Modelling the health and budget impact of introducing diphtheria-tetanus-pertussis-containing-vaccine booster doses in Uganda
- 1University of Cape Town
Abstract
Routine infant vaccination has helped reduce cases and deaths from diphtheria, tetanus, and pertussis globally. However, these diseases continue to pose serious health risks as protective immunity wanes over time. Three booster doses of diphtheria-tetanus-pertussis-containing vaccine (DTPCV) administered from 12-months to 15-years of age increase duration of protection beyond childhood. Growing demands on government health spending underscore the importance of understanding the health and economic impact of vaccines prior to introduction.
Using an integrated multi-disease epidemiological-economic model, we estimated the health impact (cases averted, deaths averted, and changes to population immunity) and budget impact of introducing DTPCV booster doses in Uganda.
Compared to no DTPCV boosters, introducing all three booster doses is projected to result in 2.2 times the proportion of the population protected against symptomatic diphtheria and 2.8 times against tetanus infection among Ugandans under 15 years of age by 2039. Compared to introduction of the early childhood booster (EC) at 18 months of age, introducing all three DTPCV boosters simultaneously is projected to avert 3.2 times the number of tetanus cases over fifteen years at 2.4 times the incremental cost. The projected government vaccination cost per planned dose was USD 0.58 for simultaneous introduction of all three boosters compared with USD 0.68 for the EC booster alone. The average annual incremental cost of all three DTPCV booster doses is USD 2.79 million. Under modelled assumptions, simultaneous introduction of all three DTPCV booster doses in Uganda provides the greatest health gains, with a lower government vaccination cost per planned dose than introduction of the EC booster alone, but may still pose affordability challenges for Ugandas government.
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BibTeX
@misc{hounsell2026modelling,
title = {{Modelling the health and budget impact of introducing diphtheria-tetanus-pertussis-containing-vaccine booster doses in Uganda}},
author = {R. Hounsell and S. P. Silal and J. Norman and R. Monyake and A. Immaculate and A. Besigye and G. Biroma and J. Magoola and N. Kishore and S. E. Pallas and K. Ward},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.15.26365602},
url = {https://www.medrxiv.org/content/10.64898/2026.10.15.26365602v1},
note = {CC0},
}
RIS
TY - UNPB
TI - Modelling the health and budget impact of introducing diphtheria-tetanus-pertussis-containing-vaccine booster doses in Uganda
AU - R. Hounsell
AU - S. P. Silal
AU - J. Norman
AU - R. Monyake
AU - A. Immaculate
AU - A. Besigye
AU - G. Biroma
AU - J. Magoola
AU - N. Kishore
AU - S. E. Pallas
AU - K. Ward
PY - 2026
DA - 2026/10/15
PB - medRxiv
DO - 10.64898/2026.10.15.26365602
UR - https://www.medrxiv.org/content/10.64898/2026.10.15.26365602v1
AB - Routine infant vaccination has helped reduce cases and deaths from diphtheria, tetanus, and pertussis globally. However, these diseases continue to pose serious health risks as protective immunity wanes over time. Three booster doses of diphtheria-tetanus-pertussis-containing vaccine (DTPCV) administered from 12-months to 15-years of age increase duration of protection beyond childhood. Growing demands on government health spending underscore the importance of understanding the health and economic impact of vaccines prior to introduction. Using an integrated multi-disease epidemiological-economic model, we estimated the health impact (cases averted, deaths averted, and changes to population immunity) and budget impact of introducing DTPCV booster doses in Uganda. Compared to no DTPCV boosters, introducing all three booster doses is projected to result in 2.2 times the proportion of the population protected against symptomatic diphtheria and 2.8 times against tetanus infection among Ugandans under 15 years of age by 2039. Compared to introduction of the early childhood booster (EC) at 18 months of age, introducing all three DTPCV boosters simultaneously is projected to avert 3.2 times the number of tetanus cases over fifteen years at 2.4 times the incremental cost. The projected government vaccination cost per planned dose was USD 0.58 for simultaneous introduction of all three boosters compared with USD 0.68 for the EC booster alone. The average annual incremental cost of all three DTPCV booster doses is USD 2.79 million. Under modelled assumptions, simultaneous introduction of all three DTPCV booster doses in Uganda provides the greatest health gains, with a lower government vaccination cost per planned dose than introduction of the EC booster alone, but may still pose affordability challenges for Ugandas government.
ER -