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Health and economic impacts of Lassa vaccination campaigns in West Africa

  • David R. M. Smith,
  • Joanne Turner,
  • Patrick Fahr,
  • Lauren A. Attfield,
  • Paul R. Bessell,
  • Christl A. Donnelly,
  • Rory Gibb,
  • Kate E. Jones,
  • David W. Redding,
  • Danny Asogun,
  • Oladele Oluwafemi Ayodeji,
  • Benedict N. Azuogu,
  • William A. Fischer II,
  • Kamji Jan,
  • Adebola T. Olayinka,
  • David A. Wohl,
  • Andrew A. Torkelson,
  • Katelyn A. Dinkel,
  • Emily J. Nixon,
  • Koen B. Pouwels,
  • T. Déirdre Hollingsworth

摘要

Lassa fever is a zoonotic disease identified by the World Health Organization (WHO) as having pandemic potential. This study estimates the health-economic burden of Lassa fever throughout West Africa and projects impacts of a series of vaccination campaigns. We also model the emergence of ‘Lassa-X’—a hypothetical pandemic Lassa virus variant—and project impacts of achieving 100 Days Mission vaccination targets. Our model predicted 2.7 million (95% uncertainty interval: 2.1–3.4 million) Lassa virus infections annually, resulting over 10 years in 2.0 million (793,800–3.9 million) disability-adjusted life years (DALYs). The most effective vaccination strategy was a population-wide preventive campaign primarily targeting WHO-classified ‘endemic’ districts. Under conservative vaccine efficacy assumptions, this campaign averted $20.1 million ($8.2–$39.0 million) in lost DALY value and $128.2 million ($67.2–$231.9 million) in societal costs (2021 international dollars ($)). Reactive vaccination in response to local outbreaks averted just one-tenth the health-economic burden of preventive campaigns. In the event of Lassa-X emerging, spreading throughout West Africa and causing approximately 1.2 million DALYs within 2 years, 100 Days Mission vaccination averted 22% of DALYs given a vaccine 70% effective against disease and 74% of DALYs given a vaccine 70% effective against both infection and disease. These findings suggest how vaccination could alleviate Lassa fever’s burden and assist in pandemic preparedness.