{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T04:08:21Z","timestamp":1748923701397,"version":"3.41.0"},"reference-count":37,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T00:00:00Z","timestamp":1748822400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000769","name":"University of Oxford","doi-asserted-by":"publisher","award":["EUPAS43571"],"award-info":[{"award-number":["EUPAS43571"]}],"id":[{"id":"10.13039\/501100000769","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000769","name":"University of Oxford","doi-asserted-by":"publisher","award":["NCT05047822"],"award-info":[{"award-number":["NCT05047822"]}],"id":[{"id":"10.13039\/501100000769","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.ploscompbiol.org"],"crossmark-restriction":false},"short-container-title":["PLoS Comput Biol"],"abstract":"<jats:p>Many immunocompromised individuals mount inadequate immune responses following COVID-19 vaccination, thus relying on other social distancing behaviours, particularly shielding, for protection, impacting their quality of life. However, little is known about historical\/current levels and effectiveness of shielding or factors influencing individuals\u2019 decision to continue shielding. Long-acting antibody pre-exposure prophylaxis (LAAB-PrEP) provides direct protection against COVID-19 in immunocompromised individuals who have been and may continue to shield. However, the proportion and incidence of circulating variants for which LAAB-PrEP would be effective is unpredictable. Given this uncertain behavioural and immuno-epidemiological context, we developed a modelling framework to explore features that most impact health outcomes and cost effectiveness of long-term administration of LAAB-PrEP against COVID-19 infection in immunocompromised individuals in the English context. The model predicted that the incremental cost-effectiveness ratio (ICER) of LAAB-PrEP against COVID-19 in immunocompromised individuals will be largely driven by features of utility of shielding, current\/future shielding behaviour, cost of shielding, risk of COVID-19 hospitalisation among immunocompromised individuals and the time horizon used for the cost-effectiveness analysis. The model estimated that for realistic ranges of influential factors, it is possible for LAAB-PrEP to be cost effective under the conditions that most immunocompromised individuals would shield indefinitely if it were not available but would switch to LAAB-PrEP if it were. Thus, if individuals stop shielding when taking LAAB-PrEP, then LAAB-PrEP is cost effective.<\/jats:p>","DOI":"10.1371\/journal.pcbi.1013072","type":"journal-article","created":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T18:18:21Z","timestamp":1748888301000},"page":"e1013072","update-policy":"https:\/\/doi.org\/10.1371\/journal.pcbi.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Features influencing the health and economic impact of preventing COVID-19 in immunocompromised individuals"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9418-2527","authenticated-orcid":true,"given":"Siyu","family":"Chen","sequence":"first","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2093-5781","authenticated-orcid":true,"given":"Sudhir","family":"Venkatesan","sequence":"additional","affiliation":[]},{"given":"Sofie","family":"Arnetorp","sequence":"additional","affiliation":[]},{"given":"Klas","family":"Bergenheim","sequence":"additional","affiliation":[]},{"given":"Sabada","family":"Dube","sequence":"additional","affiliation":[]},{"given":"Wilhelmine","family":"Meeraus","sequence":"additional","affiliation":[]},{"given":"C\u00e1tia","family":"Ferreira","sequence":"additional","affiliation":[]},{"given":"Sylvia","family":"Taylor","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6523-185X","authenticated-orcid":true,"given":"Lisa J.","family":"White","sequence":"additional","affiliation":[]}],"member":"340","published-online":{"date-parts":[[2025,6,2]]},"reference":[{"issue":"1","key":"pcbi.1013072.ref001","doi-asserted-by":"crossref","first-page":"2027160","DOI":"10.1080\/21645515.2022.2027160","article-title":"The efficacy and effectiveness of the COVID-19 vaccines in reducing infection, severity, hospitalization, and mortality: a systematic review","volume":"18","author":"I Mohammed","year":"2022","journal-title":"Hum Vaccin Immunother"},{"issue":"10328","key":"pcbi.1013072.ref002","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1016\/S0140-6736(22)00152-0","article-title":"Duration of effectiveness of vaccines against SARS-CoV-2 infection and COVID-19 disease: results of a systematic review and meta-regression","volume":"399","author":"DR Feikin","year":"2022","journal-title":"Lancet"},{"key":"pcbi.1013072.ref003","year":"2022"},{"issue":"10","key":"pcbi.1013072.ref004","doi-asserted-by":"crossref","first-page":"880","DOI":"10.1001\/jama.2023.28019","article-title":"Prevalence of immunosuppression among US adults","volume":"331","author":"ML Martinson","year":"2024","journal-title":"JAMA"},{"key":"pcbi.1013072.ref005","doi-asserted-by":"crossref","first-page":"101965","DOI":"10.1016\/j.eclinm.2023.101965","article-title":"Vaccines and therapeutics for immunocompromised patients with COVID-19","volume":"59","author":"S Shoham","year":"2023","journal-title":"EClinicalMedicine"},{"key":"pcbi.1013072.ref006","doi-asserted-by":"crossref","first-page":"100747","DOI":"10.1016\/j.lanepe.2023.100747","article-title":"Impact of COVID-19 on immunocompromised populations during the Omicron era: insights from the observational population-based INFORM study","volume":"35","author":"RA Evans","year":"2023","journal-title":"Lancet Reg Health Eur"},{"key":"pcbi.1013072.ref007","author":"National Institute for Health and Care Excellence.","year":"2023"},{"key":"pcbi.1013072.ref008","author":"Office for National Statistics."},{"issue":"4","key":"pcbi.1013072.ref009","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1192\/bjp.2022.44","article-title":"The impact of shielding during the COVID-19 pandemic on mental health: evidence from the English Longitudinal Study of Ageing","volume":"221","author":"G Di Gessa","year":"2022","journal-title":"Br J Psychiatry"},{"key":"pcbi.1013072.ref010","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.puhe.2023.02.008","article-title":"Did the UK\u2019s public health shielding policy protect the clinically extremely vulnerable during the COVID-19 pandemic in Wales? 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