Health Technology Assessment of Vaccination: Strategies, Public Health and Values

A special issue of Vaccines (ISSN 2076-393X). This special issue belongs to the section "Human Vaccines and Public Health".

Deadline for manuscript submissions: 31 December 2025 | Viewed by 5259

Special Issue Editors


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Guest Editor
Unit of Global Health, Department of Health Sciences, University Medical Center Groningen (UMCG), University of Groningen, 9713 GZ Groningen, The Netherlands
Interests: vaccines; global health; health technology assessment; cost-effectiveness; health economics
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Unit of Global Health, Department of Health Sciences, University Medical Center Groningen (UMCG), University of Groningen, 9713 GZ Groningen, The Netherlands
Interests: health care sciences and services; health policy and services; public; environmental and occupational health

E-Mail Website
Guest Editor
Unit of Global Health, Department of Health Sciences, University Medical Center Groningen (UMCG), University of Groningen, 9713 GZ Groningen, The Netherlands
Interests: health economics; health policy; health outcomes; epidemiology; prevention; health systems
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Health Technology Assessment (HTA) has an increasing role worldwide in the accessibility and use of vaccines. This Special Issue aims to bring together the views and interests of different stakeholders to enhance mutual understanding. The topics to be addressed include time-to-population access vaccine studies, cost-effectiveness analyses, real-world monitoring of vaccine performances, and guidelines for adequate vaccine HTA evaluations.

Specific aims include a better understanding of vaccine hesitancy, long periods of population access, roles of cost-effectiveness and budgets, views of patient groups, and the advantages of vaccines. Original research articles and reviews, within the journal’s scope, are welcome for submission, focusing on themes such as the value of vaccines, the time it takes for innovative vaccines to reach patients, cost-effectiveness assessments, real-world data analyses on vaccines' properties, and overcoming vaccine hesitancy to increase coverage.

We look forward to receiving valuable contributions.

Prof. Dr. Maarten J. Postma
Dr. Jurjen Van der Schans
Prof. Dr. Cornelis Boersma
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Vaccines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • health technology assessment
  • population access vaccine studies
  • vaccination cost-effectiveness
  • vaccine hesitancy

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Published Papers (4 papers)

