TY - JOUR
T1 - Cost effectiveness of child pneumococcal conjugate vaccination in middle-income countries
AU - Nakamura, Mari M.
AU - Tasslimi, Azadeh
AU - Lieu, Tracy A.
AU - Levine, Orin
AU - Knoll, Maria Deloria
AU - Russell, Louise B.
AU - Sinha, Anushua
N1 - Funding Information:
This work was funded by the GAVI Alliance through collaborative arrangements among GAVI's PneumoADIP at Johns Hopkins Bloomberg School of Public Health (Baltimore, MD, USA), University of Medicine & Dentistry of New Jersey (UMDNJ)–New Jersey Medical School (Newark, NJ, USA), and Harvard Medical School (Boston, MA, USA). The study sponsors had no role in the study design; collection, analysis and interpretation of data; writing of the manuscript; and decision to submit the paper for publication.
PY - 2011/12
Y1 - 2011/12
N2 - Policy-makers require information on the potential benefits of and economic case for pneumococcal conjugate vaccination in middle-income countries. We built decision analysis models to evaluate a three-dose infant series of the 7-, 10- or 13-valent pneumococcal conjugate vaccines in 77 middle-income countries compared with no vaccination, accounting for direct protection of vaccinated children as well as herd protection and serotype replacement in unvaccinated children and adults. Over 10 years, pneumococcal vaccination would prevent at least 11.0 million cases and 314. 000 deaths in children under-5, one-third of the pneumonia and invasive disease cases and deaths that would occur in this age group without vaccination. Herd protection would prevent 3.1 million cases and 163. 000 deaths in older children and adults. A total of 11.1 million discounted disability-adjusted life-years (DALY) would be averted. At a dose cost of $10 for lower- middle-income and $20 for upper-middle-income countries, the net pooled (for all countries together) discounted vaccination cost would be $18.1 billion ($1600 per DALY averted). Vaccination would be cost effective for 72 countries with the 7-valent vaccine and for all countries with the 10- or 13-valent vaccines. The economic case for vaccination is compelling for middle-income countries.
AB - Policy-makers require information on the potential benefits of and economic case for pneumococcal conjugate vaccination in middle-income countries. We built decision analysis models to evaluate a three-dose infant series of the 7-, 10- or 13-valent pneumococcal conjugate vaccines in 77 middle-income countries compared with no vaccination, accounting for direct protection of vaccinated children as well as herd protection and serotype replacement in unvaccinated children and adults. Over 10 years, pneumococcal vaccination would prevent at least 11.0 million cases and 314. 000 deaths in children under-5, one-third of the pneumonia and invasive disease cases and deaths that would occur in this age group without vaccination. Herd protection would prevent 3.1 million cases and 163. 000 deaths in older children and adults. A total of 11.1 million discounted disability-adjusted life-years (DALY) would be averted. At a dose cost of $10 for lower- middle-income and $20 for upper-middle-income countries, the net pooled (for all countries together) discounted vaccination cost would be $18.1 billion ($1600 per DALY averted). Vaccination would be cost effective for 72 countries with the 7-valent vaccine and for all countries with the 10- or 13-valent vaccines. The economic case for vaccination is compelling for middle-income countries.
KW - Cost-effectiveness analysis
KW - Decision analysis
KW - Middle-income countries
KW - Seven-valent pneumococcal conjugate vaccine
KW - Ten-valent pneumococcal conjugate vaccine
KW - Thirteen-valent pneumococcal conjugate vaccine
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U2 - 10.1016/j.inhe.2011.08.004
DO - 10.1016/j.inhe.2011.08.004
M3 - Article
C2 - 24038500
AN - SCOPUS:84855981268
SN - 1876-3413
VL - 3
SP - 270
EP - 281
JO - International health
JF - International health
IS - 4
ER -