Simplified Pneumococcal Vaccination Schedules for Adults Age 50 and Over Lead to Worse Health
Journal Title: UNKNOWN - Year 2017, Vol 8, Issue 6
Abstract
Background: In 2014 the Advisory Committee on Immunization Practices (ACIP) approved a dose of 13-valent pneumococcal conjugate vaccine (PCV13) for all adults at age 65 years. This further complicated the pneumococcal vaccination schedule, which was already one of the most complicated schedules. Objective: This study documents simplified schedules that were considered and discarded by the pneumococcal working group before making the most recent recommendation. We examined the marginal cost-effectiveness of several simplified schedules for older adults (age 50+ years) when compared with current recommendations. Our primary outcome was the cost-effectiveness ratio of quality-adjusted life years to cost. Methods: We used a probabilistic model following a cohort of 50 year-olds with separate vaccination coverage and disease incidence data for healthy adults and adults at increased risk of pneumococcal disease. We compared incremental cost-effectiveness ratios from the schedule that was ultimately recommended with each potential simplified vaccination strategy. Results: Most schedules analyzed resulted in several hundred additional deaths. While several possible schedules resulted in cost savings, these cost savings were modest compared to the health costs associated with them. Conclusion: The schedule recommended by the ACIP in 2014, while complex, is the most health promoting compared to the modeled alternative schedules. The incremental cost-effectiveness ratio of the current schedule when compared to simplified alternatives is comparable to other vaccine-related interventions.
Authors and Affiliations
Charles Stoecker, Lindsay Kim, Ryan Gierke, Tamara Pilishvili
Keywords
Related Articles
- EP ID EP363367
- DOI 10.4172/2157-7560.1000373
- Views 33
- Downloads 0
MEFA (multiepitope fusion antigen) - Novel Technology for Structural Vaccinology, Proof from Computational and Empirical Immunogenicity Characterization of an Enterotoxigenic Escherichia coli (ETEC) Adhesin MEFA
Vaccine development often encounters the challenge of virulence heterogeneity. Enterotoxigenic Escherichia coli (ETEC) bacteria producing immunologically heterogeneous virulence factors are a leading cause of children’s...
Development of an in vitro Biochemical Assay System for the Measurement of Residual Toxin Activities in Pertussis Toxin Containing Vaccines
Pertussis (whooping cough) vaccines play an essential role in immunisation programmes worldwide and the histamine sensitisation test (HIST) is currently the official batch-release test for acellular pertussis containing...
Lactococcosis in Reared Fish in Brazil and Control Strategies
Lactococcus garvieae is a Gram positive bacterium responsible for diseases in humans, domestic animals, and fish [1]. This bacterium is an emerging pathogen that could pose a worldwide problem for fish farming, particula...
Primary Immunization among Children in Malaysia: Reasons for Incomplete Vaccination
Objective: Incomplete primary immunization against vaccine preventable diseases is a significant public health problem. This study aimed to identify population at-risk for incomplete immunization and their associated fac...
Complete Child Immunisation: A Cluster Analysis of Positive Deviant Regions in Ghana
Background: The Global Vaccine Action Plan sets a target of 90% child immunisation coverage, a rare achievement in the Global South. Yet two of the poorest of Ghana’s 10 regions have accomplished this feat-what can polic...