Health economic analysis of vaccine options for the polio eradication endgame: 2022-2036

ABSTRACT

Background

Multiple vaccine options are available for polio prevention and risk management. Integrated global risk, economic, and poliovirus transmission modeling provides a tool to explore the dynamics of ending all use of one or more poliovirus vaccines to simplify the polio eradication endgame.

Research design and methods

With global reported cases of poliomyelitis trending higher since 2016, we apply an integrated global model to simulate prospective vaccine policies and strategies for OPV-using countries starting with initial conditions that correspond to the epidemiological poliovirus transmission situation at the beginning of 2022.

Results

Abruptly ending all OPV use in 2023 and relying only on IPV to prevent paralysis with current routine immunization coverage would lead to expected reestablished endemic transmission of poliovirus types 1 and 2, and approximately 150,000 expected cases of poliomyelitis per year. Alternatively, if OPV-using countries restart trivalent OPV (tOPV) use for all immunization activities and end IPV use, the model shows the lowest anticipated annual polio cases and lowest costs.

Conclusions

Poor global risk management and coordination of OPV cessation remain a critical failure mode for the polio endgame, and national and global decision makers face difficult choices due to multiple available polio vaccine options and immunization strategies.

KEYWORDS:

• polio
• eradication
• health economic analysis
• dynamic modeling
• interdependent risks
• poliovirus vaccine

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

KMT, DAK, and KB conceived the study and contributed to the writing of the first draft and all subsequent revisions. KMT and DAK developed the model used. DAK performed all of the modeling. KMT acquired the funding for the study. All authors read and approved all versions of the article before submission, during revision and the final manuscript, including changes introduced at the proofing stage. All authors agreed on submission to this Journal and are accountable for all aspects of the work.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14760584.2022.2128108

Additional information

Funding

We acknowledge support for this publication under Cooperative Agreement Number NU2RGH001915-02-00 funded by the Centers for Disease Control and Prevention. The views expressed are solely those of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or Department of Health and Human Services.