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Research

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15 pages, 5002 KiB  
Article
Vaccination Schedules Recommended by the Centers for Disease Control and Prevention: From Human-Readable to Machine-Processable
by Xia Jing, Hua Min, Yang Gong, Mytchell A. Ernst, Aneesa Weaver, Chloe Crozier, David Robinson, Dean F. Sittig, Paul G. Biondich, Samuil Orlioglu, Akash Shanmugan Boobalan, Kojo Abanyie, Richard D. Boyce, Adam Wright, Christian Nøhr, Timothy D. Law, Arild Faxvaag, Lior Rennert and Ronald W. Gimbel
Vaccines 2025, 13(5), 437; https://doi.org/10.3390/vaccines13050437 - 22 Apr 2025
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Abstract
Background: Reusable, machine-processable clinical decision support system (CDSS) rules have not been widely achieved in the medical informatics field. This study introduces the process, results, challenges faced, and lessons learned while converting the United States of America Centers for Disease Control and Prevention [...] Read more.
Background: Reusable, machine-processable clinical decision support system (CDSS) rules have not been widely achieved in the medical informatics field. This study introduces the process, results, challenges faced, and lessons learned while converting the United States of America Centers for Disease Control and Prevention (CDC)-recommended immunization schedules (2022) to machine-processable CDSS rules. Methods: We converted the vaccination schedules into tabular, charts, MS Excel, and clinical quality language (CQL) formats. The CQL format can be automatically converted to a machine-processable format using existing tools. Therefore, it was regarded as a machine-processable format. The results were reviewed, verified, and tested. Results: We have developed 465 rules for 19 vaccines in 13 categories, and we have shared the rules via GitHub to make them publicly available. We used cross-review and cross-checking to validate the CDSS rules in tabular and chart formats. The CQL files were tested for syntax and logic with hypothetical patient HL7 FHIR resources. Our rules can be reused and shared by the health IT industry, CDSS developers, medical informatics educators, or clinical care institutions. The unique contributions of our work are twofold: (1) we created ontology-based, machine-processable, and reusable immunization recommendation rules, and (2) we created and shared multiple formats of immunization recommendation rules publicly which can be a valuable resource for medical and medical informatics communities. Conclusions: These CDSS rules can be important contributions to informatics communities, reducing redundant efforts, which is particularly significant in resource-limited settings. Despite the maturity and concise presentation of the CDC recommendations, careful attention and multiple layers of verification and review are necessary to ensure accurate conversion. The publicly shared CDSS rules can also be used for health and biomedical informatics education and training purposes. Full article
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15 pages, 1783 KiB  
Article
Cost-Effectiveness of Bivalent Respiratory Syncytial Virus Prefusion F Vaccine for Prevention of Respiratory Syncytial Virus Among Older Adults in Greece
by George Gourzoulidis, Charalampos Tzanetakos, Argyro Solakidi, Eleftherios Markatis, Marios Detsis, Diana Mendes and Myrto Barmpouni
Vaccines 2024, 12(11), 1232; https://doi.org/10.3390/vaccines12111232 - 29 Oct 2024
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Abstract
Background/Objectives: To evaluate the health benefits, costs, and cost-effectiveness of vaccination with bivalent respiratory syncytial virus stabilized prefusion F vaccine (RSVpreF) for the prevention of lower respiratory tract disease caused by respiratory syncytial virus (RSV) in Greek adults 60 years of age and [...] Read more.
Background/Objectives: To evaluate the health benefits, costs, and cost-effectiveness of vaccination with bivalent respiratory syncytial virus stabilized prefusion F vaccine (RSVpreF) for the prevention of lower respiratory tract disease caused by respiratory syncytial virus (RSV) in Greek adults 60 years of age and older. Methods: A Markov model was adapted to simulate lifetime risk of health and economic outcomes from the public payer’s perspective over a lifetime horizon. Epidemiology, vaccine effectiveness, utilities, and direct medical costs (EUR, 2024) were obtained from published studies, official sources, and local experts. Model outcomes included the number of medically attended RSV cases, stratified by care setting (i.e., hospital, emergency department [ED], outpatient visits [OV]), and attributable RSV-related deaths, costs, life years (LY), quality-adjusted life-years (QALY), and incremental cost-effectiveness ratios (ICERs) of RSVpreF vaccination compared with no vaccination. Results: The model projected 258,170 hospitalizations, 112,248 ED encounters, 1,201,604 OV, and 25,463 deaths related to RSV in Greek older adults resulting in direct medical costs of EUR 1.6 billion over the lifetime horizon. Assuming RSV vaccination would reach the same coverage rates as pneumococcal and influenza programmes, 18,118 hospitalizations, 7874 ED encounters, 48,079 OV, and 1706 deaths could be prevented over the modelled time horizon. The health benefits associated with RSVpreF contributed to an incremental gain of 10,976 LYs and 7230 QALYs compared with no vaccination. The incremental analysis reported that vaccination with RSVpreF was estimated to be a cost-effective strategy resulting in ICERs of EUR 12,991 per LY gained, EUR 19,723 per QALY gained, and EUR 7870 per hospitalized RSV case avoided compared with no vaccination. Conclusions: Vaccination with RSVpreF was a cost-effective strategy for the prevention of RSV disease in Greek adults over 60 years of age. The introduction of RSV vaccination can improve public health by averting RSV cases and deaths and has the potential to fulfil an unmet medical need. Full article
