Priority setting for older adult vaccines in Indonesia: a multi-criteria decision analysis using SMART vaccines.

IF 5.6 3区医学 Q1 IMMUNOLOGY

Expert Review of Vaccines Pub Date : 2026-12-01 Epub Date: 2026-08-24 DOI:10.1080/14760584.2026.2720954

Mohammed Alfaqeeh, Neily Zakiyah, Maarten J Postma, Anas Hamad, Auliya A Suwantika

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引用次数: 0

Abstract

Background: Indonesia's aging population faces substantial vaccine-preventable disease burdens, while vaccine introduction decisions remain constrained by limited resources and the absence of a prioritization framework. This study prioritized vaccines for older adults in Indonesia using a structured prioritization approach.

Research design and methods: A multi-criteria decision analysis was conducted using the Strategic Multi-Attribute Ranking Tool for Vaccines. Influenza vaccine (IV), pneumococcal conjugate vaccine (PCV), recombinant zoster vaccine (RZV), and respiratory syncytial virus vaccine (RSVV) were assessed across 10 attributes. Stakeholders confirmed vaccine candidates, validated criteria, assigned weights, and scored vaccines. One-way sensitivity analyses and an exploratory proxy uncertainty analysis were performed to assess ranking robustness.

Results: Seventeen representatives from ten stakeholder institutions participated. The highest weighted attributes were quality-adjusted life years gained/disability-adjusted life years averted (14.44%), relevance to older adult public health priorities (12.78%), premature deaths averted (11.89%), net budget impact (11.44%), and cost-effectiveness (11.22%). Composite scores ranked IV first (858.25), followed by PCV (809.24), RSVV (569.39), and RZV (558.03). Rankings remained unchanged across all sensitivity and proxy uncertainty analyses.

Conclusions: IV was the highest-priority vaccine for older adults in Indonesia, followed by PCV, RSVV, and RZV. This framework provides an evidence-informed basis for vaccine policy and healthy aging strategies.

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印度尼西亚老年成人疫苗的优先确定：使用SMART疫苗的多标准决策分析。

背景：印度尼西亚的老龄化人口面临着疫苗可预防疾病的沉重负担，而引进疫苗的决定仍然受到资源有限和缺乏优先框架的制约。本研究采用结构化的优先排序方法对印度尼西亚老年人的疫苗进行了优先排序。研究设计和方法：采用疫苗战略多属性排序工具进行多标准决策分析。流感疫苗（IV）、肺炎球菌结合疫苗（PCV）、重组带状疱疹疫苗（RZV）和呼吸道合胞病毒疫苗（RSVV）通过10个属性进行评估。利益攸关方确认候选疫苗、验证标准、分配权重并对疫苗进行评分。采用单向敏感性分析和探索性代理不确定性分析来评估排名稳健性。结果：来自10个利益相关机构的17名代表参加了会议。权重最高的属性是获得的质量调整生命年/避免的残疾调整生命年（14.44%）、与老年人公共卫生优先事项的相关性（12.78%）、避免过早死亡（11.89%）、净预算影响（11.44%）和成本效益（11.22%）。综合得分最高的是IV(858.25)，其次是PCV（809.24）、RSVV（569.39）和RZV（558.03）。在所有敏感性和代理不确定性分析中，排名保持不变。结论：IV是印度尼西亚老年人最优先接种的疫苗，其次是PCV、RSVV和RZV。该框架为疫苗政策和健康老龄化战略提供了循证基础。

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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来源期刊

Expert Review of Vaccines 医学-免疫学

CiteScore

9.10

自引率

3.20%

发文量

136

审稿时长

4-8 weeks

期刊介绍： Expert Review of Vaccines (ISSN 1476-0584) provides expert commentary on the development, application, and clinical effectiveness of new vaccines. Coverage includes vaccine technology, vaccine adjuvants, prophylactic vaccines, therapeutic vaccines, AIDS vaccines and vaccines for defence against bioterrorism. All articles are subject to rigorous peer-review. The vaccine field has been transformed by recent technological advances, but there remain many challenges in the delivery of cost-effective, safe vaccines. Expert Review of Vaccines facilitates decision making to drive forward this exciting field.