Delivering measles vaccination through microarray patches in low- and middle-income countries can be a cost-effective strategy to increase uptake

A new mathematical modelling and early-stage economic evaluation led by the London School of Hygiene & Tropical Medicine has found that introducing measles-rubella micro-array patches (MR-MAPs) in low- and middle- income countries (LMICs) can be a cost-effective means of revitalising measles immunisation programmes and reaching undervaccinated children. Sustainable introduction and uptake of MR-MAPs also has the potential to improve vaccine equity within and between countries and accelerate progress towards measles elimination.

MAPs are a promising technology being developed to reduce barriers to vaccine delivery based on needles and syringes. To address the evidence gap on the public health value of applying this potential technology to immunisation programmes, researchers evaluated the health impact on measles burden and cost-effectiveness of introducing MR-MAPs in 70 LMICs.

The research team projected measles cases, deaths and disability-adjusted life-years during 2030–2040, comparing continuing the current needle and syringes practice to introducing MR-MAPs under different measles vaccine coverage projections and MR-MAP introduction strategies. Costs were calculated based on the ingredients approach, including direct cost of measles treatment, vaccine procurement and vaccine delivery.

The study found that MR-MAP introduction could prevent 27%–37% of measles burden between 2030 and 2040 in 70 LMICs, compared with the a needles and syringes-only immunisation strategy. The largest health impact could be achieved under lower coverage projection and accelerated introduction strategy, with 39 million measles cases averted. Measles treatment cost is a key driver of the net cost of introduction. In countries with a relatively higher income, introducing MR-MAPs could be a cost-saving intervention due to reduced treatment costs. Compared with country-specific health opportunity costs, introducing MR-MAPs would be cost-effective in 16%–81% of LMICs, depending on the MR-MAPs procurement prices and vaccine coverage projections.