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Cost-effectiveness of routine adolescent vaccination with an M72/AS01E-like tuberculosis vaccine in South Africa and India

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  • Rebecca C. Harris

    (London School of Hygiene and Tropical Medicine
    Sanofi Pasteur)

  • Matthew Quaife

    (London School of Hygiene and Tropical Medicine)

  • Chathika Weerasuriya

    (London School of Hygiene and Tropical Medicine)

  • Gabriela B. Gomez

    (London School of Hygiene and Tropical Medicine
    Sanofi Pasteur)

  • Tom Sumner

    (London School of Hygiene and Tropical Medicine)

  • Fiammetta Bozzani

    (London School of Hygiene and Tropical Medicine)

  • Richard G. White

    (London School of Hygiene and Tropical Medicine)

Abstract

The M72/AS01E tuberculosis vaccine showed 50% (95%CI: 2–74%) efficacy in a phase 2B trial in preventing active pulmonary tuberculosis disease, but potential cost-effectiveness of adolescent immunisation is unknown. We estimated the impact and cost-effectiveness of six scenarios of routine adolescent M72/AS01E-like vaccination in South Africa and India. All scenarios suggested an M72/AS01E-like vaccine would be highly (94–100%) cost-effective in South Africa compared to a cost-effectiveness threshold of $2480/disability-adjusted life-year (DALY) averted. For India, a prevention of disease vaccine, effective irrespective of recipient’s M. tuberculosis infection status at time of administration, was also highly likely (92–100%) cost-effective at a threshold of $264/DALY averted; however, a prevention of disease vaccine, effective only if the recipient was already infected, had 0–6% probability of cost-effectiveness. In both settings, vaccinating 50% of 18 year-olds was similarly cost-effective to vaccinating 80% of 15 year-olds, and more cost-effective than vaccinating 80% of 10 year-olds. Vaccine trials should include adolescents to ensure vaccines can be delivered to this efficient-to-target population.

Suggested Citation

  • Rebecca C. Harris & Matthew Quaife & Chathika Weerasuriya & Gabriela B. Gomez & Tom Sumner & Fiammetta Bozzani & Richard G. White, 2022. "Cost-effectiveness of routine adolescent vaccination with an M72/AS01E-like tuberculosis vaccine in South Africa and India," Nature Communications, Nature, vol. 13(1), pages 1-8, December.
    • Handle: RePEc:nat:natcom:v:13:y:2022:i:1:d:10.1038_s41467-022-28234-7
    DOI: 10.1038/s41467-022-28234-7
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    References listed on IDEAS

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    1. Han Fu & Joseph A. Lewnard & Isabel Frost & Ramanan Laxminarayan & Nimalan Arinaminpathy, 2021. "Modelling the global burden of drug-resistant tuberculosis avertable by a post-exposure vaccine," Nature Communications, Nature, vol. 12(1), pages 1-9, December.
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