Data_Sheet_1_One vaccine to counter many diseases? Modeling the economics of oral polio vaccine against child mortality and COVID-19.docx

IntroductionRecent reviews summarize evidence that some vaccines have heterologous or non-specific effects (NSE), potentially offering protection against multiple pathogens. Numerous economic evaluations examine vaccines' pathogen-specific effects, but less than a handful focus on NSE. This paper addresses that gap by reporting economic evaluations of the NSE of oral polio vaccine (OPV) against under-five mortality and COVID-19.Materials and methodsWe studied two settings: (1) reducing child mortality in a high-mortality setting (Guinea-Bissau) and (2) preventing COVID-19 in India. In the former, the intervention involves three annual campaigns in which children receive OPV incremental to routine immunization. In the latter, a susceptible-exposed-infectious-recovered model was developed to estimate the population benefits of two scenarios, in which OPV would be co-administered alongside COVID-19 vaccines. Incremental cost-effectiveness and benefit-cost ratios were modeled for ranges of intervention effectiveness estimates to supplement the headline numbers and account for heterogeneity and uncertainty.ResultsFor child mortality, headline cost-effectiveness was $650 per child death averted. For COVID-19, assuming OPV had 20% effectiveness, incremental cost per death averted was $23,000–65,000 if it were administered simultaneously with a COVID-19 vaccine

近期综述总结了有关某些疫苗具有异源或非特异性效应的证据，这些效应可能对多种病原体提供保护。众多经济评估探讨了疫苗针对特定病原体的效应，但关注非特异性效应的评估寥寥无几。本文旨在填补这一空白，通过对口服脊髓灰质炎疫苗（OPV）的非特异性效应进行经济评估，探讨其对五岁以下儿童死亡率及COVID-19的防护作用。

材料与方法：本研究探讨了两种场景：（1）在死亡率较高的地区（几内亚比绍）降低儿童死亡率；（2）在印度预防COVID-19。在前者中，干预措施包括三年内对儿童进行三次年度疫苗接种活动，作为常规免疫的补充。在后者中，建立易感-暴露-感染-康复模型，以估算两种情景下OPV与COVID-19疫苗联合使用的种群效益。针对干预措施有效性的不同估计范围，建模增量成本效益和效益成本比，以补充主要数据并考虑异质性和不确定性。

结果：针对儿童死亡率，主要成本效益为每避免一个儿童死亡650美元。对于COVID-19，假设OPV的有效性为20%，若与COVID-19疫苗同时接种，则避免一个死亡病例的增量成本为23,000至65,000美元。