The London School of Hygiene & Tropical Medicine (LSHTM) has been awarded three five-year grants from the National Institute for Health Research (NIHR) in collaboration with Public Health England (PHE) for three Heath Protection Research Units (HPRUs) in Environmental Change & Health, Immunisation, and Modelling & Economics.

Within the Immunisation HPRU, funding is available for a full-time PhD studentship to start in September 2020 on one of the following topics:

Project 1: Impact and cost-effectiveness modelling of a COVID-19 vaccine
Coronavirus disease 2019 (COVID-19) is likely to spread around the world and to become endemic, with a substantial impact forecasted on the national and global economy and population health; hence one of the main long-term preventive measures against it is development of a prophylactic vaccine. Several such vaccine candidates are in development and may enter human trials in the near future. The aim of this project is to examine the potential impact and cost-effectiveness of different COVID-19 vaccination strategies given vaccines with different characteristics, and in combination with other public health measures. The project will have the potential to benefit from data on COVID-19 outbreaks in affected settings worldwide, as well as expertise at both LSHTM and PHE on conducting economic evaluations alongside transmission models of infectious disease interventions.

Project 2: Improving the way vaccines are assessed
The decisions to introduce a vaccine, as well as the price paid by the government to manufacturers for a vaccine, is determined by using cost-effectiveness modelling conducted by PHE and academic collaborators including LSHTM. However, current methods for determining the cost-effectiveness of a vaccine may ignore important features of vaccines. (i) After introduction, disease prevented by a vaccine can increase or decrease over time and lead to replacement effects, which alters the cost-effectiveness. This could lead to perverse recommendations for decisions such as stopping and re-starting vaccine programmes or switching between several vaccines leading to variation in protection and disrupted vaccine uptake levels (intergenerational inequity). (ii) Socio-economic gradients for disease risk may lead to equity issues of vaccine access and uptake at sub-national level that may not be accounted for and alter the recommendation. (iii) Vaccines may produce intangible benefits such as peace of mind and reducing seasonal bed pressures. The WHO advocates capturing such benefits within its “full value of vaccines framework” but the analytical methods to do so are not well developed. This project will develop methods to address these shortcomings in current analyses, and then use them to evaluate the cost-effectiveness of vaccines currently being evaluated for the national schedule.