Economic value of vaccinating geographically hard-to-reach populations with measles vaccine: A modeling application in Kenya. Issue 17 (17th April 2019)

• Record Type: Journal Article
• Authors: Lee, Bruce Y.; Brown, Shawn T.; Haidari, Leila A.; Clark, Samantha; Abimbola, Taiwo; Pallas, Sarah E.; Wallace, Aaron S.; Mitgang, Elizabeth A.; Leonard, Jim; Bartsch, Sarah M.; Yemeke, Tatenda T.; Zenkov, Eli; Ozawa, Sachiko
• Is Part Of: Vaccine. Volume 37:Issue 17(2019)
• Page Start: 2377
• Page End: 2386
• Publication Date: 2019-04-17
• Subjects: Vaccination -- Economic -- Hard-to-reach populations; Vaccines -- Periodicals; 615.372
• DOI: 10.1016/j.vaccine.2019.03.007
• Languages: English
• ISSNs: 0264-410X

Abstract

Abstract: Background: Since special efforts are necessary to vaccinate people living far from fixed vaccination posts, decision makers are interested in knowing the economic value of such efforts. Methods: Using our immunization geospatial information system platform and a measles compartment model, we quantified the health and economic value of a 2-dose measles immunization outreach strategy for children <24 months of age in Kenya who are geographically hard-to-reach (i.e., those living outside a specified catchment radius from fixed vaccination posts, which served as a proxy for access to services). Findings: When geographically hard-to-reach children were not vaccinated, there were 1427 total measles cases from 2016 to 2020, resulting in $9.5 million ($3.1–$18.1 million) in direct medical costs and productivity losses and 7504 (3338–12, 903) disability-adjusted life years (DALYs). The outreach strategy cost $76 ($23–$142)/DALY averted (compared to no outreach) when 25% of geographically hard-to-reach children received MCV1, $122 ($40-$226)/DALY averted when 50% received MCV1, and $274 ($123-$478)/DALY averted when 100% received MCV1. Conclusion: Outreach vaccination among geographically hard-to-reach populations was highly cost-effective in a wide variety of scenarios, offering support for investment in an effective outreach vaccination strategy.