Dashpagam, Otgonbayar

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Dashpagam Otgonbayar

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Dashpagam Otgonbayar

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Анагаахын Шинжлэх Ухааны Үндэсний Их Сургууль

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Impact of Booster Vaccination on Infection and Hospitalization Rates during the Mass Vaccination in Mongolia
(Mongolian National University of Medical Sciences, 2025-09-30)
Dashpagam, Otgonbayar
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Batmunkh, Burenjargal
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Gunchin, Batbaatar
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Lkhagvasuren, Khorolsuren
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Davaalkham, Dambadarjaa
Objective: Our study aims to evaluate the effectiveness of booster vaccination in preventing new COVID-19 infections and related hospitalizations among groups that received the primary vaccination series. Methods: Booster vaccination started on August 31, 2021, at recruitment in May 2022. By May 2022, 64% of the Mongolian population had received two primary doses of a COVID-19 vaccine, and 31% had received a booster dose. We followed 1,251 participants (459 males and 792 females, with a mean age of 41.5 ± 14.5 years [18–93], and a median age of 39.0 years) over six months, from the start of booster immunization on September 1, 2021, to February 28, 2022. We compared infection and hospitalization rates among vaccinated groups using logistic regression and calculated vaccine effectiveness (VE) for booster recipients with the formula: VE = 1 – (vaccinated rate/unvaccinated rate) × 100. Results: All participants received two doses of one of four vaccines used in the nationwide campaign. During the study period, we identified 449 new infection cases, accounting for 35.9% of all participants, and 150 subsequent hospitalizations, or 12.0% of the total. Participants who did not receive a booster demonstrated significantly higher infection rates compared to those who did. Booster vaccination provided notably better protection against new infections among frontline workers and reduced hospitalizations in high-risk groups. No significant differences were found in VE when comparing participants based on seroconversion after initial vaccination or the type of booster vaccine used.Conclusion: Therefore, we concluded that COVID-19 booster vaccinations effectively enhanced protection against new SARS-CoV-2 infections among frontline healthcare workers, government employees, and individuals at higher risk for severe disease, thereby reducing their risk of hospitalization.
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One-year antibody kinetics and effectiveness of a BNT162b2 booster after four primary COVID-19 vaccination regimens in Mongolia
(2026-09)
Bazarjav, Purevbat
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Erdene-Ochir, Tseyenkhorloo
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Sandagdorj, Ankhbayar
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Enkhtuvshin, Altansukh
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Enkhbayar, Purevjargal
BACKGROUND: Waning immunity after primary COVID-19 vaccination and the widespread use of heterogeneous vaccine platforms have created uncertainty regarding the durability of protection following booster vaccination. Mongolia implemented a mixed-platform vaccination program and deployed BNT162b2 as a booster. We evaluated the immunogenicity, effectiveness, and safety of a BNT162b2 booster following four primary vaccination regimens with 12 months follow-up. METHODS: In this prospective observational study in Ulaanbaatar, Mongolia, adults (≥18 years) who had completed a homologous two-dose primary series with BBIBP-CorV, ChAdOx1 nCoV-19, Gam-COVID-Vac, or BNT162b2 received a BNT162b2 booster a median of 189 days (IQR 186-215) after the second dose and were grouped according to their primary vaccination regimen. Humoral immune responses (anti-SARS-CoV-2 N/S1-RBD IgG, S-RBD IgG, and neutralizing antibodies) were measured at baseline and at multiple time points up to 12 months after booster vaccination. Reactogenicity was monitored for 28 days. SARS-CoV-2 infection was ascertained by a positive antigen/lateral-flow test and/or RT-PCR. VE was estimated for prespecified follow-up intervals by comparing the risk of SARS-CoV-2 infection in each boosted group with that