Abstract

Zika virus remains a major public health concern because of its association with microcephaly and other neurologic disorders in newborns. A prophylactic vaccine has the potential to reduce disease incidence and eliminate birth defects resulting from prenatal Zika virus infection in future outbreaks. We evaluated the cost-effectiveness of a Zika vaccine candidate, assuming a protection efficacy of 60%–90%, for 18 countries in the Americas affected by the 2015–2017 Zika virus outbreaks. Encapsulating the demographics of these countries in an agent-based model, our results show that vaccinating women of reproductive age would be very cost-effective for sufficiently low (<$16) vaccination costs per recipient, depending on the country-specific Zika attack rate. In all countries studied, the median reduction of microcephaly was >75% with vaccination. These findings indicate that targeted vaccination of women of reproductive age is a noteworthy preventive measure for mitigating the effects of Zika virus infection in future outbreaks.

Highlights

  • Zika virus remains a major public health concern because of its association with microcephaly and other neurologic disorders in newborns

  • We determined the vaccination costs per individual (VCPI) for scenarios that are cost-saving, very cost-effective, and cost-effective for each country (Table), the corresponding incremental cost per disability-adjusted life-years (DALYs) averted with 95% CIs

  • We determined the VCPI within the input range of $2–$100, for which vaccination is cost-saving and is very cost-effective for 18 countries in the Americas

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Summary

Introduction

Zika virus remains a major public health concern because of its association with microcephaly and other neurologic disorders in newborns. The median reduction of microcephaly was >75% with vaccination These findings indicate that targeted vaccination of women of reproductive age is a noteworthy preventive measure for mitigating the effects of Zika virus infection in future outbreaks. The connection of Zika virus infection to prenatal microcephaly and other brain abnormalities [4,5,6] raised a public health emergency of international concern in February 2016 [7]. To inform decisions on implementing the recommended VTPP, we evaluated the cost-effectiveness of a potential Zika virus vaccine in 18 countries in the Americas where the estimated attack rates (i.e., the proportion of the population infected) during the 2015–2017 outbreaks were >2% [17,18]

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