Abstract
Vaccines are one of the most cost-effective tools for improving human health and well-being. The impact of a vaccine on population health is partly determined by its coverage rate, the proportion of eligible individuals vaccinated. Coverage rate is a function of the vaccine presentation and the population in which that presentation is deployed. This population includes not only the individuals vaccinated, but also the logistics and healthcare systems responsible for vaccine delivery. Because vaccine coverage rates remain below targets in many settings, vaccine manufacturers and purchasers have a shared interest in better understanding the relationship between vaccine presentation, population characteristics, and coverage rate. While there have been some efforts to describe this relationship, existing research and tools are limited in their ability to quantify coverage rate changes across a broad set of antigens, vaccine presentations, and geographies. In this article, we present a method for estimating the impact of improved vaccine technologies on vaccination coverage rates. It is designed for use with low- and middle-income country vaccination programs. This method uses publicly available data and simple calculations based on probability theory to generate coverage rate values. We first present the conceptual framework and mathematical approach. Using a Microsoft Excel-based implementation, we then apply the method to a vaccine technology in early-stage development: micro-array patch for a measles-rubella vaccine (MR-MAP). Example outputs indicate that a complete switch from the current subcutaneous presentation to MR-MAP in the 73 countries ever eligible for Gavi support would increase overall vaccination coverage by 3.0–4.9 percentage points depending on the final characteristics of the MR-MAP. This change equates to an additional 2.6–4.2 million children vaccinated per year. Our method can be readily extended to other antigens and vaccine technologies to provide quick, low-cost estimates of coverage impact. As vaccine manufacturers and purchasers face increasingly complex decisions, such estimates could facilitate objective comparisons between options and help these decision makers obtain the most value for money.
Highlights
Every year, organizations spend millions of dollars on the development of new vaccine technologies such as simpler and safer administration methods and improved thermostability
We propose a method for generating such estimates in a rapid and low-cost manner. This method is guided by the question, “How can publicly available data be used to estimate the impact of improved vaccine technologies on vaccination coverage rates?” While this method could be applied to any country, we focus on vaccination coverage rates in lowand middle-income countries (LMICs) for three reasons
For the barrier Acceptability of Presentation, we focused on potential acceptability issues due to the use of a pork product
Summary
Organizations spend millions of dollars on the development of new vaccine technologies such as simpler and safer administration methods and improved thermostability. These technologies may offer benefits like lower cost for vaccine storage, a reduction in the number of adverse events, and increased efficacy [1, 2]. Understanding the type and magnitude of potential benefits allows vaccine manufacturers to channel resources toward technologies with greater promise. It allows vaccine purchasers such as donor organizations and governments to make more cost-beneficial procurement decisions. One benefit rarely quantified is the expected increase in vaccination coverage rates
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