Detailed instruction manual for DenguEcon models, software to estimate the economics of a dengue vaccination program from the perspective of the health care system.
DenguEconClear evaluates the costs and benefits of vaccinating a cohort over a 10 year period with vaccination occurring at the beginning of Year 1, and benefits accruing for 10 years. In other words, the vaccine effectiveness is assumed to last for exactly 10 years.
DenguEconCompare allows for a comparative analysis of two strategies of dengue vaccine implementation examining up to 10 cohorts over a ten-year period.
DenguEconDALY evaluates the costs and benefits of vaccinating a cohort over a 10 year period with vaccination occurring/completed at the beginning of Year 1, and benefits accruing for 10 years. In other words, the vaccine effectiveness is assumed to last for exactly 10 years.
The Americas Dengue Prevention Board convened an interdisciplinary meeting in Panama City, Panama, to discuss dengue vaccine implementation. The meeting consisted of sessions focusing on the overview and review of vaccine introduction and implementation; dengue burden of disease and economics; clinical and field evaluation of vaccine candidates; and delivery strategies, markets, production, policy and financing. The goal of the meeting was to identify major issues for inclusion in dengue vaccine introduction strategies.
La reunión de la Iniciativa de la Vacuna Pediátrica del Dengue se realizó en la ciudad de Panamá, Panamá, con el fin de concentrarse en la implantación de la vacuna de dengue. En la reunión se realizaron sesiones en las que se repasó y revisó la introducción de la vacuna y su implantación; la carga de la enfermedad del dengue y la economía, la evaluación clínica y de campo de la vacuna candidata y las estrategias de entrega, mercados, producción, políticas y financiamiento. La meta de la reunión fue identificar los principales obstáculos en las estrategias para la introducción de la vacuna de dengue.
(Abstract) Preparations for dengue vaccine trials as well as vaccine introduction strategies require laboratory-based surveillance on an international and coordinated level. The Pediatric Dengue Vaccine Initiative (PDVI) has developed an international consortium of field sites in Latin America and Asia. These sites conduct community-based and enhanced passive laboratory-based surveillance of dengue fever. Through this consortium, PDVI is facilitating harmonized laboratory-based surveillance processes, so that disease incidence can be compared between different regions and countries. Prevention of dengue fever is the most suitable primary end point for a proof-of-concept dengue vaccine trial. However, such trials may provide insufficient information for stratified analysis of outcomes according to varied risk factors and virus serotype. Consequently large community-based demonstration trials may be necessary.
(Abstract) Guidelines for the clinical evaluation of dengue vaccines in endemic areas have recently been developed, building upon earlier recommendations published in 2002. This new document discusses the rationale and background of dengue vaccine trials and outlines dengue case definitions, proposed efficacy end points, requirements for trial sites, methods of measurement and proposed safety schedules. Demonstrated protective efficacy against each of the four dengue virus serotypes without safety concerns is the objective of any candidate tetravalent vaccine clinical trial. Accurate epidemiological data of dengue and other circulating flaviviruses over multiple transmission seasons are required to address factors such as background flavivirus immunity and subclinical infections that may confound serological results. Furthermore, bridging and post-licensure studies may be necessary to extend conclusions concerning vaccine characteristics, while co-administration trials are necessary in paediatrics. These guidelines are primarily aimed at national regulatory authorities, vaccine developers and research scientists and should be analysed, discussed and adjusted where necessary.