Estimating deaths averted and cost per life saved by scaling up mRNA COVID-19 vaccination in low-income and lower-middle-income countries in the COVID-19 Omicron variant era: a modelling study. Issue 9 (13th September 2022)

• Record Type: Journal Article
• Authors: Savinkina, Alexandra; Bilinski, Alyssa; Fitzpatrick, Meagan; Paltiel, A David; Rizvi, Zain; Salomon, Joshua; Thornhill, Thomas; Gonsalves, Gregg
• Is Part Of: BMJ open. Volume 12:Issue 9(2022)
• Publication Date: 2022-09-13
• Subjects: COVID-19 -- Public health -- HEALTH ECONOMICS; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2022-061752
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objectives: While almost 60% of the world has received at least one dose of COVID-19 vaccine, the global distribution of vaccination has not been equitable. Only 4% of the population of low-income countries (LICs) has received a full primary vaccine series, compared with over 70% of the population of high-income nations. Design: We used economic and epidemiological models, parameterised with public data on global vaccination and COVID-19 deaths, to estimate the potential benefits of scaling up vaccination programmes in LICs and lower-middle-income countries (LMICs) in 2022 in the context of global spread of the Omicron variant of SARS-CoV2. Setting: Low-income and lower-middle-income nations. Main outcome measures: Outcomes were expressed as number of avertable deaths through vaccination, costs of scale-up and cost per death averted. We conducted sensitivity analyses over a wide range of parameter estimates to account for uncertainty around key inputs. Findings: Globally, universal vaccination in LIC/LMIC with three doses of an mRNA vaccine would result in an estimated 1.5 million COVID-19 deaths averted with a total estimated cost of US$61 billion and an estimated cost-per-COVID-19 death averted of US$40 800 (sensitivity analysis range: US$7400–US$81 500). Lower estimated infection fatality ratios, higher cost-per-dose and lower vaccine effectiveness or uptake lead to higher cost-per-death averted estimates in the analysis. Conclusions: Scaling up COVID-19 global vaccination would avert millions of COVID-19 deaths and represents a reasonable investment in the context of the value of a statistical life. Given the magnitude of expected mortality facing LIC/LMIC without vaccination, this effort should be an urgent priority.