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The implications of using different time horizons when evaluating investment to prevent infectious disease

A lifetime time horizon is conventional for cost-effectiveness analysis, but not routine for transmission-dynamic modeling, given uncertainty in future epidemiological dynamics and high computation costs. We demonstrate implications of alternative analytic time horizons with a case study of novel tuberculosis (TB) vaccine introduction

New tuberculosis vaccines are in late-stage trials, but how confident is the public in high burden countries in vaccines?

Ongoing

With tuberculosis (TB) vaccine candidates in late-stage trials, it is important to prepare for implementation to avoid delays upon licensure. General confidence in vaccines has been identified as an anticipated barrier to introducing new TB vaccines. In the absence of detailed TB specific vaccine acceptability and confidence data, we analysed currently available vaccine confidence data in countries appearing on one of the World Health Organization (WHO) high burden lists to investigate vaccine confidence in countries with a high TB burden

Cost-effectiveness of routine adolescent vaccination with an M72/AS01E-like tuberculosis vaccine in South Africa and India

2022

M72/AS01e

Completed

We estimated the impact and cost-effectiveness of six scenarios of routine adolescent M72/AS01E-like vaccination in South Africa and India.

Affordability of adult tuberculosis vaccination in India and China: A dynamic transmission model-based analysis

2021

M72/AS01e

Completed

To estimate the total disability adjusted life years (DALYs) averted by the vaccination programme, we simulated a 50% efficacy vaccine providing 10-years of protection in post-infection populations between 2027 and 2050 in India and China using a dynamic transmission model of M. tuberculosis.

Epidemiologic study to assess the IGRA positivity in populations with a high TB

2021 - 2024

M72/AS01e

Ongoing

Tuberculosis (TB) vaccine efficacy trials evaluating prevention of disease must be feasible in size and duration and would ideally take place at clinical trial sites that enroll from communities with the highest incidence rates. In preparation for the Phase 3 trial of the investigational M72/AS01E-4 vaccine, we conducted a multi-country study, using interferon gamma release assay (IGRA) positivity as a proxy for expected incidence of TB. In addition to the above objects, the results from this study could help in in new vaccine introduction to identfy TB hotspot areas.

New tuberculosis vaccines in India: Modelling the potential health and economic impacts of adolescent/adult vaccination with M72/AS01E and BCG-revaccination

2023

BCG revaccination, M72/AS01e

Completed

We estimated the potential health and economic impact of M72/AS01E and BCG-revaccination in India and investigated the impact of variation in vaccine characteristics and delivery strategies.

Potential impact of tuberculosis vaccines in China, South Africa, and India

2020

BCG revaccination, M72/AS01e

Completed

To inform vaccine development decision making, we modeled the impact of hypothetical tuberculosis vaccines in three high-burden countries.

The epidemiologic impact and cost-effectiveness of new tuberculosis vaccines on multidrug resistant tuberculosis in India and China

2021

Hypothetical vaccines

Completed

We investigated the epidemiologic impact, cost-effectiveness, and budget impact of hypothetical novel prophylactic prevention of disease TB vaccines on RR/MDR-TB in China and India.

Potential impact of spatially targeted adult tuberculosis vaccine in Gujarat, India

2016

Hypothetical vaccines

Completed

we aimed to estimate the impact of vaccine delivery strategies that were targeted to high-incidence geographical 'hotspots' compared with randomly allocated vaccination. We developed a spatially explicit mathematical model of TB transmission that distinguished these hotspots from the general population.

The health and economic benefits possible with novel tuberculosis vaccines – A modeling study in India and Indonesia

2021

M72/AS01e

Completed

We estimated gains possible with novel post-exposure vaccines, in India and Indonesia. We modeled vaccine impact on TB incidence, TB mortality, and on national income growth and the intrinsic value of living longer, known as Full-income.