ArticleLancet regional health. Americas2026
Evaluating the potential health and economic impacts of chlamydia vaccination strategies in the United States: a mathematical modeling and cost-effectiveness simulation study.
Article in Lancet regional health. Americas, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Methods: We developed an age- and sex-structured compartmental model of heterosexual chlamydia transmission among US individuals aged 15-64 years from 2000 to 2075. The model was calibrated to adjusted annual chlamydia cases and validated against national prevalence data. We simulated routine vaccination of adolescent females or both sexes beginning in 2025, with or without a one-time catch-up campaign for unvaccinated females aged 15-24 years in 2035. Outcomes included chlamydia incidence rates, infections and sequelae averted by 2075, and incremental cost-effectiveness ratios through 2050. Findings: Without vaccination, incidence rates were projected to rise from 16.9 to 18.7 infections per 1000 person-years between 2025 and 2075. Under base-case assumptions (50% coverage, 70% efficacy, 10-year protection), incidence rates declined to 4.0 and 0.4 per 1000 person-years under female-only and sex-neutral vaccination, respectively. By 2075, female-only and sex-neutral vaccination reduced infections by 37.4% and 52.3%, respectively. Catch-up vaccination provided modest additional benefit. All strategies were cost-saving; sex-neutral vaccination yielded 145,943 additional quality-adjusted life years and $354 million in savings versus female-only vaccination by 2050. Results were robust across sensitivity analyses. Interpretation: Chlamydia vaccination could substantially reduce infections and sequelae in the US and is likely to be cost-saving or highly cost-effective across plausible scenarios. Funding: This work was primarily supported by the National Institutes of Health (1F31AI181431-01A1).
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