Objectives
COVID-19 affected regular vaccination schedules reducing Vaccine Coverage Rates (VCRs). This study evaluates the impact of incorporating an acellular hexavalent vaccine into the National Vaccination Scheme (NVS) of Peru in terms of several factors, including expected positive impact on VCRs and resulting economic benefits from a more efficient burden control.
Methods
Four scenarios were evaluated. The current scheme of a whole-cell pentavalent (DTwP-Hib-HepB)+IPV/OPV and alternative scheme of an acellular hexavalent (DTaP-IPV-Hib-HepB) were compared under 2 vaccination strategies: conventional (institution based) and alternative (institution and additional vaccination modalities). VCRs, adverse events (AEs), healthcare management and logistic costs were evaluated over a 2-year horizon and disease cases over a 5-year horizon. Current VCRs were modeled using Monte Carlo simulations based on current vaccination patterns. VCRs under alternative scheme and vaccination strategies were derived based on published literature. AE rates were obtained from previous studies. Markov modelling was used to estimate disease cases using local epidemiological data. Healthcare management costs were obtained through micro-costing and logistical costs by replicating the logistical chain of five representative regions.
Results
VCRs would increase 9.4%–14.3% with hexavalent vaccine and 3.1% with alternative strategy. A reduction of around 25 p.p. in AE and 5.7%–8.7% in disease cases would occur with hexavalent vaccination. Although, there would be a reduction of 33–38%, 4%–8% and 81% in AE, disease, and logistic costs categories respectively, overall costs would increase by 6.7%–12.8% with hexavalent vaccination. Additionally, cost per protected child and VCR p.p. obtained would be reduced by around 5%.
Conclusions
Introducing a hexavalent vaccine into the Peru NVS represents an opportunity to close VCR gaps generated by COVID-19, mitigating the risk of disease outbreaks that could bring further costs. Reduced costs per protected child and per VCR p.p. achieved with a hexavalent vaccine, implies an efficient use of resources and better value for money.