title: Assessing dengue vaccination impact: Model challenges and future directions.
abstract: In response to the sharp rise in the global burden caused by dengue virus (DENV) over the last few decades, the WHO has set out three specific key objectives in its disease control strategy: (i) to estimate the true burden of dengue by 2015; (ii) a reduction in dengue mortality by at least 50% by 2020 (used as a baseline); and (iii) a reduction in dengue morbidity by at least 25% by 2020. Although various elements will all play crucial parts in achieving this goal, from diagnosis and case management to integrated surveillance and outbreak response, sustainable vector control, vaccine implementation and finally operational and implementation research, it seems clear that new tools (e.g. a safe and effective vaccine and/or effective vector control) are key to success. The first dengue vaccine was licensed in December 2015, Dengvaxia® (CYD-TDV) developed by Sanofi Pasteur. The WHO has provided guidance on the use of CYD-TDV in endemic countries, for which there are a variety of considerations beyond the risk-benefit evaluation done by regulatory authorities, including public health impact and cost-effectiveness. Population-level vaccine impact and economic and financial aspects are two issues that can potentially be considered by means of mathematical modelling, especially for new products for which empirical data are still lacking. In December 2014 a meeting was convened by the WHO in order to revisit the current status of dengue transmission models and their utility for public health decision-making. Here, we report on the main points of discussion and the conclusions of this meeting, as well as next steps for maximising the use of mathematical models for vaccine decision-making.
authors.affiliation: Centre for Mathematics and the Environment, University of Exeter, Penryn Campus, Penryn, UK.
authors.forename: Mario
authors.initials: M
authors.lastname: Recker
authors.affiliation: Initiative for Vaccine Research, Department of Immunizations, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Vannice
authors.affiliation: Initiative for Vaccine Research, Department of Immunizations, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland.
authors.forename: Joachim
authors.initials: J
authors.lastname: Hombach
authors.affiliation: Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK; Modelling and Economics Unit, Public Health England, 61 Colindale Avenue, London NW9 6BT, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Jit
authors.affiliation: Oxford University Clinical Research Unit, Hospital for Tropical Diseases, 764 Vo Van Kiet Street, District 5, Ho Chi Minh City, Viet Nam; Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom; Department of Microbiology and Immunology, Peter Doherty Institute, University of Melbourne, Parkville, Victoria 3010, Australia. Electronic address: csimmons@unimelb.edu.au.
authors.forename: Cameron P
authors.initials: CP
authors.lastname: Simmons
mesh_terms: D003226:Congresses as Topic; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D003657:Decision Making; D003715:Dengue / Q000453:epidemiology* / Q000517:prevention & control*; D053059:Dengue Vaccines / Q000627:therapeutic use*; D006801:Humans; D008962:Models, Theoretical; D011634:Public Health; D014944:World Health Organization
chemical_list: D053059:Dengue Vaccines
keywords: Dengue; Mathematical modelling; Vaccine