{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T22:56:27Z","timestamp":1788303387833,"version":"build-2803163510"},"reference-count":109,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,2,26]],"date-time":"2021-02-26T00:00:00Z","timestamp":1614297600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,2,26]],"date-time":"2021-02-26T00:00:00Z","timestamp":1614297600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/N013638\/1"],"award-info":[{"award-number":["MR\/N013638\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009342","name":"Aeras Global Tuberculosis Vaccine Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009342","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Despite recent advances through the development pipeline, how novel tuberculosis (TB) vaccines might affect rifampicin-resistant and multidrug-resistant tuberculosis (RR\/MDR-TB) is unknown. We investigated the epidemiologic impact, cost-effectiveness, and budget impact of hypothetical novel prophylactic prevention of disease TB vaccines on RR\/MDR-TB in China and India.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We constructed a deterministic, compartmental, age-, drug-resistance- and treatment history-stratified dynamic transmission model of tuberculosis. We introduced novel vaccines from 2027, with post- (PSI) or both pre- and post-infection (P&amp;PI) efficacy, conferring 10\u2009years of protection, with 50% efficacy. We measured vaccine cost-effectiveness over 2027\u20132050 as USD\/DALY averted-against 1-times GDP\/capita, and two healthcare opportunity cost-based (HCOC), thresholds. We carried out scenario analyses.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>By 2050, the P&amp;PI vaccine reduced RR\/MDR-TB incidence rate by 73% (UI:66\u201376) and 72% (UI:65\u201377), and the PSI vaccine by 29% (UI: 27\u201331) and 47% (UI: 37\u201358) in China and India, respectively.<\/jats:p>\n                <jats:p>In India, we found both USD 10 P&amp;PI and PSI vaccines cost-effective at the 1-times GDP and upper HCOC thresholds and P&amp;PI vaccines cost-effective at the lower HCOC threshold. In China, both vaccines were cost-effective at the 1-times GDP threshold. P&amp;PI vaccine remained cost-effective at the lower HCOC threshold with 49% probability and PSI vaccines at the upper HCOC threshold with 21% probability. The P&amp;PI vaccine was predicted to avert 1.0 million (UI: 0.6\u20131.3) and 0.8 million (UI: 0.5\u20131.4) second-line therapy regimens in China and India between 2027 and 2050, respectively.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Novel TB vaccination is likely to substantially reduce the future burden of RR\/MDR-TB, while averting the need for second-line therapy. Vaccination may be cost-effective depending on vaccine characteristics and setting.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12916-021-01932-7","type":"journal-article","created":{"date-parts":[[2021,2,26]],"date-time":"2021-02-26T02:02:52Z","timestamp":1614304972000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["The epidemiologic impact and cost-effectiveness of new tuberculosis vaccines on multidrug-resistant tuberculosis in India and China"],"prefix":"10.1186","volume":"19","author":[{"given":"Chathika K","family":"Weerasuriya","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca C","family":"Harris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C Finn","family":"McQuaid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiammetta","family":"Bozzani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunzhou","family":"Ruan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renzhong","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirankumar","family":"Rade","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raghuram","family":"Rao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann M","family":"Ginsberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela B","family":"Gomez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard G","family":"White","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,2,26]]},"reference":[{"key":"1932_CR1","doi-asserted-by":"crossref","first-page":"1799","DOI":"10.1016\/S0140-6736(15)60570-0","volume":"385","author":"M Uplekar","year":"2015","unstructured":"Uplekar M, Weil D, Lonnroth K, Jaramillo E, Lienhardt C, Dias HM, et al. 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RCH reports currently being employed at Sanofi Pasteur. RCH reports grants from IAVI, during the conduct of the study; personal fees from Sanofi Pasteur, unrelated to TB and outside the submitted work. Sanofi Pasteur did not provide funding for this work and had no role in study design, data collection, data analysis, data interpretation, or writing of the report. AG reports grants from Bill and Melinda Gates Foundation, grants from UK DFID, during the conduct of the study; and during this period, Aeras and IAVI (AG\u2019s employers during the time period) conducted TB vaccine clinical trials in collaboration with Sanofi and with GSK. However, neither paid any funds directly to AG or to Aeras or IAVI. All other authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"60"}}