in an unvaccinated comparison group. FINDINGS: Among 311 participants (mean age 41.88 years [SD 13.64]; 175 [56.27%] women and 136 [43.73%] men), antibody responses peaked at day 14 and declined through day 365 in all groups. At day 14, total antibody concentrations were highest in BNT + BNT (385.03 U/mL) and lowest in Gam + BNT (341.74 U/mL). S-RBD IgG at day 14 was highest in BNT + BNT (967.0 ng/mL) and lowest in BBIBP+BNT (863.70 ng/mL). Neutralizing antibodies at day 14 were highest in BNT + BNT (368.13 AU/mL) and BBIBP+BNT (336.70 AU/mL). During follow-up, 64 participants acquired SARS-CoV-2 infection and 15 (23.44%) were admitted to hospital. Reactogenicity was predominantly mild-to-moderate, and laboratory parameters were generally within acceptable ranges. Vaccine effectiveness declined from 1 month to 12 months: BBIBP+BNT 90.54% (95% CI 59.71-97.78) to 71.17% (39.66-86.23); ChAd+BNT 84.97% (49.75-95.51) to 52.59% (8.61-75.41); Gam + BNT 89.68% (23.95-98.60) to 63.84% (15.10-84.60); BNT + BNT 91.89% (40.06-98.90) to 72.29% (34.37-88.30). INTERPRETATION: A BNT162b2 booster following diverse primary COVID-19 vaccination regimens induced strong humoral responses that declined over 12 months and showed an acceptable reactogenicity profile. VE against SARS-CoV-2 infection was highest soon after boosting and lower later in follow-up. Although antibody levels and VE showed similar temporal patterns, these findings should be interpreted as complementary outcomes rather than evidence of a direct causal relationship or a formal immunological correlate of protection.
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The potential cost-effectiveness of HPV vaccination among girls in Mongolia
(2022-08)
Luvsan, Munkh-Erdene
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Vodicka, Elisabeth
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Jugder, Uranbolor
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Tudev, Undarmaa
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Clark, Andy
INTRODUCTION: Cervical cancer is a leading cause of cancer among women in Mongolia with an age-standardized incidence rate of 23.5 per 100,000. HPV vaccination has not been introduced nationally and Gavi co-financing support is not available in Mongolia. Extended Gavi pricing for HPV vaccine may be available from vaccine manufacturers for a number of years. To inform introduction decision-making, we evaluated the potential cost-effectiveness of HPV vaccination among girls and young women in Mongolia. METHODS: We used UNIVAC (version 1.4), a static decision model, to evaluate the health and economic outcomes of single-cohort vaccination among females from the government perspective compared to no vaccination. We modeled vaccine introduction over 10 birth cohorts starting in 2022 comparing quadrivalent or bivalent vaccine selection and vaccine pricing variations. We used locally-specific data for cancer incidence, mortality, treatment and costs. Model outcomes included cancer cases, hospitalizations, deaths, disability-adjusted life years (DALY), and costs presented in 2018 USD. Incremental costs and health outcomes were discounted at 3% and aggregated into an Incremental Cost-Effectiveness Ratio (ICER). RESULTS: The base-case scenario of HPV vaccination among 9 year-old girls was projected to avert 5,692 cervical cancer cases, 3,240 deaths, and 11,886 DALYs and incur $2.4-3.1M more costs compared to no vaccination. At prices of ($4.50-$4.60/dose), we estimated an ICER of $166-$265/DALY averted among 9-year-olds. When price per dose was increased to reported mean vaccine purchase price for non-Gavi LMICs ($14.17/dose), the ICER ranged from $556-820/DALY averted. CONCLUSION: HPV vaccination among girls is highly likely to be a cost-effective investment in Mongolia compared to no vaccination with projected ICERs less than 20% of the 2018 GDP per capita of $3,735.
Scopus© Citations 5
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Projected impact, cost-effectiveness, and budget implications of rotavirus vaccination in Mongolia.
(2019-02)
Lusvan, Munkh-Erdene
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Debellut, Frédéric
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Clark, Andrew
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Demberelsuren, Sodbayar
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Otgonbayar, Dashpagam
Scopus© Citations 11

Dashpagam, Otgonbayar

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