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Clinical outcomes and cost-effectiveness of COVID-19 vaccination in South Africa

Author

Listed:
  • Krishna P. Reddy

    (Massachusetts General Hospital
    Massachusetts General Hospital
    Harvard Medical School)

  • Kieran P. Fitzmaurice

    (Massachusetts General Hospital)

  • Justine A. Scott

    (Massachusetts General Hospital)

  • Guy Harling

    (Africa Health Research Institute
    University of the Witwatersrand
    University of KwaZulu-Natal
    University College London)

  • Richard J. Lessells

    (University of KwaZulu-Natal)

  • Christopher Panella

    (Massachusetts General Hospital)

  • Fatma M. Shebl

    (Massachusetts General Hospital
    Harvard Medical School)

  • Kenneth A. Freedberg

    (Massachusetts General Hospital
    Harvard Medical School
    Massachusetts General Hospital
    Massachusetts General Hospital)

  • Mark J. Siedner

    (Massachusetts General Hospital
    Harvard Medical School
    Africa Health Research Institute
    Massachusetts General Hospital)

Abstract

Low- and middle-income countries are implementing COVID-19 vaccination strategies in light of varying vaccine efficacies and costs, supply shortages, and resource constraints. Here, we use a microsimulation model to evaluate clinical outcomes and cost-effectiveness of a COVID-19 vaccination program in South Africa. We varied vaccination coverage, pace, acceptance, effectiveness, and cost as well as epidemic dynamics. Providing vaccines to at least 40% of the population and prioritizing vaccine rollout prevented >9 million infections and >73,000 deaths and reduced costs due to fewer hospitalizations. Model results were most sensitive to assumptions about epidemic growth and prevalence of prior immunity to SARS-CoV-2, though the vaccination program still provided high value and decreased both deaths and health care costs across a wide range of assumptions. Vaccination program implementation factors, including prompt procurement, distribution, and rollout, are likely more influential than characteristics of the vaccine itself in maximizing public health benefits and economic efficiency.

Suggested Citation

  • Krishna P. Reddy & Kieran P. Fitzmaurice & Justine A. Scott & Guy Harling & Richard J. Lessells & Christopher Panella & Fatma M. Shebl & Kenneth A. Freedberg & Mark J. Siedner, 2021. "Clinical outcomes and cost-effectiveness of COVID-19 vaccination in South Africa," Nature Communications, Nature, vol. 12(1), pages 1-10, December.
  • Handle: RePEc:nat:natcom:v:12:y:2021:i:1:d:10.1038_s41467-021-26557-5
    DOI: 10.1038/s41467-021-26557-5
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    References listed on IDEAS

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    1. Andrew Briggs & Anna Vassall, 2021. "Count the cost of disability caused by COVID-19," Nature, Nature, vol. 593(7860), pages 502-505, May.
    2. John N. Nkengasong & Nicaise Ndembi & Akhona Tshangela & Tajudeen Raji, 2020. "COVID-19 vaccines: how to ensure Africa has access," Nature, Nature, vol. 586(7828), pages 197-199, October.
    3. Gesine Meyer-Rath & Craig van Rensburg & Bruce Larson & Lise Jamieson & Sydney Rosen, 2017. "Revealed willingness-to-pay versus standard cost-effectiveness thresholds: Evidence from the South African HIV Investment Case," PLOS ONE, Public Library of Science, vol. 12(10), pages 1-9, October.
    4. Houriiyah Tegally & Eduan Wilkinson & Marta Giovanetti & Arash Iranzadeh & Vagner Fonseca & Jennifer Giandhari & Deelan Doolabh & Sureshnee Pillay & Emmanuel James San & Nokukhanya Msomi & Koleka Mlis, 2021. "Detection of a SARS-CoV-2 variant of concern in South Africa," Nature, Nature, vol. 592(7854), pages 438-443, April.
    5. Beth Woods & Paul Revill & Mark Sculpher & Karl Claxton, 2015. "Country-level cost-effectiveness thresholds: initial estimates and the need for further research," Working Papers 109cherp, Centre for Health Economics, University of York.
    6. Sandile Cele & Inbal Gazy & Laurelle Jackson & Shi-Hsia Hwa & Houriiyah Tegally & Gila Lustig & Jennifer Giandhari & Sureshnee Pillay & Eduan Wilkinson & Yeshnee Naidoo & Farina Karim & Yashica Ganga , 2021. "Escape of SARS-CoV-2 501Y.V2 from neutralization by convalescent plasma," Nature, Nature, vol. 593(7857), pages 142-146, May.
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    Cited by:

    1. Beate Jahn & Sarah Friedrich & Joachim Behnke & Joachim Engel & Ursula Garczarek & Ralf Münnich & Markus Pauly & Adalbert Wilhelm & Olaf Wolkenhauer & Markus Zwick & Uwe Siebert & Tim Friede, 2022. "On the role of data, statistics and decisions in a pandemic," AStA Advances in Statistical Analysis, Springer;German Statistical Society, vol. 106(3), pages 349-382, September.

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