法国免疫力低下患者接种变异型 mRNA COVID-19 疫苗后,疾病的临床和经济负担大幅减轻

Amy Lee, Benjamin Davido, Ekkehard Beck, Clarisse Demont, Keya Joshi, Michele Kohli, Michael Maschio, Mathieu Uhart, Nadia El Mouaddin
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摘要

我们进行了一项经济评估,以预测法国在 2023 年秋季和 2024 年春季为年龄≥30 岁的免疫力低下 (IC) 患者接种 mRNA-1273 变异适应型 COVID-19 疫苗与 BNT162b2 变异适应型疫苗的经济和临床负担。采用静态决策分析模型估算了无症状 COVID-19 感染、住院、死亡和长期 COVID 病例的数量、成本和质量调整生命年 (QALY)。预测的疫苗有效性(VE)是基于先前版本的实际数据,表明使用 mRNA-1273 疫苗可提高对感染和住院的保护。VE 估计值与 COVID-19 发病率和 COVID-19 严重后果的概率相结合。在敏感性分析中对 VE、疫苗覆盖率、感染发生率、住院率和死亡率、成本和 QALY 的不确定性进行了测试。与 BNT162b2 变态反应疫苗相比,mRNA-1273 变态反应疫苗预计可在 23 万名 IC 感染者中额外预防 3882 例感染、357 例住院、81 例死亡和 326 例长期 COVID 病例。从社会角度来看,这相当于节省了 1,010 万欧元的成本和 645 QALY。所有分析的结果都是一致的,而且对VE和覆盖率的变化最为敏感。这些发现强调了提高疫苗覆盖率的重要性,以及在这一易感人群中使用 mRNA-1273 制剂诱导更高水平保护的能力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Substantial reduction in the clinical and economic burden of disease following variant-adapted mRNA COVID-19 vaccines in immunocompromised patients in France
An economic evaluation was conducted to predict the economic and clinical burden of vaccinating immunocompromised (IC) individuals aged ≥30 years with mRNA-1273 variant-adapted COVID-19 vaccines in Fall 2023 and Spring 2024 versus BNT162b2 variant-adapted vaccines in France. The number of symptomatic COVID-19 infections, hospitalizations, deaths, and long COVID cases, costs and quality-adjusted life years (QALYs) was estimated using a static decision-analytic model. Predicted vaccine effectiveness (VE) were based on real-world data from prior versions, suggesting higher protection against infection and hospitalization with mRNA-1273 vaccines. VE estimates were combined with COVID-19 incidence and probability of COVID-19 severe outcomes. Uncertainty surrounding VE, vaccine coverage, infection incidence, hospitalization and mortality rates, costs and QALYs were tested in sensitivity analyses. The mRNA-1273 variant-adapted vaccine is predicted to prevent an additional 3,882 infections, 357 hospitalizations, 81 deaths, and 326 long COVID cases when compared to BNT162b2 variant-adapted vaccines in 230,000 IC individuals. This translates to €10.1 million cost-savings from a societal perspective and 645 QALYs saved. Results were consistent across all analyses and most sensitive to variations surrounding VE and coverage. These findings highlight the importance of increasing vaccine coverage, and ability to induce higher levels of protection with mRNA-1273 formulations in this vulnerable population.
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