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17 pages, 428 KiB  
Article
A Clinical and Economic Comparison of Cell-Based Versus Recombinant Influenza Vaccines in Adults 18–64 Years in the United States
by Myron J. Levin, Neda Al Rawashdh, Liliane Mofor, Pablo Anaya, Richard M. Zur, Emily B. Kahn, Daniel Yu and Joaquin F. Mould-Quevedo
Vaccines 2024, 12(11), 1217; https://doi.org/10.3390/vaccines12111217 - 26 Oct 2024
Cited by 1 | Viewed by 1818
Abstract
Background: This analysis compares the cost-effectiveness of a cell-based influenza vaccine to a recombinant influenza vaccine, and each to no vaccination. The analysis is based on United States (US) commercial and societal perspectives. Methods: A Susceptible–Exposed–Infectious–Recovered (SEIR) transmission model of the total US [...] Read more.
Background: This analysis compares the cost-effectiveness of a cell-based influenza vaccine to a recombinant influenza vaccine, and each to no vaccination. The analysis is based on United States (US) commercial and societal perspectives. Methods: A Susceptible–Exposed–Infectious–Recovered (SEIR) transmission model of the total US population followed with a cost-effectiveness model for 18–64-year-olds was used to estimate the clinical and economic impact of vaccination over one influenza season (2018–2019). Deterministic and probabilistic sensitivity analyses were conducted. Results: Both enhanced vaccines prevented a substantial number of influenza cases and influenza-related deaths compared to no vaccination. The cell-based vaccine was associated with higher quality-adjusted life years (QALYs) gained compared to the recombinant vaccine or no vaccination. The cell-based vaccine had a 36% lower vaccination cost, amounting to $2.8 billion in cost savings, compared to the recombinant vaccine. The incremental cost-effectiveness ratios (ICERs) for the cell-based vaccine, compared to the recombinant vaccine or no vaccination, were dominant from all payer perspectives, regardless of risk groups. Conclusions: Overall, the cell-based vaccine was cost-saving compared to the recombinant vaccine for subjects aged 18–64 years in the US, achieving comparable health outcomes with a significant reduction in associated costs. Full article
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19 pages, 1261 KiB  
Systematic Review
Effectiveness of General Practitioners’ Involvement in Adult Vaccination Practices: A Systematic Review and Meta-Analysis of International Evidence
by Andrea Ceccarelli, Gabriele Munafò, Francesco Sintoni, Christian Cintori, Davide Gori and Marco Montalti
Vaccines 2024, 12(12), 1438; https://doi.org/10.3390/vaccines12121438 - 20 Dec 2024
Cited by 1 | Viewed by 931
Abstract
Background: General practitioners (GPs) and primary care units collaborate with Prevention Departments (PDs) to improve immunization by participating in vaccination campaigns, sharing tools, and implementing educational programs to raise patient awareness. This review aimed to identify effective strategies for involving GPs in PD [...] Read more.
Background: General practitioners (GPs) and primary care units collaborate with Prevention Departments (PDs) to improve immunization by participating in vaccination campaigns, sharing tools, and implementing educational programs to raise patient awareness. This review aimed to identify effective strategies for involving GPs in PD vaccination practices. Methods: A systematic review following PRISMA guidelines was conducted on MEDLINE, TripDatabase, ClinicalTrials, CINAHL, and Cochrane up to January 2024 to identify full-text studies in English evaluating the effectiveness of GP involvement. A meta-analysis was also performed. Results: Of 1018 records, 15 studies were included, with an intermediate quality assessment. Studies originated from the United States (n = 9), Europe (5), Singapore (1), and China (1). Eight studies investigated educational programs for GPs, while seven focused on organizational or technological interventions to enhance immunization practices. Twelve studies reported increased vaccine uptake after intervention. Vaccines addressed included influenza, SARS-CoV-2, pneumococcal, zoster, and trivalent (diphtheria, tetanus, pertussis). Interventions involving GPs in PD vaccination campaigns, focusing on organizational or technological strategies, demonstrated a significant increase in vaccine uptake (OR = 1.15; 95% CI: 1.03–1.27; p < 0.0001; I2 = 96%). Conclusions: GPs emerged as valuable allies for PDs due to their extensive territorial reach and trusted relationships with patients. Additionally, up-to-date organizational and technological tools could play a decisive role in increasing vaccine uptakes. This study, offering valuable insights into the effectiveness of GPs involvement, may be useful to implement similar intervention in different contexts. Full article
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