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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 \u2018Lassa-X\u2019\u2014a hypothetical pandemic Lassa virus variant\u2014and project impacts of achieving 100 Days Mission vaccination targets. Our model predicted 2.7 million (95% uncertainty interval: 2.1\u20133.4 million) Lassa virus infections annually, resulting over 10\u2009years in 2.0 million (793,800\u20133.9 million) disability-adjusted life years (DALYs). The most effective vaccination strategy was a population-wide preventive campaign primarily targeting WHO-classified \u2018endemic\u2019 districts. Under conservative vaccine efficacy assumptions, this campaign averted $20.1 million ($8.2\u2013$39.0 million) in lost DALY value and $128.2 million ($67.2\u2013$231.9 million) in societal costs (2021 international dollars ($)). 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\u2009years, 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\u2019s burden and assist in pandemic preparedness.<\/jats:p>","DOI":"10.1038\/s41591-024-03232-y","type":"journal-article","created":{"date-parts":[[2024,8,28]],"date-time":"2024-08-28T06:02:59Z","timestamp":1724824979000},"page":"3568-3577","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Health and economic impacts of Lassa vaccination campaigns in West Africa"],"prefix":"10.1038","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7330-4262","authenticated-orcid":false,"given":"David R. 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