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

Rebecca C. Harris (), Matthew Quaife, Chathika Weerasuriya, Gabriela B. Gomez, Tom Sumner, Fiammetta Bozzani and Richard G. White
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Rebecca C. Harris: London School of Hygiene and Tropical Medicine
Matthew Quaife: London School of Hygiene and Tropical Medicine
Chathika Weerasuriya: London School of Hygiene and Tropical Medicine
Gabriela B. Gomez: London School of Hygiene and Tropical Medicine
Tom Sumner: London School of Hygiene and Tropical Medicine
Fiammetta Bozzani: London School of Hygiene and Tropical Medicine
Richard G. White: London School of Hygiene and Tropical Medicine

Nature Communications, 2022, vol. 13, issue 1, 1-8

Abstract: Abstract The M72/AS01E tuberculosis vaccine showed 50% (95%CI: 2–74%) efficacy in a phase 2B trial in preventing active pulmonary tuberculosis disease, but potential cost-effectiveness of adolescent immunisation is unknown. We estimated the impact and cost-effectiveness of six scenarios of routine adolescent M72/AS01E-like vaccination in South Africa and India. All scenarios suggested an M72/AS01E-like vaccine would be highly (94–100%) cost-effective in South Africa compared to a cost-effectiveness threshold of $2480/disability-adjusted life-year (DALY) averted. For India, a prevention of disease vaccine, effective irrespective of recipient’s M. tuberculosis infection status at time of administration, was also highly likely (92–100%) cost-effective at a threshold of $264/DALY averted; however, a prevention of disease vaccine, effective only if the recipient was already infected, had 0–6% probability of cost-effectiveness. In both settings, vaccinating 50% of 18 year-olds was similarly cost-effective to vaccinating 80% of 15 year-olds, and more cost-effective than vaccinating 80% of 10 year-olds. Vaccine trials should include adolescents to ensure vaccines can be delivered to this efficient-to-target population.

Date: 2022
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DOI: 10.1038/s41467-022-28234-7

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