Table 6 Summary of values & vaccine characteristics in the demonstration scenario
From: Modeling the public health impact of malaria vaccines for developers and policymakers
Parameter name | Assumed value | Rationale or source, as applicable |
|---|---|---|
Supply and demand module | ||
Time period modeled | 10 years | Mid-range period that is long enough to allow for countries to implement and observe impact; a longer period would increase model uncertainty |
Year of vaccine approval | 2016 | Date in the medium term selected to avoid the increased model uncertainty associated with longer time horizons |
Countries | 40 African countries with high disease burden | 100 deaths/year or malaria mortality rate of 10 deaths per 100,000 per year or greater [45] |
Years between vaccine approval and country adoption | 0-10, based on each country’s adoption of Haemophilus influenza type B (Hib) vaccine (see Methods) | See Methods under “Supply and demand forecast” |
Maximum coverage | 3rd dose of diphtheria-tetanus-pertussis vaccine (DTP3) level of each country, as projected (see Methods) | Demonstration scenario assumes routine vaccination (below); DTP3 coverage is therefore a realistic estimate of what might be achieved |
Years for each country to reach maximum coverage | 1 to 3, based upon each country’s adoption of Hib vaccine (see Methods) | See Methods under “Supply and demand forecast” |
Number of doses per regimen | 3 | Consistent with other, licensed vaccines |
Vaccine wastage | 10% (assumed 2 doses/vial) | Consistent with other, licensed vaccines |
Target population | Infants | Infants carry the greatest burden of disease [20] |
Public health module | ||
Type of vaccine | Pre-erythrocytic | The most advanced candidate is a pre-erythrocytic vaccine and therefore the most likely type to first reach 85% efficacy |
Vaccine efficacy against clinical disease | 85% | Consistent with the strategic goal of the 2006 Malaria Vaccine Technology Roadmap |
Decay rate of efficacy against infection | 4 years | Consistent with the strategic goal of the 2006 Malaria Vaccine Technology Roadmap |
Future malaria transmission | ¼ of the population in each Entomological Inoculation Rate category shifted to the next lowest by 2020 (0, 0.1, 1, 10, 100) | Assumes continued scale-up of other interventions and progress toward global targets |
Mode of vaccine delivery | Routine infant immunization (Expanded Program on Immunization (EPI)) | Infants carry the greatest burden of disease and are routinely vaccinated via the EPI system |
Booster compliance rate | Not used in demo. scenario | None assumed |
Financial module | ||
Vaccine price | $5/dose | There is no price yet determined for any potential malaria vaccine; consistent with the cost of other new vaccines for low-income countries |
Cost of injection equipment and disposal | $0.07/dose | See Methods section under Implementation cost and financing requirements [42, 44, 46] |
Cost of vaccine delivery, including: | $0.33/dose | Consistent with experience with pentavalent vaccine in Ethiopia [42, 44, 46] |
• Cold chain requirement of 2-8°C | ||
• Personnel and training | ||
Discount rates | 0% and 5% | Consistent with the full range of rates used in the sub-Saharan context [43] |