Different vaccination strategies for preventing coronavirus disease 2019 in Kenya: A dynamic modelling study of health impact and cost-effectiveness

D. Zhou, Hanqiao Shao, Y. Tu, T. Shao, Mingye Zhao, Kejia Zhou, Kevin Wang, Xiaoying Tang, Yilan Xing, Zeyao Liu, D. Malone, Wenxi Tang
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Abstract

Background: Vaccination can significantly reduce the health impact and economic burden of coronavirus disease 2019 (COVID-19), but vaccination levels for COVID-19 in most African countries lag far behind global averages. We assessed the cost-effectiveness of different COVID-19 vaccination strategies in Kenya and determined the optimal vaccination strategy. Methods: Using a dynamic transmission model, we divided the population into three groups: 0-18 years, 19-58 years and 58+ years. We assessed the effectiveness and cost-effectiveness of three vaccination strategies at different numbers of daily vaccinations based on previous studies and public databases. Nine scenarios were modeled and compared to no-continuation-vaccination to calculate the number of averted diseases, averted deaths, and net benefits of different vaccination strategies. One-way sensitivity analysis and probabilistic sensitivity analysis were conducted to assess the stability of our findings. Results: Compared to no-continuation-vaccination for various vaccination scenarios, all vaccination strategies were found to be effective and cost-saving. The incremental net benefit ranged from 0.235 billion USD to 2.305 billion USD, and prioritizing vaccination boosters for individuals aged 19-58 was identified as the most cost-effective option. On the other hand, prioritizing vaccination for the unvaccinated population aged 58 and above could potentially reduce COVID-19 related deaths by 1.59%-56.60%, which was the most effective approach in avoiding cause-specific deaths. However, all vaccination strategies were found to be ineffective in controlling the infection trend when compared to no intervention under different vaccination scenarios, with only 474,318-5,306,865 infections potentially being prevented. Conclusion: Timely and widespread vaccination against COVID-19 in Kenya is effective and cost-effective, a specific vaccination strategy should be selected based on decision-making needs. Priority vaccination for the elderly without vaccination may be more cost-effective compared with other vaccination strategies.
2019年肯尼亚预防冠状病毒病的不同疫苗接种策略:健康影响和成本效益的动态建模研究
背景:疫苗接种可以显著减少2019冠状病毒病(COVID-19)的健康影响和经济负担,但大多数非洲国家的COVID-19疫苗接种水平远远落后于全球平均水平。我们评估了肯尼亚不同COVID-19疫苗接种策略的成本效益,并确定了最佳疫苗接种策略。方法:采用动态传播模型,将人群分为0 ~ 18岁、19 ~ 58岁和58+岁3组。基于以往的研究和公共数据库,我们评估了三种疫苗接种策略在不同日疫苗接种次数下的有效性和成本效益。对9种情况进行建模,并与不继续接种疫苗进行比较,以计算避免疾病的数量,避免死亡的数量以及不同疫苗接种策略的净收益。我们进行了单向敏感性分析和概率敏感性分析来评估我们研究结果的稳定性。结果:与不继续接种相比,各种接种方案均有效且节省成本。增量净效益在2.35亿美元至23.05亿美元之间,优先为19-58岁的个体接种疫苗增强剂被确定为最具成本效益的选择。另一方面,优先为58岁及以上未接种疫苗的人群接种疫苗,可能会使COVID-19相关死亡人数减少1.59%-56.60%,这是避免原因特异性死亡的最有效方法。然而,在不同的疫苗接种情景下,与不干预相比,所有疫苗接种策略在控制感染趋势方面都是无效的,只有474,318-5,306,865例感染可能被预防。结论:在肯尼亚及时和广泛接种COVID-19疫苗是有效且具有成本效益的,应根据决策需要选择具体的疫苗接种策略。与其他疫苗接种策略相比,对未接种疫苗的老年人优先接种疫苗可能更具成本效益。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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