Cost-Effectiveness and Impact of a Targeted Age- and Incidence-based West Nile Virus Vaccine Strategy

Details

• Alternative Title:
  Clin Infect Dis
• Personal Author:
  Curren, Emily J. ; Shankar, Manjunath B. ; Fischer, Marc ; Meltzer, Martin I. ; Staples, J. Erin ; Gould, Carolyn V.
• Description:
  Background.
  
  West Nile virus (WNV) is the leading cause of arboviral disease in the United States and is associated with significant morbidity and mortality. A previous analysis found that a vaccination program targeting persons aged ≥60 years was more cost-effective than universal vaccination, but costs remained high.
  
  Methods.
  
  We used a mathematical Markov model to evaluate cost-effectiveness of an age- and incidence-based WNV vaccination program. We grouped states and large counties (≥100 000 persons aged ≥60 years) by median annual WNV incidence rates from 2004 to 2017 for persons aged ≥60 years. We defined WNV incidence thresholds, in increments of 0.5 cases per 100 000 persons ≥60 years. We calculated potential cost per WNV vaccine-prevented case and per quality adjusted life-years (QALYs) saved.
  
  Results.
  
  Vaccinating persons aged ≥60 years in states with an annual incidence of WNV neuroinvasive disease of ≥0.5 per 100 000 resulted in approximately half the cost per health outcome averted compared to vaccinating persons aged ≥60 years in the contiguous United States. This approach could potentially prevent 37% of all neuroinvasive disease cases and 63% of WNV-related deaths nationally. Employing such a threshold at a county level further improved cost-effectiveness ratios while preventing 19% and 30% of WNV-related neuroinvasive disease cases and deaths, respectively.
  
  Conclusions.
  
  An age- and incidence-based WNV vaccination program could be a more cost-effective strategy than an age-based program while still having a substantial impact on lowering WNV-related morbidity and mortality.
  
  
• Subjects:
  Article Cost-Benefit Analysis Cost-effectiveness Humans Impact Incidence United States Vaccination West Nile Fever West Nile Virus West Nile Virus Vaccines

  More +
• Source:
  Clin Infect Dis. 73(9):1565-1570
• Pubmed ID:
  34117746
• Pubmed Central ID:
  PMC9070563
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  73
• Issue:
  9
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:d4d7fedad561f2d6b1c076b5eb18ac5958c71db8d7596c8b9add9174020ffe3b
• Download URL:
  https://stacks.cdc.gov/view/cdc/117068/cdc_117068_DS1.pdf
• File Type:
  [PDF - 71.19 KB ]