In a recent study posted in medRxiv Researchers at pharmaceutical and biotechnology company Moderna Inc. are using preprint* servers to assess the economic and clinical impact of the latest messenger ribonucleic acid (mRNA) vaccines against coronavirus disease 2019 (COVID-19). I estimated it.
study: Clinical efficacy and cost-effectiveness of the latest novel coronavirus infection mRNA fall 2023 vaccine in Germany. Image credit: etraveler / Shutterstock
*Important Notices: medRxiv has published preliminary scientific reports that have not been peer-reviewed and should therefore not be considered definitive, guide clinical practice or health-related behavior, or be treated as established information. Not.
The global health emergency caused by COVID-19 will end in May 2023 after a 12-month decline in the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Did. Omicron (sub)variants and high herd immunity from infection and vaccination have resulted in a significant reduction in severe disease cases compared to the beginning of the pandemic. The epidemiological situation in Germany has transitioned from a pandemic to an endemic SARS-CoV-2 epidemic.
With this transition, Germany has updated its COVID-19 vaccination guidelines, recommending primary vaccination for adults aged 18 years and older, and for older adults (60 years and older), high-risk groups, and healthcare workers. It was recommended that a booster vaccination adapted to the variant be carried out every year. COVID-19 vaccines have been modified as the virus evolved into mutant omicron variants. The new bivalent vaccine contains antigens from the ancestral SARS-CoV-2 strain and the Omicron BA.4/5 subvariant.
However, the emergence of XBB subvariants reduced the efficacy of bivalent vaccines, leading to the development of vaccines for XBB subvariants. The European Union has authorized two mRNA vaccines, Moderna’s mRNA-1273.815 vaccine and Pfizer’s XBB.1.5 BNT162b2 vaccine, which encodes the spike of the XBB.1.5 subvariant, for active immunization in people aged 12 and older. . The efficacy and safety of these two vaccines has been demonstrated in phase 3 trials.
About research
In this study, researchers modeled the clinical and economic impact of mRNA-1273.815 vaccination in high-risk individuals aged 30 to 59 years and older adults (60 years and older) in Germany. A previous susceptibility-exposure-infection-recovery (SEIR) model was adapted to examine the effects of mRNA-1273.8.15 vaccination.
Use decision trees to estimate the number of outpatients with COVID-19, the number of symptomatic patients, the number of hospitalizations, the number of deaths, social and medical costs of vaccination, and quality-adjusted life years. (QALY) was estimated. The estimated cost-effectiveness and clinical outcomes of mRNA-1273.815 were compared with no vaccination and XBB.1.5 BNT162b2.
The simulation begins with everyone who was in an unvaccinated state on January 31, 2020, and moves through the next vaccination state: initial series, 1st, 2nd, and 3rd booster doses. did. mRNA-1273.815 vaccination was modeled from September to December 2023, regardless of the type or number of boosters received.
Additional primary series/1st booster and 2nd/3rd booster doses were not assumed to be administered after 27 February and 21 December 2022, respectively. The coverage and uptake of both updated mRNA vaccines were assumed to be the same as for the 2021-22 influenza vaccine season in Germany.
Both updated vaccines were considered to be a good match for the circulating variants. The vaccine efficacy (VE) of mRNA-1273.815 against infection and severe disease was assumed to be the same as that of Moderna’s monovalent and bivalent booster vaccines against BA.1/2 and severe disease, respectively. .
We determined the VE of XBB.1.5 BNT162b2 using the relative VE rates between the Pfizer and Moderna bivalent vaccines estimated in a previous study. The base case economic analysis was performed from the healthcare payer perspective. Additionally, a scenario analysis from a social perspective including productivity loss costs was performed.
Investigation result
mRNA-1273.815 vaccination was associated with better clinical outcomes and lower costs than no vaccine. This model predicts that without vaccination between September 2023 and August 2024, there would be 12.9 million symptomatic cases, 305,711 hospitalizations, and 11,125 deaths. It was predicted. However, mRNA-1273.815 vaccination would reduce the number of symptomatic cases, hospitalizations, and deaths by 13.1%, 27.9%, and 36.8%. Each compared with no vaccination.
A cost-effectiveness analysis revealed that the mRNA-1273.815 vaccination program was dominant in healthcare payer and infrastructure cases. Additionally, the mRNA-1273.815 vaccination program was associated with better clinical outcomes and lower costs than the XBB.1.5 BNT162b2 vaccination campaign.
mRNA-1273.915 vaccination would have prevented more than 90,000 symptomatic cases, 3,471 hospitalizations, and 157 deaths compared to XBB.1.5 BNT162b2 vaccination. The mRNA-1273.815 program is superior from a healthcare payer and societal perspective and is estimated to have lower total direct medical and indirect costs and fewer QALYs lost than XBB.1.5 BNT162b2 vaccination.
conclusion
In this study, mRNA-1273.815 vaccination prevented more than 1.6 million symptomatic cases, 85,000 hospitalizations, and 4,000 deaths compared to no vaccination, and compared to XBB.1.5 BNT162b2 vaccination. It was found that over 90,000 symptomatic cases, over 3,400 hospitalizations, and 157 deaths could be prevented. . Overall, our findings show that mRNA-1273.815 is cost-effective compared to It shows that it has the potential to yield a rate of return.
*Important Notices: medRxiv has published preliminary scientific reports that have not been peer-reviewed and should therefore not be considered definitive, guide clinical practice/health-related behavior, or be treated as established information. Not.
