The Cost Effectiveness of Partially Effective HIV Vaccines

Summary

Development of a vaccine remains the best hope for curtailing the worldwide pandemic caused by human immunodeficiency virus (HIV) infection. Due to the complex biology of HIV infection, there is increasing concern that an HIV vaccine may provide incomplete protection from infection. In addition to reducing susceptibility to disease, an HIV vaccine may also prolong life in people who acquire HIV despite vaccination, and may reduce HIV transmission. We evaluated how varying degrees of vaccine efficacy for susceptibility, progression of disease, and infectivity influence the costs and benefits of a vaccine program in a population of men who have sex with men, We found that the health benefits, and thus cost effectiveness, of HIV vaccines were strikingly dependent on each of the types of vaccine efficacy. We also found that vaccines with even modest efficacy provided substantial health benefits and were cost effective or cost saving. Although development of an HIV vaccine has been extremely difficult, even a partially effective HIV vaccine could dramatically change the course of the HIV epidemic.