Epidemiological impact and cost-effectiveness analysis of COVID-19 vaccination in Kenya
This article has been Reviewed by the following groups
Listed in
- Evaluated articles (ScreenIT)
- Evaluated articles (Rapid Reviews Infectious Diseases)
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
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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.
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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.
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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) | 📗📗📗📗◻️
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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 Sentences Resources 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. Costsuggested: (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 …
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 Sentences Resources 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. Costsuggested: (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 substantial socio-economic impacts, in addition to health impacts. These findings mirror cost-effectiveness studies of COVID-19 vaccination done in Turkey and Pakistan that found that although COVID-19 vaccination strategies were cost-effective from a health system’s perspective, they were cost-saving from a societal perspective.[39,41] This is in line with arguments from studies that estimate the public health value and impact of vaccination, which argue the need to broaden the perspectives for cost-effectiveness analysis of vaccines, as their impact is far-reaching, especially in the context of a pandemic.[42–44] These findings have implications for COVID-19 vaccination policy in Kenya and other low-and middle-income countries (LMIC) settings with comparable demographic and COVID-19 epidemiological profiles. First, not unexpectedly, where an outbreak is imminent efforts to rapidly deploy the vaccine not only avert more cases, hospitalization, and deaths, but are also more cost-effective. By extension, had Kenya been able to deploy vaccines more rapidly, benefits would have been greater. Second, COVID-19 vaccination is likely to offer the best value for money when targeted to older age groups and possibly other vulnerable groups (such as those with risk increasing com...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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