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Health and Economic Outcomes Associated with Polio Vaccine Policy Options: 2019–2029
Author(s) -
Kalkowska Dominika A.,
Thompson Kimberly M.
Publication year - 2021
Publication title -
risk analysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.972
H-Index - 130
eISSN - 1539-6924
pISSN - 0272-4332
DOI - 10.1111/risa.13664
Subject(s) - poliomyelitis , poliomyelitis eradication , chess endgame , polio vaccination , inactivated poliovirus vaccine , transmission (telecommunications) , poliovirus , herd immunity , environmental health , cost–benefit analysis , medicine , immunization , disease eradication , economic cost , vaccination , business , virology , economics , political science , disease , immunology , engineering , virus , neoclassical economics , pathology , antigen , law , microeconomics , electrical engineering
The polio endgame remains complicated, with many questions about future polio vaccines and national immunization policies. We simulated possible future poliovirus vaccine routine immunization policies for countries stratified by World Bank Income Levels and estimated the expected costs and cases using an updated integrated dynamic poliovirus transmission, stochastic risk, and economic model. We consider two reference cases scenarios: one that achieves the eradication of all wild polioviruses (WPVs) by 2023 and one in which serotype 1 WPV (WPV1) transmission continues. The results show that the addition of inactivated poliovirus vaccine (IPV) to routine immunization in all countries substantially increased the expected costs of the polio endgame, without substantially increasing its expected health or economic benefits. Adding a second dose of IPV to the routine immunization schedules of countries that currently include a single IPV dose further increases costs and does not appear economically justified in the reference case that does not stop WPV transmission. For the reference case that includes all WPV eradication, adding a second IPV dose at the time of successful oral poliovirus vaccine (OPV) cessation represents a cost‐effective option. The risks and costs of needing to restart OPV use change the economics of the polio endgame, although the time horizon used for modeling impacts the overall economic results. National health leaders will want to consider the expected health and economic net benefits of their national polio vaccine strategies recognizing that preferred strategies may differ.