Epidemiological impact and cost-effectiveness analysis of COVID-19 vaccination in Kenya

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Abstract

A few studies have assessed the epidemiological impact and the cost-effectiveness of COVID-19 vaccines in settings where most of the population had been exposed to SARS-CoV-2 infection.

Methods

We conducted a cost-effectiveness analysis of COVID-19 vaccine in Kenya from a societal perspective over a 1.5-year time frame. An age-structured transmission model assumed at least 80% of the population to have prior natural immunity when an immune escape variant was introduced. We examine the effect of slow (18 months) or rapid (6 months) vaccine roll-out with vaccine coverage of 30%, 50% or 70% of the adult (>18 years) population prioritising roll-out in those over 50-years (80% uptake in all scenarios). Cost data were obtained from primary analyses. We assumed vaccine procurement at US$7 per dose and vaccine delivery costs of US$3.90–US$6.11 per dose. The cost-effectiveness threshold was US$919.11.

Findings

Slow roll-out at 30% coverage largely targets those over 50 years and resulted in 54% fewer deaths (8132 (7914–8373)) than no vaccination and was cost saving (incremental cost-effectiveness ratio, ICER=US$−1343 (US$−1345 to US$−1341) per disability-adjusted life-year, DALY averted). Increasing coverage to 50% and 70%, further reduced deaths by 12% (810 (757–872) and 5% (282 (251–317) but was not cost-effective, using Kenya’s cost-effectiveness threshold (US$919.11). Rapid roll-out with 30% coverage averted 63% more deaths and was more cost-saving (ICER=US$−1607 (US$−1609 to US$−1604) per DALY averted) compared with slow roll-out at the same coverage level, but 50% and 70% coverage scenarios were not cost-effective.

Interpretation

With prior exposure partially protecting much of the Kenyan population, vaccination of young adults may no longer be cost-effective.

Article activity feed

  1. Ciaran Kohli-Lynch

    Review 2: "Epidemiological Impact and Cost-Effectiveness Analysis of COVID-19 Vaccination in Kenya"

    This study assesses the benefits of COVID-19 vaccines where most have already been exposed to SARS-CoV-2. Reviewers agree that their transmission modeling approach and sensitivity analyses were reliable, though further research in other counties would validate their findings.

  2. Mark Jit

    Review 1: "Epidemiological Impact and Cost-Effectiveness Analysis of COVID-19 Vaccination in Kenya"

    This study assesses the benefits of COVID-19 vaccines where most have already been exposed to SARS-CoV-2. Reviewers agree that their transmission modeling approach and sensitivity analyses were reliable, though further research in other counties would validate their findings.

  3. Mark Jit, Ciaran Kohli-Lynch

    Reviews of: "Epidemiological Impact and Cost-Effectiveness Analysis of COVID-19 Vaccination in Kenya"

    Reviewers: M Jit (London School of Hygiene and Tropical Medicine) | 📗📗📗📗◻️ • C Kohli-Lynch (Northwestern) | 📗📗📗📗◻️

  4. SciScore for 10.1101/2022.04.21.22274150: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Cost estimates: The cost estimates used in this study were derived using a hybrid method that involved both an ingredients approach (bottom-up) and a top-down approach.
    Cost
    suggested: (COST, RRID:SCR_014098)

    Results from OddPub: Thank you for sharing your code and data.


    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    This underlines the limitations of using a narrow health system perspective that ignores broader societal costs of health system interventions. This is even more so for a vaccine deployed in a pandemic that has …