Table 3.
Epidemiologic, Clinical, and Economic Outcomes for Zika Vaccination When Vaccinating Young Adults 5 Years Before the Start of an Outbreak With a 2% Attack Rate
| Country and Model | Total Vaccinateda, Millions | Symptomatic Zika Cases | DALYs, Median (95% UI) | Vaccination Costs | Total Direct Costs, Median (95% UI) | Total Societal Costs, Median (95% UI) | Cost per Case Avertedb |
|---|---|---|---|---|---|---|---|
| Honduras | |||||||
| No vaccinec | … | 9229 | 3506 (1015–7703) | … | 2.1 (1.4–3.4) | 5.8 (3.2–10.4) | … |
| $5 vaccine | |||||||
| 25% efficacy | |||||||
| 25% coveragec | 0.8 | 7398 | 2873 (818–6432) | 3.6 | 5.2 (4.7–6.2) | 8.3 (6.0–12.4) | 1381 |
| 75% coveraged | 2.2 | 4968 | 1931 (551–4322) | 10.4 | 11.6 (11.2–12.2) | 13.6 (12.1–16.4) | 1849 |
| 75% efficacy | |||||||
| 25% coveraged | 0.8 | 5779 | 2246 (640–5026) | 3.6 | 4.9 (4.5–5.7) | 7.3 (5.5–10.5) | 442 |
| 75% coveraged | 2.2 | 3110 | 1211 (347–2707) | 10.4 | 11.2 (10.9–11.6) | 12.5 (11.5–14.2) | 1097 |
| $25 vaccine | |||||||
| 25% efficacy | |||||||
| 25% coveragec | 0.8 | 7398 | 2812 (815–6176) | 23.7 | 19.6 (19.0–20.7) | 22.6 (20.5–26.3) | 9172 |
| 75% coveraged | 2.2 | 4968 | 1891 (550–4150) | 70.7 | 53.4 (53.0–54.1) | 55.3 (53.9–57.9) | 11637 |
| 75% efficacy | |||||||
| 25% coveraged | 0.8 | 5779 | 2198 (638–4826) | 23.7 | 19.2 (18.8–20.1) | 21.6 (19.9–24.5) | 4579 |
| 75% coveraged | 2.2 | 3110 | 1185 (346–2600) | 70.7 | 52.9 (52.7–53.4) | 54.2 (53.3–55.8) | 7915 |
| Brazil | |||||||
| No vaccine | … | 346206 | 107296 (28385–255941) | … | 193.4 (132.4–266.2) | 737.5 (357.0–1443.0) | … |
| $5 vaccine | |||||||
| 25% efficacy | |||||||
| 25% coverage | 14.8 | 279544 | 85716 (27720–204492) | 69.3 | 225.4 (176.2–282.9) | 663.1 (358.2–1252.4) | –1115 |
| 75% coverage | 43.2 | 191468 | 58716 (18994–140072) | 202.5 | 310.3 (276.2–350.0) | 610.7 (401.5–1014.9) | –819 |
| 75% efficacy | |||||||
| 25% coverage | 14.8 | 212635 | 65206 (21093–155556) | 69.3 | 188.8 (151.1–233.1) | 522.5 (290.2–971.6) | –1609 |
| 75% coveragec | 43.2 | 109844 | 33692 (10905–80368) | 202.4 | 265.1 (245.3–288.1) | 437.9 (317.8–670.2) | –1268 |
| $25 vaccine | |||||||
| 25% efficacy | |||||||
| 25% coverage | 14.8 | 279544 | 86644 (22925–206669) | 23.7 | 503.5 (454–562.6) | 943.5 (635.8–1514.2) | 3090 |
| 75% coverage | 43.2 | 191468 | 59355 (15708–141564) | 70.7 | 1120.6 (1086.5–1161.3) | 1422.6 (1211.4–1814.4) | 4427 |
| 75% efficacy | |||||||
| 25% coverage | 14.8 | 212635 | 65915 (17444–157212) | 23.7 | 466.7 (428.8–511.9) | 802.0 (567.6–1237.2) | 483 |
| 75% coveragec | 43.2 | 109844 | 34061 (9018–81225) | 70.7 | 1075.1 (1055.2–1098.4) | 1248.6 (1127.3–1474.1) | 2163 |
| Puerto Rico | |||||||
| No vaccine | … | 7860 | 2421 (701–5659) | … | 9.4 (6.2–23.1) | 36.5 (17.3–71.7) | … |
| $5 vaccine | |||||||
| 25% efficacy | |||||||
| 25% coverage | 0.2 | 6369 | 1881 (549–4504) | 1.0 | 8.8 (6.1–21.5) | 30.2 (15.0–61.4) | –4180 |
| 75% coverage | 0.6 | 4407 | 1302 (380–3117) | 2.9 | 8.4 (6.5–17.2) | 23.3 (12.7–44.9) | –3823 |
| 75% efficacy | |||||||
| 25% coverage | 0.2 | 4787 | 1414 (413–3386) | 1.0 | 6.9 (4.9–16.5) | 23.1 (11.6–46.6) | –4360 |
| 75% coveragec | 0.6 | 2435 | 720 (210–1722) | 2.9 | 6.0 (5.0–10.9) | 14.3 (8.4–26.2) | –4093 |
| $25 vaccine | |||||||
| 25% efficacy | |||||||
| 25% coverage | 0.2 | 6369 | 1962 (568–4585) | 23.7 | 12.7 (10.1–23.8) | 34.7 (19.1–63.3) | –1195 |
| 75% coverage | 0.6 | 4407 | 1358 (393–3173) | 70.7 | 20.1 (18.3–27.8) | 35.3 (24.5–55.2) | –327 |
| 75% efficacy | |||||||
| 25% coverage | 0.2 | 4787 | 1475 (427–3447) | 23.7 | 10.9 (8.9–19.2) | 27.4 (15.7–49.0) | –2944 |
| 75% coveragec | 0.6 | 2435 | 751 (218–1753) | 70.7 | 17.8 (16.7–22.0) | 26.2 (20.2–37.2) | –1894 |
Costs are shown as million 2017 US dollars. Simulated outbreak occurs 5 years after the start of vaccination; all outbreaks lasted 5 years unless otherwise noted.
Abbreviations: DALY, disability-adjusted life-year; GBS, Guillain-Barré syndrome; UI, uncertainty interval.
aTransmission model result.
bFrom the societal perspective; US dollars; negative values imply savings.
cOutbreak duration 4 years.
dOutbreak duration 3 years.