In especially neglected settings (such as conflict zones) since elsewhere could be covered, or increased uptake (such as community leaders endorsement)
It’s not clear to me if the cost-effectiveness assessment is just for the vaccine itself or for a program implementing its provision. I assume distributing vaccines in conflict zones is hard work (meaning costs more), and same for increasing uptake in other areas. I’m not sure about the scalability of either.
Thank you. See my response to Jack_S on the hypothesized cost-effectiveness in conflict settings. Based on the scale and neglectedness of this particular conflict in Ambazonia—according to the Norwegian Refugee Council “4.4 million people [are] in need of humanitarian support” and 1.9 million have been reached. Thus, there seem to be, broadly, coverage opportunities. Pneumococcus vaccination rates are not specified.
This reasoning is based on these anecdotes so can be biased by overestimating the neglectedness of conflict areas and underestimating the coverage in non-conflict settings.
The community leaders endorsement is another hypothesis, based on the relative cost and effectiveness of incentives and community leaders endorsement: vaccine incentive can be of the cost of a bag of lentils while a radio show recorded with community leaders can be much lower per person and could change behavior comparably. For the COVID example in Ambazonia, maybe >10% of people knew about COVID before the program, so informing extremely poor people could be cost-effective, if that is the bottleneck.
It’s not clear to me if the cost-effectiveness assessment is just for the vaccine itself or for a program implementing its provision. I assume distributing vaccines in conflict zones is hard work (meaning costs more), and same for increasing uptake in other areas. I’m not sure about the scalability of either.
Thank you. See my response to Jack_S on the hypothesized cost-effectiveness in conflict settings. Based on the scale and neglectedness of this particular conflict in Ambazonia—according to the Norwegian Refugee Council “4.4 million people [are] in need of humanitarian support” and 1.9 million have been reached. Thus, there seem to be, broadly, coverage opportunities. Pneumococcus vaccination rates are not specified.
This reasoning is based on these anecdotes so can be biased by overestimating the neglectedness of conflict areas and underestimating the coverage in non-conflict settings.
The community leaders endorsement is another hypothesis, based on the relative cost and effectiveness of incentives and community leaders endorsement: vaccine incentive can be of the cost of a bag of lentils while a radio show recorded with community leaders can be much lower per person and could change behavior comparably. For the COVID example in Ambazonia, maybe >10% of people knew about COVID before the program, so informing extremely poor people could be cost-effective, if that is the bottleneck.