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Peer reviewedOpen accessMalaria

Modelling the relative cost-effectiveness of the RTS,S/AS01 malaria vaccine compared to investment in vector control or chemoprophylaxis

Vaccine·

Hillary M. Topazian, Nora Schmit, Ines Gerard-Ursin, Giovanni D. Charles, Hayley Thompson, Azra C. Ghani, Peter Winskill

DOI
10.1016/j.vaccine.2023.04.011
PMID
37080831
PMCID
OpenAlex
W4366251011
Study type
Mathematical modelling
Publisher
Elsevier BV
Article type
journal-article
Integrity
current

Why this research matters now

The findings are relevant to global funders and national malaria programs allocating limited resources by characterizing when RTS,S adds value beyond established vector-control and chemoprevention measures.

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Structured evidence summary

Research question

This study models the relative cost-effectiveness of the RTS,S/AS01 malaria vaccine compared with alternative intervention investments across varied transmission settings in sub-Saharan Africa.

Study design

The work is an individual-based mathematical modelling study of P. falciparum, comparing age-based and seasonal RTS,S administration with changes in ITN coverage, next-generation nets, and seasonal malaria chemoprevention (SMC) under diverse rainfall, treatment coverage, and prevalence scenarios.

Population and setting

The modelled population represents children and broader communities in sub-Saharan African settings, spanning varying rainfall patterns, ITN usage levels, treatment coverage, and parasite prevalence bands (including up to 40% PfPR 2-10).

Main findings

RTS,S was the most cost-effective option only when the maximum cost per dose stayed below approximately $9.30 USD in 90.9% of scenarios; most higher-cost scenarios occurred where 60% ITN use and/or SMC were already established, often in the highest prevalence band. Layering RTS,S on top of these existing interventions still produced additional case reductions, with medians of roughly 2,653 cases averted per 100,000 people annually and 82,270 per 100,000 fully vaccinated children. The authors emphasize prioritizing ITN scale-up, SMC introduction, and switching to new-technology nets in eligible settings on cost-effectiveness grounds.

Public-health relevance

The findings are relevant to global funders and national malaria programs allocating limited resources by characterizing when RTS,S adds value beyond established vector-control and chemoprevention measures.

Important limitations

This summary is limited to the supplied single-article abstract and metadata and requires the original paper for decision-grade interpretation; the abstract does not state explicit study limitations, and the work is a mathematical model rather than empirical data.

GIDS interpretation

The article sits within GIDS topical areas of vaccination, treatment, transmission dynamics, and climate/environment for malaria. No connection to a live surveillance signal can be drawn from the supplied evidence.

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Related GIDS surveillance

Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.

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Evidence relationships

This article has 11 auditable classifier relationships to diseases, places, topics, and study design.

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