保护巴西婴儿的母体RSV疫苗接种:基于模型的成本效益分析,用于纳入国家免疫计划
Sophia Aguiar Monteiro Borges1,2, Erick Ohanesian Polli1, Ana Carolina Nonato1
1Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
Lancet regional health. Americas
|January 16, 2026
概括
在巴西,针对呼吸道同胞病毒 (RSV) 的孕产妇免疫可以减少疾病负担,但以当前价格来看,这并不具有成本效益. 需要大幅降低疫苗价格才能达到巴西的成本效益值.
科学领域:
- 公共卫生 公共卫生
- 疫苗学 疫苗学 疫苗学
- 卫生经济学 卫生经济学
背景情况:
- 呼吸道同胞病毒 (RSV) 是巴西幼儿下呼吸道感染的主要原因之一.
- 用RSV预注射F蛋白疫苗 (RSVpreF) 进行母体免疫接种,在保护婴儿在头六个月内免受RSV-LRTI的高疗效.
- 巴西母婴RSV免疫接种的成本效益需要评估.
研究的目的:
- 评估在巴西实施母体RSV免疫计划的成本效益.
- 从医疗保健系统和社会角度来看,比较母婴接种疫苗与不接种疫苗.
- 确定在巴西母体RSV免疫接种具有成本效益的条件.
主要方法:
- 使用决策树模型,追踪出生队列在生命的第一年.
- 数据来源于巴西卫生信息系统,行政数据库和国际文献.
- 主要结局是每年残疾调整寿命年 (DALY) 的增量成本效益比 (ICER) 被避免,使用每DALY8000美元的门.
主要成果:
- 在50%的覆盖率下,母体RSV疫苗接种可以预防每年约37,000例RSV病例,9400例住院治疗,并避免80例死亡和1660例DALY.
- ICER的价值为29,700美元 (医疗保健系统) 和29,200美元 (社会),显著超过巴西的8000美元门.
- 疫苗的价格和有效性是最有影响力的参数;成本效益需要大约12美元的剂量价格.
结论:
- 母亲的RSV免疫可以大大减少巴西的疾病负担.
- 目前的疫苗价格使得该计划无法达到巴西的成本效益值.
- 为了在巴西广泛实施母婴RSV免疫接种,需要大幅降低价格.
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