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. 2025 Dec;21(1):2528409.
doi: 10.1080/21645515.2025.2528409. Epub 2025 Jul 15.

Economic evaluations of vaccines against respiratory infections in adults in Southeast Asia: A systematic review

Ba Khuong Cao  1   2 , Rachmadianti Sukma Hanifa  1 , Thi-Phuong-Lan Nguyen  2 , Maarten J Postma  1   3   4   5 , Jurjen van der Schans  1   6   7
Affiliations

Economic evaluations of vaccines against respiratory infections in adults in Southeast Asia: A systematic review

Ba Khuong Cao et al. Hum Vaccin Immunother. 2025 Dec.

Abstract

Respiratory infections significantly impact adult health in Southeast Asia, yet vaccine coverage remains low. This systematic review evaluated the economic evaluations of vaccines targeting respiratory infections in the region. A comprehensive search was conducted across several databases, including MEDLINE/PubMed, EMBASE, NHSEED, CINAHL, EconLit, Web of Science, Scopus, and Cochrane Library, up to April 24, 2024. Nineteen eligible studies were identified, focusing primarily on influenza (8 studies) and COVID-19 vaccines (7 studies), with fewer studies on pneumococcal (2 studies), varicella (1 study), and pertussis (1 study) vaccines. Overall, influenza, COVID-19 (boosters), and pneumococcal vaccines were found to be cost-effective or highly cost-effective compared to no-vaccine or no-booster scenarios. The only study on maternal pertussis vaccination found it not to be cost-effective. The most common parameters considered in sensitivity analyses were vaccine efficacy and discount rates. This review highlights the economic evaluations of influenza, COVID-19, and pneumococcal vaccines in Southeast Asia, providing essential evidence to guide vaccine policy. Future studies should address limitations in model selection, incorporate herd immunity, ensure the model validation (i.e. validity of cost and benefit measurements), and explore the cost-effectiveness of other vaccines across the region.

Keywords: Southeast Asia; Systematic review; adults; economic evaluation; respiratory infection; vaccine.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Flow chart of the study.
Figure 2.
Figure 2.
Authors’ assessment of the good practice compliance of the included studies using CHEC-extended checklist.
See this image and copyright information in PMC

References

    1. Bender RG, Sirota SB, Swetschinski LR, Dominguez RMV, Novotney A, Wool EE, Ikuta KS, Vongpradith A, Rogowski ELB, Doxey M, et al. Global, regional, and national incidence and mortality burden of non-COVID-19 lower respiratory infections and aetiologies, 1990–2021: a systematic analysis from the global burden of disease study 2021. Lancet Infect Dis. 2024;24(9):974–23. doi: 10.1016/S1473-3099(24)00176-2. - DOI - PMC - PubMed
    1. Worldometer . Reported cases and deaths by country or territory. 2024. [accessed 2024 Oct 4]. https://www.worldometers.info/coronavirus/.
    1. WHO . COVID-19 remains a persistent public health threat. 2024. [accessed 2024 Oct 4]. https://www.emro.who.int/media/news/covid-19-remains-a-persistent-public....
    1. WHO . Global immunization policy and guidance. [accessed 2024 Aug 28]. https://www.who.int/teams/immunization-vaccines-and-biologicals/policies.
    1. Hunter P, Fryhofer SA, Szilagyi PG.. Vaccination of adults in general medical practice. Mayo Clinic Proc. 2020;95(1):169–183. doi: 10.1016/j.mayocp.2019.02.024. - DOI - PubMed

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