Forecasting Demand for the Typhoid Conjugate Vaccine in Low- and Middle-income Countries.


Journal

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
ISSN: 1537-6591
Titre abrégé: Clin Infect Dis
Pays: United States
ID NLM: 9203213

Informations de publication

Date de publication:
07 03 2019
Historique:
entrez: 8 3 2019
pubmed: 8 3 2019
medline: 29 5 2020
Statut: ppublish

Résumé

The World Health Organization (WHO) released a position paper in March 2018 calling for integration of a novel typhoid conjugate vaccine (TCV) into routine immunization along with catch-up campaigns for children up to age 15. Gavi, the Vaccine Alliance, has committed funding to help resource-constrained countries introduce this vaccine. In this article, the Typhoid Vaccine Acceleration Consortium forecasts demand if WHO recommendations are followed. We built a model of global TCV introductions between 2020 and 2040 to estimate the demand of the vaccine for 133 countries. We estimated each country's year of introduction by examining its estimated incidence of typhoid fever, its history of introducing new vaccines, and any knowledge we have of its engagement with typhoid prevention, including intention to apply for Gavi funding. Our model predicted use in routine infant vaccination as well as campaigns targeting varying proportions of the unvaccinated population up to 15 years of age. Between 2020 and 2025, demand will predominantly come from African countries, many receiving Gavi support. After that, Asian countries generate most demand until 2030, when campaigns are estimated to end. Demand will then track the birth cohort of participating countries, suggesting an annual routine demand between 90 and 100 million doses. Peak demand is likely to occur between 2023 and 2026, approaching 300 million annual doses if campaign implementation is high. In our analysis, target population for catch-up campaigns is the main driver of uncertainty. At peak demand, there is some risk of exceeding presently estimated peak production capacity. Therefore, it will be important to carefully coordinate introductions, especially when accompanied by campaigns targeting large proportions of the eligible population.

Sections du résumé

BACKGROUND
The World Health Organization (WHO) released a position paper in March 2018 calling for integration of a novel typhoid conjugate vaccine (TCV) into routine immunization along with catch-up campaigns for children up to age 15. Gavi, the Vaccine Alliance, has committed funding to help resource-constrained countries introduce this vaccine. In this article, the Typhoid Vaccine Acceleration Consortium forecasts demand if WHO recommendations are followed.
METHODS
We built a model of global TCV introductions between 2020 and 2040 to estimate the demand of the vaccine for 133 countries. We estimated each country's year of introduction by examining its estimated incidence of typhoid fever, its history of introducing new vaccines, and any knowledge we have of its engagement with typhoid prevention, including intention to apply for Gavi funding. Our model predicted use in routine infant vaccination as well as campaigns targeting varying proportions of the unvaccinated population up to 15 years of age.
RESULTS
Between 2020 and 2025, demand will predominantly come from African countries, many receiving Gavi support. After that, Asian countries generate most demand until 2030, when campaigns are estimated to end. Demand will then track the birth cohort of participating countries, suggesting an annual routine demand between 90 and 100 million doses. Peak demand is likely to occur between 2023 and 2026, approaching 300 million annual doses if campaign implementation is high.
CONCLUSIONS
In our analysis, target population for catch-up campaigns is the main driver of uncertainty. At peak demand, there is some risk of exceeding presently estimated peak production capacity. Therefore, it will be important to carefully coordinate introductions, especially when accompanied by campaigns targeting large proportions of the eligible population.

Identifiants

pubmed: 30845321
pii: 5371221
doi: 10.1093/cid/ciy1076
pmc: PMC6405267
doi:

Substances chimiques

Typhoid-Paratyphoid Vaccines 0
Vaccines, Conjugate 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

S154-S160

Informations de copyright

© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America.

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Auteurs

Frédéric Debellut (F)

Center for Vaccine Innovation and Access, PATH, Geneva, Switzerland.

Nathaniel Hendrix (N)

The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, University of Washington, Seattle.

Virginia E Pitzer (VE)

Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut.

Kathleen M Neuzil (KM)

Center for Vaccine Development and Global Health at the University of Maryland School of Medicine, Baltimore, MD.

Dagna Constenla (D)

Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.

Naor Bar-Zeev (N)

Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.

Anthony Marfin (A)

Center for Vaccine Innovation and Access, PATH, Seattle, Washington.

Clint Pecenka (C)

Center for Vaccine Innovation and Access, PATH, Seattle, Washington.

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Classifications MeSH