Projected clinical outcomes, costs and the cost-effectiveness of different vaccination strategies in Kenya from a societal perspective
| Health outcomes | Economic outcomes | One-way sensitivity analysis of under-reporting in hospitalisations and deaths (factor of under-reporting) | |||||||
| *Averted SARS-CoV-2 infections per 100 000 Median (2.5–97.5th percentile) | *Averted SARS-CoV-2 deaths Median (2.5–97.5th percentile) | Total costs (US$ millions) Median (2.5–97.5th percentile) | Total DALYs (thousands) Median (2.5–97.5th percentile) | †ICER, (US$ per DALY averted) Mean (95% CI) | ICER (4) | ICER (3) | ICER (2) | ICER (1) | |
| Non-rapid vaccination strategy (administered within 1.5 years) | |||||||||
| No vaccination | – | – | 787 (740 to 882) | 247 (243 to 252) | – | – | – | – | – |
| 30% coverage | 32 (24 to 38) | 8132 (7914 to 8373) | 614 (589 to 659) | 114 (110 to 118) | −1343 (−1345 to −1341) Dominant | −905 (−907 to −902) Dominant | −175 (−178 to −173) Dominant | 1278 (1275 to 1280) | 5595 (5592 to 5598) |
| 50% coverage | 4 (3 to 5) | 810 (757 to 872) | 658 (636 to 699) | 101 (97 to 104) | 3291 (3287 to 3295) | 4908 (4903 to 4913) | 7598 (7592 to 7605) | 12 958 (12 949 to 12 967) | 28 878 (28 860 to 28 896) |
| 70% coverage | 2 (1 to 3) | 282 (251 to 317) | 763 (742 to 801) | 96 (92 to 100) | 22 623 (22 602 to 22 645) | 29 075 (29 048 to 29 101) | 39 791 39 756 to 39 827) | 61 093 (61 040 to 61 146) | 123 967 (123 863 to 124 072) |
| Rapid vaccination strategy (administered within 6 months) | |||||||||
| No vaccination | – | – | 787 (740 to 882) | 247 (243 to 252) | – | – | – | – | – |
| 30% coverage | 39 (29 to 48) | 9433 (9197 to 9711) | 545 (524 to 582) | 93 (89 to 96) | −1,607 (−1609 to −1604) Dominant | −1,230 (−1232 to −1227) Dominant | −603 (−605 to −600) Dominant | 646 (644 to 649) | 4357 (4354 to 4360) |
| 50% coverage | 1 (0.5 to 2) | 250 (201 to 296) | 620 (599 to 655) | 88 (85 to 92) | 18 257 (18 226 to 18 287) | 23 582 (23 543 to 23 620) | 32 440 (32 389 to.32 491) | 50 096 (50 020 to 50 173) | 102 582 (102 430 to 102 733) |
| 70% coverage | 0.5 (−0.05 to 1) | 161 (106 to 208) | 731 (713 to 765) | 86 (82 to 89) | 44 250 (44 126 to 44 374) | 56 074 (55 919 to 56 230) | 75 768 (75 560 to 75 976) | 115 100 (114 788 to 115 413) | 232 667 (232 036 to 233 298) |
ICER (4), ICER (3), ICER (2) and ICER (1)= under-reporting factors for hospitalisation and deaths used were 4, 3, 2 and 1, respectively. Total averted infections=rounded off to the nearest 100 000; Total Cost=rounded off to the nearest 1 000 000; Total DALY rounded off to the nearest 1000; Total deaths and ICERs=rounded off to the nearest whole number.
*Averted SARS-Cov-2 infections and deaths = This is the incremental averted infections/deaths compared with the vaccination strategy that appears in the row above.
†ICER=Baseline ICER used in analysis where under-reporting in hospitalisations and deaths is adjusted with a factor of 5.
DALYs, disability-adjusted life-years; ICER, incremental cost-effectiveness ratio.