The following is a summary of “Cost-effectiveness of 4CMenB vaccination against gonorrhea: the importance of dosing schedule, vaccine sentiment, targeting strategy, and duration of protection,” published in the April 2024 issue of Infectious Disease by Nikitin et al.
Researchers conducted a retrospective study investigating the cost-effectiveness of one- versus two-dose 4CMenB vaccination as a gonorrhea prevention strategy for men-who-have-sex-with-men (MSM) in the UK, considering prior evidence of partial protection from the meningococcal vaccine.
They modeled the effects of targeting strategy, uptake levels for the first and second doses, and the duration of vaccine protection using observational estimates of vaccine protection in an integrated transmission-dynamic health-economic study (Integrated transmission-dynamic health-economic modeling).
The results showed that vaccinating with one or two primary doses saved costs consistently, regardless of uptake, though vaccine sentiment played a crucial role in impact and cost-effectiveness. The most impactful and cost-effective targeting was providing “Vaccination-according-to-Risk” (VaR) to all patients with gonorrhea and those reporting high numbers of sexual partners. If implementing VaR was not feasible, the more restrictive strategy of “Vaccination-on-Diagnosis” (VoD) with gonorrhea remained cost-effective but less impactful. Under conservative assumptions, VaR (2-dose) saved £7.62M (95%CrI:1.15-17.52) and gained 81.41 (28.67-164.23) QALYs over 10 years; VoD (2-dose) saved £3.40M (0.48-7.71) and earned 41.26 (17.52-78.25) QALYs compared to no vaccination. Optimistic versus pessimistic vaccine-sentiment assumptions increased net benefits by ∼30% (VoD) or ∼60% (VaR).
Investigators found that targeted 4CMenB vaccination for MSM in the UK is cost-effective and improves health outcomes.
Source: academic.oup.com/jid/advance-article/doi/10.1093/infdis/jiae123/7646143