritizing vaccine development initiatives.
• To identify vaccine candidates offering the most significant health gains at the lowest cost per Quality-Adjusted Life Year (QALY).

Main Methods:

• A cost-effectiveness model was created, measuring health benefits in additional QALYs gained by birth cohorts.
• Costs included development, procurement, and administration, compared to the status quo, with weighted resource allocation.
• The model was applied to 13 candidate vaccines prioritized by CVI based on feasibility.

Main Results:

• The model identified five highly cost-effective vaccine improvements, each costing less than $25 per QALY.
• These included early measles vaccination (single or double dose), slow-release tetanus toxoid for women, improved typhoid vaccine, and a combined Hepatitis B/DTP vaccine.

Conclusions:

• The developed cost-effectiveness model provides a framework for prioritizing vaccine development for maximum public health impact.
• Specific vaccine interventions, such as enhanced measles and typhoid vaccines, offer substantial value for money in global child health.