Vaccine-preventable haemophilus influenza type B disease burden and cost-effectiveness of infant vaccination in Indonesia

Bradford D. Gessner, Endang R. Sedyaningsih, Ulla K. Griffiths, Agustinus Sutanto, Mary Linehan, Dave Mercer, Edward Kim Mulholland, Damian G. Walker, Mark Steinhoff, Mardiati Nadjib

Research output: Contribution to journalArticle

Abstract

Background: Most of Asia, including Indonesia, does not use Haemophilus influenzae type b (Hib) conjugate vaccines. We estimated total vaccine-preventable disease burden and the cost-effectiveness of Hib conjugate vaccine in Indonesia. Methods: Hib pneumonia and meningitis incidences for children with access to health care were derived from a randomized vaccine probe study on Lombok Island, Indonesia during 1998 "2002. Incidences were adjusted for limited access to care. Health system and patient out-of-pocket treatment cost data were collected concurrent with the probe study. For Hib vaccine in monovalent and combined (with DTP-HepB) presentations, we used 2007 UNICEF vaccine prices of US$3.30 and $3.75 per dose. Results: For the 2007 Indonesian birth cohort, Hib vaccine would prevent meningitis in 1 of every 179 children, pneumonia in 1 of every 18 children, and 4.9% of mortality among those younger than 5 years. The total incremental societal costs of introducing Hib vaccine in monovalent and pentavalent presentations were, respectively, US$11.74 and $8.93 per child vaccinated. Annual discounted treatment costs averted amounted to 20% of pentavalent vaccine costs. For the pentavalent vaccine, the incremental costs per discounted death and disability adjusted life-year averted amounted to US$3102 and $74, respectively, versus $4438 and $102 for monovalent vaccine. Conclusions: Routine infant Hib vaccination would prevent a large burden of pediatric illness and death in Indonesia. Even without external funding support, Hib vaccine will be a highly cost-effective intervention in either a monovalent or pentavalent presentation based on commonly used benchmarks.

Original languageEnglish (US)
Pages (from-to)438-443
Number of pages6
JournalPediatric Infectious Disease Journal
Volume27
Issue number5
DOIs
StatePublished - May 2008

Keywords

  • Haemophilus influenzae type b
  • Indonesia
  • cost effectiveness
  • vaccine
  • vaccine effectiveness

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)
  • Infectious Diseases

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    Gessner, B. D., Sedyaningsih, E. R., Griffiths, U. K., Sutanto, A., Linehan, M., Mercer, D., Mulholland, E. K., Walker, D. G., Steinhoff, M., & Nadjib, M. (2008). Vaccine-preventable haemophilus influenza type B disease burden and cost-effectiveness of infant vaccination in Indonesia. Pediatric Infectious Disease Journal, 27(5), 438-443. https://doi.org/10.1097/INF.0b013e318165f1ba