Exact(4)
Wild initially estimated that they would have to wait one month for rescue, and refused to allow long-term stockpiling of seal and penguin meat because this, in his view, was defeatist.
Development of cheaper and more effective vaccines is therefore necessary for long-term stockpiling to be feasible.
At case-fatality rates of 0.1% [similar to inter-pandemic epidemics [20] [22]], most of the cost-benefit decisions favor treatment-only over long-term stockpiling (Figure 2).
The alternative strategy, which avoids the costs and problems associated with long-term stockpiling, is to await the appearance of a candidate pandemic strain before accumulating a vaccine stock, with a view to immediate vaccination once the vaccine stock becomes available.
Similar(56)
Even under the lower cost of USD$6.6, long term stockpiling strategies were cost-beneficial only with high vaccine effectiveness of >60% or high attack rates of >40%.
If the perceived risk of disease severity is high (e.g. similar to the 1918 pandemic), the willingness to pay will be greater and even long term stockpiling will be cost-beneficial.
In the scenario where the next pandemic occurred in 10 years and vaccine shelf-life was 5 years, it is evident that long term stockpiling of vaccines is not cost-effective in the mean scenario even with 100% vaccine efficacy and strain matching, and is only cost effective at the 5th percentile with 100% vaccines efficacy and up to 20% strain mismatch.
For long term stockpiling strategies with 1957 and 1968 pandemic case-fatality rates of 0.4 to 0.6%, stockpiling would be cost-beneficial only if the pandemic occurred within 10 years, the shelf-life was 5 years, and vaccine effectiveness was >80%.
It may therefore be useful to develop low-cost vaccines that provide good cross-protection and lasting-immunity against a variety of influenza strains for long term stockpiling, of perhaps consider vaccines with good cross-protection for seasonal influenza vaccination programs.
As evident from Table 3, in the case of long term stockpiling wastage of earlier stockpiles occurs given the short shelf-life of the vaccines, with the result being generally less cost-beneficial, unless costs are reduced to seasonal vaccine levels or the perception of severity is high.
Our study has shown that long-term vaccine stockpiling is expensive and may not be cost-effective at the population level for mild pandemics.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com