Evidence map›Paper›PMID 36827972›Full record

ArticleMed (New York, N.Y.)2023

Cost effectiveness of fractional doses of COVID-19 vaccine boosters in India.

Zhanwei Du, Lin Wang, Yuan Bai, Shuo Feng, Sabareesh Ramachandran, Wey Wen Lim, Eric H Y Lau, Anup Malani, Benjamin J Cowling

Open access · greenAbstract read
In one paragraph

Article in Med (New York, N.Y.), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
1.2field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 6 institutions in 4 countries.

Zhanwei DuWHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China; Laboratory of Data Discovery for Health Limited (D24H), Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, China. Electronic address: zwdu@hku.hk.
Lin WangDepartment of Genetics, University of Cambridge, Cambridge CB2 3EH, UK.
Yuan BaiWHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China; Laboratory of Data Discovery for Health Limited (D24H), Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, China.
Shuo FengOxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK.
Sabareesh RamachandranDepartment of Economics, University of California San Diego, San Diego, CA, USA.
Wey Wen LimWHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.
Eric H Y LauWHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China; Laboratory of Data Discovery for Health Limited (D24H), Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, China.
Anup MalaniLaw School, University of Chicago, Chicago, IL, USA.
Benjamin J CowlingWHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China; Laboratory of Data Discovery for Health Limited (D24H), Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, China. Electronic address: bcowling@hku.hk.
Department of Health · CNUniversity of California San Diego · USUniversity of Cambridge · GBUniversity of Chicago · USUniversity of Hong Kong · HKUniversity of Oxford · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCoronavirus disease 2019 (COVID-19) continues to be a major global public health crisis that exacts significant human and economic costs. Booster vaccination of individuals can improve waning immunity and reduce the impact of community epidemics.

methodsUsing an epidemiological model that incorporates population-level severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission and waning of vaccine-derived immunity, we identify the hypothetical potential of mass vaccination with fractionated vaccine doses specific to ChAdOx1 nCoV-19 (AZD1222 [Covishield]; AstraZeneca) as an optimal and cost-effective strategy in India's Omicron outbreak.

findingsWe find that the optimal strategy is 1/8 fractional dosing under mild (Re ∼ 1.2) and rapid (Re ∼ 5) transmission scenarios, leading to an estimated $6 (95% confidence interval [CI]: -13, 26) billion and $2 (95% CI: -26, 30) billion in health-related net monetary benefit over 200 days, respectively. Rapid and broad use of fractional dosing for boosters, together with delivery costs divided by fractionation, could substantially gain more net monetary benefit by $11 (95% CI: -10, 33) and $2 (95% CI: -23, 28) billion, respectively, under the mild and rapid transmission scenarios.

conclusionsMass vaccination with fractional doses of COVID-19 vaccines to boost immunity in a vaccinated population could be a cost-effective strategy for mitigating the public health costs of resurgences caused by vaccine-evasive variants, and fractional dosing deserves further clinical and regulatory evaluation.

fundingFinancial support was provided by the AIR@InnoHK Program from Innovation and Technology Commission of the Government of the Hong Kong Special Administrative Region.

Indexed as

COVID-19COVID-19 VaccinesChAdOx1 nCoV-19Cost-Effectiveness AnalysisHumansImmunization, SecondaryIndiaSARS-CoV-2ChAdOx1 nCoV-19COVID-19 Vaccinescost effectivenessCOVID-19dose fractionationepidemiological modelSARS-CoV-2Translation to population healthvaccine booster

Identifiers

PMID36827972
PMCPMC9922587
OpenAlexW4320497903

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.