Maternal pneumococcal vaccination in low-income, high-burden settings such as Sierra Leone found to be potentially cost-effective

Researchers from the Australian National University have found that maternal pneumococcal vaccines have the potential to be cost-effective in low-income settings. However, the likelihood of low-income countries self-financing this intervention will depend on negotiations with vaccine providers on vaccine price, which is the largest program cost driving the cost-effectiveness of a future maternal pneumococcal vaccine.

To assess the cost-effectiveness of a maternal pneumococcal polysaccharide vaccine, the research team used results from a dynamic transmission model from both the health care and societal perspectives. The metrics estimated were the costs of delivering a maternal pneumococcal polysaccharide vaccine, the health care costs averted, and productivity losses avoided through the prevention of severe pneumococcal outcomes such as pneumonia and meningitis.

The findings showed that a maternal pneumococcal program would cost $606 (2020 USD) from a health care perspective and $132 from a societal perspective per DALY averted for one year of vaccine delivery. Therefore, a maternal pneumococcal vaccine would be cost-effective from a societal perspective but not cost-effective from a health care perspective using Sierra Leone’s GDP per capita of $527 as a cost-effectiveness threshold. Sensitivity analysis demonstrates how the choice to discount ongoing health benefits determines whether the maternal pneumococcal vaccine was deemed cost-effective from a health care perspective. Without discounting, the cost per DALY averted would be $292 (55% of Sierra Leone’s GDP per capita) from a health care perspective.