ArticleThe Lancet. Global health2019
Sustaining pneumococcal vaccination after transitioning from Gavi support: a modelling and cost-effectiveness study in Kenya.
Article in The Lancet. Global health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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13 citing papers in PubMed, 25 citations in OpenAlex.
- Aid withdrawal: an event study of mortality, vaccine coverage and DALY following transitioning from Gavi support.BMJ global health · 2026Article
- Supply, demand and use of economic evidence in vaccine policymaking in Africa: A scoping review.PLOS global public health · 2026Article
- Cost-Effectiveness of the Pneumococcal Vaccine in the Adult Population: A Systematic Review.Healthcare (Basel, Switzerland) · 2024Review
- Inequitable Distribution of Global Economic Benefits from Pneumococcal Conjugate Vaccination.Vaccines · 2024Article
- Article
- Prevalence of prolonged otitis media with effusion among 2 to 3 years old Cameroonian children in the era of 13-valent pneumococcal conjugate vaccines.IJID regions · 2024Article
- Model Choice for Quantitative Health Impact Assessment and Modelling: An Expert Consultation and Narrative Literature Review.International journal of health policy and management · 2023Review
- Cost-effectiveness analysis of a maternal pneumococcal vaccine in low-income, high-burden settings such as Sierra Leone.PLOS global public health · 2023Article
- Engineering a suite of E. coli strains for enhanced expression of bacterial polysaccharides and glycoconjugate vaccines.Microbial cell factories · 2022Article
- Pneumococcal conjugate vaccination in The Gambia: health impact, cost effectiveness and budget implications.BMJ global health · 2021Article
- Postmortem Study of Cause of Death Among Children Hospitalized With Respiratory Illness in Kenya.The Pediatric infectious disease journal · 2021Article
- Seasonal influenza vaccination in Kenya: an economic evaluation using dynamic transmission modelling.BMC medicine · 2020Article
- Determinants of high residual post-PCV13 pneumococcal vaccine-type carriage in Blantyre, Malawi: a modelling study.BMC medicine · 2019Article
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Authors and funding
8 authors at 4 institutions in 3 countries.
Funding
Abstract
backgroundIn 2009, Gavi, the World Bank, and donors launched the pneumococcal Advance Market Commitment, which helped countries access more affordable pneumococcal vaccines. As many low-income countries begin to reach the threshold at which countries transition from Gavi support to self-financing (3-year average gross national income per capita of US$1580), they will need to consider whether to continue pneumococcal conjugate vaccine (PCV) use at full cost or to discontinue PCV in their childhood immunisation programmes. Using Kenya as a case study, we assessed the incremental cost-effectiveness of continuing PCV use.
methodsIn this modelling and cost-effectiveness study, we fitted a dynamic compartmental model of pneumococcal carriage to annual carriage prevalence surveys and invasive pneumococcal disease (IPD) incidence in Kilifi, Kenya. We predicted disease incidence and related mortality for either continuing PCV use beyond 2022, the start of Kenya's transition from Gavi support, or its discontinuation. We calculated the costs per disability-adjusted life-year (DALY) averted and associated 95% prediction intervals (PI).
findingsWe predicted that if PCV use is discontinued in Kenya in 2022, overall IPD incidence will increase from 8·5 per 100 000 in 2022, to 16·2 per 100 000 per year in 2032. Continuing vaccination would prevent 14 329 (95% PI 6130-25 256) deaths and 101 513 (4386-196 674) disease cases during that time. Continuing PCV after 2022 will require an estimated additional US$15·8 million annually compared with discontinuing vaccination. We predicted that the incremental cost per DALY averted of continuing PCV would be $153 (95% PI 70-411) in 2032.
interpretationContinuing PCV use is essential to sustain its health gains. Based on the Kenyan GDP per capita of $1445, and in comparison to other vaccines, continued PCV use at full costs is cost-effective (on the basis of the assumption that any reduction in disease will translate to a reduction in mortality). Although affordability is likely to be a concern, our findings support an expansion of the vaccine budget in Kenya.
fundingWellcome Trust and Gavi, the Vaccine Alliance.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.