Estimates of Potential Demand for Measles and Rubella Microarray Patches

Abstract

Global measles vaccine coverage has stagnated at approximately 85% for over a decade. By simplifying vaccine logistics and administration, the measles and rubella microarray patch (MR-MAP) may improve coverage. Clinical trials have demonstrated similar safety and immunogenicity in 9-month-old infants for MR-MAPs compared with syringe-and-needle vaccination. To aid commercialization, we present estimates of MR-MAP demand. We created a spreadsheet-based tool to estimate demand for MR-MAPs using data from 180 WHO countries during 2000-2016. Five immunization scenarios were analyzed: (1a) Supplementary Immunization Activities (SIAs) in Gavi, the Vaccine Alliance (Gavi)-eligible countries and (1b) WHO countries where preventive SIAs are routinely conducted; (2) SIAs and outbreak response immunization in all WHO countries; (3) routine immunization (RI) and SIAs in six high-burden measles countries (the Democratic Republic of the Congo, Ethiopia, India, Indonesia, Nigeria, and Pakistan); (4) RI and SIAs in six high-burden countries and Gavi-eligible countries; and (5) hard-to-reach populations. MR-MAP demand varied greatly across scenarios. Forecasts for 2025-2034 estimate from 137 million doses in hard-to-reach populations (scenario 5) to 2.587 billion doses for RI and SIAs in six high-burden countries and Gavi-eligible countries (scenario 4). When policymakers and manufacturers assess MR-MAP demand, they may consider multiple scenarios to allow for a complete consideration of potential markets and public health needs.

Keywords: health service needs and demand; measles vaccine; microneedle; rubella vaccine; transdermal patch; vaccination.

Figure 1

Examples of MCV1 and MCV2 historical coverage and estimated future coverage (2000–2055) Notes: Blue and green dots represent the historical coverage rates for the measles-containing vaccine first dose (MCV1) and measles-containing vaccine second dose (MCV2), respectively. The solid blue and green lines represent the future estimates of such coverage based on extrapolations from regression analyses. See text for additional details. The equations in each graph are logistic regressions used to fit the historical data and subsequently used to estimate future potential demand by extrapolating forward, producing the solid line shown.

Figure 2

MR-MAP potential demand by estimation scenario and by year (2025–2034) Notes: The measles–rubella microarray patch potential demand scenarios are for (1A) SIAs in Gavi, the Vaccine Alliance (Gavi)-eligible countries; (1B) SIAs in all WHO countries; (2) SIAs and outbreak response immunization; (3) SIAs and routine immunization in six high-burden measles countries: the Democratic Republic of the Congo, Ethiopia, India, Indonesia, Nigeria, and Pakistan; (4) SIAs and routine immunization in six high-burden countries and in Gavi countries; and (5) hard-to-reach populations. Note that for Scenario 5, because there are no existing coverage data, we assume in the base case that 100% of this population will be vaccinated with MAPs.