COVID-19 vaccination programmes with early start dates are likely to incur the most health benefits and be most cost-effective, according to a new policy brief released by the Africa Centres for Disease Control and Prevention (Africa CDC).
The retrospective study, which includes an analysis of 27 countries, was conducted by a coalition of research groups including the London School of Hygiene & Tropical Medicine (LSHTM); Africa CDC; Kenya Medical Research Institute (KEMRI) – Wellcome Trust; University of Nigeria; Ethiopian Public Health Institute; University of Warwick; the Center for Global Development; and the international Decision Support Initiative (iDSI).
It demonstrates that earlier roll-out of COVID-19 vaccination programmes, and rapid scale-up, delivered greater health benefits and were more cost-effective when compared to programmes that began later and scaled more slowly. Vaccination programmes that began earlier in 2021 saw larger reductions in cases and deaths compared to programmes that began later in the year.
The policy brief, published ahead of the 2nd Global COVID-19 summit, aims to support policymakers to make informed decisions on the procurement of COVID-19 vaccines and roll out of vaccination programmes, especially in countries where large proportions of the population are unvaccinated.
The evidence makes a clear case for continuing to rollout COVID-19 vaccinations across the African continent where there are wide disparities in vaccination programmes between countries.
Dr Yang Liu, Assistant Professor at LSHTM who led the analysis, said: “For African countries with large proportions of their population unvaccinated a year after the first COVID-19 vaccine was licensed, vaccination programmes can still provide health benefits and be cost-effective. Cost per dose is an important determinant of the latter.”
Compared to a no vaccination scenario, investing in COVID-19 vaccination programmes will likely be more cost-effective, averting cases, hospitalisations and deaths due to COVID-19.
As the effectiveness of most COVID-19 vaccinations against severe illness doesn’t vary significantly, countries should try and obtain vaccines as the lowest price possible and scale programmes quickly to be cost-effective and have the greatest health impact.
The policy brief demonstrates that COVID-19 vaccine programmes are likely to deliver the best value for money when targeting the most vulnerable groups in society, including the elderly, pregnant women, health workers and those with comorbidities. In countries where a large proportion of the population remains unvaccinated, or vaccination programmes have been delayed, speeding up rollout will likely improve cost-effectiveness, particularly if these vulnerable groups are prioritised.
The policy brief draws on regional analysis covering 27 African Union Member States led by researchers at LSHTM. It is supplemented by country-specific case studies in Kenya, Nigeria, Ethiopia and South Africa.
The researchers assessed cost-effectiveness by measuring the cost of COVID-19 vaccines themselves, alongside the delivery costs for campaigns. The costs of COVID-19 were estimated by the cost per ‘disability adjusted life-year’ (DALY) averted. DALYs are used by the World Health Organization to measure the global burden of disease and includes years of life lost due to COVID-19 and years lived with disability for symptomatic cases. Hospitalisations were also included but wider societal costs such as the result of lockdowns were excluded from the analysis.
Policy brief
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