Evidence map›Paper›PMID 40950948›Full record

ArticleThe Lancet regional health. Europe2025

Cost-effectiveness of vaccination strategies to control future mpox outbreaks in England: a modelling study.

Xu-Sheng Zhang, Siwaporn Niyomsri, Sema Mandal, Hamish Mohammed, Miranda Mindlin, Bennet Dugbazah, Solomon Adjei, Bukky Owoseni, Andre Charlett, Jessica I'Anson and 12 more

Abstract read
In one paragraph

Article in The Lancet regional health. Europe, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. 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

22 authors.

Xu-Sheng ZhangStatistics, Modelling and Economics, Data, Analytics & Surveillance, UK Health Security Agency, London, UK.
Siwaporn NiyomsriPopulation Health Sciences, University of Bristol, Bristol, UK.
Sema MandalImmunisation and Vaccine Preventable Diseases Division, UK Health Security Agency, London, UK.
Hamish MohammedBlood Safety, Hepatitis, Sexually Transmitted Infections and HIV Division, UK Health Security Agency, London, UK.
Miranda MindlinBlood Safety, Hepatitis, Sexually Transmitted Infections and HIV Division, UK Health Security Agency, London, UK.
Bennet DugbazahHealth Protection Operations, UK Health Security Agency, London, UK.
Solomon AdjeiNHS Arden and Greater East Midlands Commissioning Support Unit, Derby, UK.
Bukky OwoseniNHS Arden and Greater East Midlands Commissioning Support Unit, Derby, UK.
Andre CharlettStatistics, Modelling and Economics, Data, Analytics & Surveillance, UK Health Security Agency, London, UK.
Jessica I'AnsonBlood Safety, Hepatitis, Sexually Transmitted Infections and HIV Division, UK Health Security Agency, London, UK.
Elliot SugarsPeople Delivery Unit, UK Health Security Agency, London, UK.
Merav KlinerNorthwest Health Protection Team, UK Health Security Agency, Manchester, UK.
Trish MannesRegional Deputy Director, UKHSA South East, Ashford, Kent, UK.
Ellie JewittSouth London and Maudsley NHS Foundation Trust, UK.
Lorna GilbertDirectorate of Emergency Preparedness, Resilience and Response, UK Health Security Agency, London, UK.
Samihah MoazamNorthwest Health Protection Team, UK Health Security Agency, Manchester, UK.
Claire DewsnapSheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
David PhillipsCroydon Health Services NHS Trust, Croydon, Surrey, UK.
Gayatri AmirthalingamImmunisation and Vaccine Preventable Diseases Division, UK Health Security Agency, London, UK.
Mary E RamsayImmunisation and Vaccine Preventable Diseases Division, UK Health Security Agency, London, UK.
Peter VickermanPopulation Health Sciences, University of Bristol, Bristol, UK.
Josephine G WalkerPopulation Health Sciences, University of Bristol, Bristol, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: In 2022, a global mpox outbreak occurred among gay and bisexual men who have sex with men (GBMSM). In England, the outbreak was controlled through reductions in sexual risk behaviour and vaccination of high-risk GBMSM. However, mpox continues to circulate, including an expanding outbreak in Africa. We evaluated the most cost-effective vaccination strategy to minimise future mpox outbreaks among GBMSM in England. Methods: A mathematical model of mpox transmission among GBMSM was developed to estimate the costs per quality-adjusted-life-year (QALY) gained for different vaccination strategies starting in 2024 (10-year time-horizon; 3.5% discount rate; willingness-to-pay threshold £20,000/QALY). Reactive vaccination (only during outbreaks) and/or pre-emptive vaccination (continuous routine) strategies targeting high-risk GBMSM were compared to no vaccination. Baseline projections assumed importation of new mpox cases, and a vaccine effectiveness following 1/2 doses of 78%/89% for 5/10 years at £160/dose. Costs were estimated for case management, vaccination and public health responses during an outbreak. Findings: All vaccination strategies reduced future outbreaks, gained QALYs and reduced costs compared to no vaccination. Continuous pre-emptive vaccination (daily rate 54 doses) with reactive vaccination (daily rate 81 doses) if there is an outbreak was most cost-effective, saving £8.8 million and gaining 108.6 QALYs over 10-years. Vaccination remains cost-effective if the vaccine costs less than £330/dose. Pre-emptive with reactive vaccination remains the preferred strategy across many sensitivity analyses, with just pre-emptive vaccination at a higher rate becoming the preferred strategy in some sensitivity analyses. Just reactive vaccination only becomes the preferred strategy when public health response costs are not included, and in this case the vaccine has to cost less than £110 per dose for vaccination to be cost-effective. Interpretation: Vaccination of high-risk GBMSM is likely to be a cost-saving strategy for preventing future mpox outbreaks. Funding: NIHR and Wellcome Trust.

Indexed as

Cost-effectivenessGBMSMMathematical modellingMonkeypoxmpoxVaccination

Identifiers

PMID40950948
PMCPMC12426832

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.