Estimating deaths averted and cost per life saved by scaling up mRNA COVID-19 vaccination in low-income and lower-middle-income countries in the COVID-19 Omicron variant era: a modelling study

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Abstract

While almost 60% of the world has received at least one dose of COVID-19 vaccine, the global distribution of vaccination has not been equitable. Only 4% of the population of low-income countries (LICs) has received a full primary vaccine series, compared with over 70% of the population of high-income nations.

Design

We used economic and epidemiological models, parameterised with public data on global vaccination and COVID-19 deaths, to estimate the potential benefits of scaling up vaccination programmes in LICs and lower-middle-income countries (LMICs) in 2022 in the context of global spread of the Omicron variant of SARS-CoV2.

Setting

Low-income and lower-middle-income nations.

Main outcome measures

Outcomes were expressed as number of avertable deaths through vaccination, costs of scale-up and cost per death averted. We conducted sensitivity analyses over a wide range of parameter estimates to account for uncertainty around key inputs.

Findings

Globally, universal vaccination in LIC/LMIC with three doses of an mRNA vaccine would result in an estimated 1.5 million COVID-19 deaths averted with a total estimated cost of US$61 billion and an estimated cost-per-COVID-19 death averted of US$40 800 (sensitivity analysis range: US$7400–US$81 500). Lower estimated infection fatality ratios, higher cost-per-dose and lower vaccine effectiveness or uptake lead to higher cost-per-death averted estimates in the analysis.

Conclusions

Scaling up COVID-19 global vaccination would avert millions of COVID-19 deaths and represents a reasonable investment in the context of the value of a statistical life. Given the magnitude of expected mortality facing LIC/LMIC without vaccination, this effort should be an urgent priority.

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  1. SciScore for 10.1101/2022.02.08.22270465: (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

    No key resources detected.


    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).


    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Our analysis also did not include limitations on the capacity of health systems, which could affect mortality beyond what we capture with IFR. In addition, we do not attempt to model disease transmission dynamics, or include a temporal component in the model, so we assume anyone without immunity from vaccine or natural protection as of December 13, 2021 retains their risk of COVID-19 mortality through 2022. This is a major limitation given the speed with which the Omicron variant of COVID-19 has been spreading; however, our analysis considering vaccination scale-up after the whole population has been previously infected still estimates a cost-per-death averted of $115,000. Finally, our main analysis uses reported deaths or excess mortality estimates to estimate rates of prior infection with COVID-19, which are inexact measures especially for the regions of most concern. Nevertheless, they are the best available estimates to date. Experts have proposed several plans to rapidly expand global COVID-19 vaccine production and delivery.15,17,18 However, the international community has not yet invested the resources required nor displayed the political commitment necessary to scale global vaccination. As a result, 86 countries did not reach the World Health Organization’s target of vaccinating 40 percent of their populations by the end of 2021.29 This analysis shows that global vaccination can be undertaken for a fraction of the trillions of US$ already spent on global COVID-19 resp...

    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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