Multiple Criteria Decision Analysis (MCDA) to inform uptake of Next-Generation Influenza Vaccines in Kenya and Thailand

Principal investigator: Carlo Federici (CeRGAS)

Partners: Mantel Malvolti Global Health Consulting (MMGH) - Switzerland

Sponsor: World Health Organization

Duration: Mar 2023- Nov 2024

Abstract:

Background/Objective

Seasonal influenza vaccines reduce global morbidity and mortality but remain underused in low- and middle-income countries (LMICs). This study was part of the World Health Organization's Full Value of Improved Influenza Vaccines Assessment (FVIVA) and explored LMICs’ decision-makers' priorities and preferences for improved influenza vaccines (IIVs) so as to increase their adoption in these settings.

Methods

A multi-criteria decision analysis (MCDA) to evaluate IIVs was conducted in Kenya and Thailand. A set of criteria was defined through a literature review and expert opinion and then further refined during a first online workshop (WS1) with national stakeholders. Criteria weights and scores were elicited in a second workshop (WS2) using a swing weighting approach and a bisection approach, respectively. Results were validated against one current influenza vaccine and 3 hypothetical IIVs for which a performance matrix had previously been developed. To gain a more generalizable understanding of product preferences regarding IIVs, WS1 was also repeated in 11 other countries.

Main Results

In both Kenya and Thailand, 7 criteria were included in the MCDA, 6 of which were shared: vaccine efficacy, duration of protection, breadth of protection, serious adverse events, temperature requirements, and shelf life. Scores and weights were also similar across criteria in both countries.

Conclusions

Based on the results from Kenya and Thailand, as well as from the other 11 countries, a core set of key criteria can be identified for consideration in the decision-making processes regarding IIVs. Using MCDA to evaluate IIVs was a well-accepted and feasible approach for prioritisation and optimisation of vaccine portfolios in national immunisation programmes.