Key result
Pre-marriage CMV vaccination in young women was cost-effective compared with no vaccination, preventing 38.8% of cCMV infections with an ICER of US$4751 per DALY averted.
Why the study?
Congenital CMV imposes a substantial economic burden in China, but dynamic models evaluating CMV vaccination strategies in its high-seroprevalence population are lacking.
Does cytomegalovirus vaccination reduce congenital CMV infection incidence and is it cost-effective in young women in China?
Does cytomegalovirus vaccination reduce congenital CMV infection incidence and is it cost-effective in young women in China?
Effect estimate: ICER US$4751 (95% CI 4124-5378)
A pre-marriage cytomegalovirus vaccination strategy for young women in China is projected to be cost-effective and substantially reduce the incidence of congenital CMV infection.
Should not yet change practice in China; leaves open need for efficacy trials to confirm modeled cost-effectiveness.
Background: Congenital cytomegalovirus (cCMV) infection imposes a substantial economic burden on both families and society in China. There is currently a paucity of dynamic models to study cytomegalovirus (CMV) vaccination strategies for China's high-seroprevalence population (over 95%). Recent clinical trials demonstrated that the messenger RNA (mRNA) vaccine candidate, mRNA-1647, exhibited potential efficacy in both preinfection and postinfection contexts. This study aims to assess the cost-effectiveness of various CMV vaccination strategies for Chinese young women. Method: An age-structured dynamic model was adopted, using Mathematica software, to simulate three strategies: (1) no vaccination (status quo); (2) pre-marriage vaccination (age 20-28 years); (3) reproductive-age vaccination (age 20-40 years). The vaccine was assumed to have 50% coverage and 50% efficacy for the first 5 years, with efficacy gradually decreasing over the next 15 years, costing US$300 per treatment course. This study period covers 2025-2050. Health outcomes included reductions in cCMV infection incidence, morbidity and mortality. We conducted cost-effectiveness, scenario and sensitivity analyses, discounting costs and disability-adjusted life years (DALYs) at 3% annually. The strategy would be considered cost-effective if the incremental cost-effectiveness ratio (ICER) was below China's 2023 per capita gross domestic product (US$12 675). Results: By 2050, pre-marriage and reproductive-age vaccination strategies could prevent cCMV infection incidence by 38.8% (95% uncertainty interval [UI], 33.7% to 43.5%) and 43.3% (38.3% to 47.1%), respectively, with ICERs of US$4751 (4124 to 5378) and US$10 814 (10 290 to 11 338) per DALY averted compared with the status quo. However, the reproductive-age strategy is not cost-effective, with an ICER of US$25 553 (12 566 to 36 126) versus the pre-marriage strategy. Conclusions: Prioritising pre-marriage vaccination could control cCMV infection in China. Our findings would inform public health policies and guide future research on optimising CMV vaccination strategies.
No takes yet. Share an insight, caveat, or question.
Yin et al. (2025) studied Congenital cytomegalovirus (cCMV) infection. Pre-marriage CMV vaccination vs. No vaccination (status quo) was evaluated on Incremental cost-effectiveness ratio (ICER) per DALY averted (ICER US$4751, 95% CI 4124-5378). Pre-marriage CMV vaccination in young women was cost-effective compared with no vaccination, preventing 38.8% of cCMV infections with an ICER of US$4751 per DALY averted.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: