This peer-reviewed article was published Vaccines presents findings from economic and epidemiological modeling to evaluate the cost-effectiveness of a hypothetical bivalent EV-A71/CV-A16 vaccine for hand, foot, and mouth disease (HFMD) in Beijing, China. Using a dynamic transmission model integrated with incremental cost-effectiveness analysis, the study simulates multiple vaccination strategies under varying assumptions of vaccine effectiveness, coverage, pricing, and population immunity to estimate which implementation strategies could provide economically viable public-health benefits.
Key findings:
Under baseline assumptions of 85% vaccine effectiveness and 45% coverage, a targeted vaccination strategy was associated with a 91.5% reduction in CV-A16 infections compared with no vaccination.
The threshold vaccine price — the maximum cost per dose at which vaccination remains cost-effective — averaged about USD 107.7 at moderate coverage, with the threshold declining substantially when coverage exceeded 80 %.
Strategies targeting individuals unvaccinated with the existing monovalent EV-A71 vaccine demonstrated the most favorable cost-effectiveness in early stages of bivalent vaccine introduction.
At higher coverage levels, the economic viability of broad inclusion in a national immunization program diminishes, suggesting targeted voluntary vaccination may be more practical and cost-effective initially.
How can the findings be used?
Policy makers and immunization program planners can use this analysis to inform pricing negotiations, introduction strategies, and coverage prioritization for novel HFMD vaccines in China and similar settings, guiding decisions on whether, how, and at what price a new bivalent HFMD vaccine should be incorporated into immunization programs.
Thumbnail image credit: WHO
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