Vaccination strategies, public health impact and cost-effectiveness of dengue vaccine TAK-003: A modeling case study in Thailand

Background: Dengue is an increasing global problem associated with negative health and economic impacts. Vaccination is an important measure to reduce the significant public health and economic burden caused by dengue. Our study assesses the public health impact and cost-effectiveness of a new dengue vaccine, TAK-003, using Thailand as a case study. Methods and findings: We developed a dynamic transmission model with both host and vector populations, 4 serotype-specific infections, seasonality, and other key elements of dengue natural history. We estimated efficacy of TAK-003 from the DEN-301 trial. We first used the model to determine the optimal cohort age for different vaccination strategies with TAK-003, based on Thai dengue epidemiology. Secondly, we assessed the public health impact of a pragmatic strategy integrating TAK-003 into an existing national immunization program in Thailand. Cost-effectiveness was evaluated from a societal perspective using disability-adjusted life-years (DALYs) over a 20-year horizon. Conclusions: TAK-003 can considerably reduce dengue burden and lead to cost savings in Thailand. These benefits can be maximized by identifying optimal age cohorts for vaccination and adding catch-up programs. Our model can be used to assess the vaccination impact in other dengue-endemic countries. Author summary: Why was this study done?The World Health Organization has identified dengue as a significant global threat.There is no adequate treatment for dengue and prevention is key; TAK-003 is the only licensed vaccine that can be used for individuals both with and without a previous dengue infection.Our work uses Thailand as an example to demonstrate optimal design of an efficient dengue vaccination program using mathematical modeling. In a case study of Thailand, modeling vaccination with the TAK-003 dengue vaccine can help optimize strategies to reduce health and economic burdens of dengue disease.