The health and economic impact of vaccination with 7-valent pneumococcal vaccine (PCV7) during an annual influenza epidemic and influenza pandemic in China

BMC Infectious Diseases

Research Article

Ronald Caldwell¹  Bruce Wang²  Craig S. Roberts³  Chieh-I Chen⁴  Zhijie An⁵ 

[1] Department of Economics, University of Michigan, 611 Tappan Street, 48109, Ann Arbor, MI, USA;Elysia Group, LLC, Xiamen Street, Alley 113, No. 17-1, Floor 2, Taipei, Taiwan;Health Economics and Outcomes Research, Pfizer Inc, 500 Arcola Road, 19426, Collegeville, PA, USA;Health Economics and Outcomes Research, Pfizer Investment Co. Ltd, 8/F, Citic Square, 1168 Nan Jing Road (W), 200041, Shanghai, P.R. China;National Immunization Programme, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, 100050, Beijing, P.R. China;

关键词: Pneumococcal disease;    Influenza;    PCV7;   

DOI  :  10.1186/s12879-015-1021-x

 received in 2014-12-18, accepted in 2015-07-13,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundChina has experienced several severe outbreaks of influenza over the past century: 1918, 1957, 1968, and 2009. Influenza itself can be deadly; however, the increase in mortality during an influenza outbreak is also attributable to secondary bacterial infections, specifically pneumococcal disease. Given the history of pandemic outbreaks and the associated morbidity and mortality, we investigated the cost-effectiveness of a PCV7 vaccination program in China from the context of typical and pandemic influenza seasons.MethodsA decision-analytic model was employed to evaluate the impact of a 7-valent pneumococcal vaccine (PCV7) infant vaccination program on the incidence, mortality, and cost associated with pneumococcal disease during a typical influenza season (15 % flu incidence) and influenza pandemic (30 % flu incidence) in China. The model incorporated Chinese data where available and included both direct and indirect (herd) effects on the unvaccinated population, assuming a point in time following the initial introduction of the vaccine where the impact of the indirect effects has reached a steady state, approximately seven years following the implementation of the vaccine program. Pneumococcal disease incidence, mortality, and costs were evaluated over a one year time horizon. Healthcare costs were calculated using a payer perspective and included vaccination program costs and direct medical expenditures from pneumococcal disease.ResultsThe model predicted that routine PCV7 vaccination of infants in China would prevent 5,053,453 cases of pneumococcal disease and 76,714 deaths in a single year during a normal influenza season.The estimated incremental-cost-effectiveness ratios were ¥12,281 (US$1,900) per life-year saved and ¥13,737 (US$2,125) per quality-adjusted-life-year gained. During an influenza pandemic, the model estimated that routine vaccination with PCV7 would prevent 8,469,506 cases of pneumococcal disease and 707,526 deaths, and would be cost-saving.ConclusionsRoutine vaccination with PCV7 in China would be a cost-effective strategy at limiting the negative impact of influenza during a typical influenza season. During an influenza pandemic, the benefit of PCV7 in preventing excess pneumococcal morbidity and mortality renders a PCV7 vaccination program cost-saving.

【 授权许可】

Unknown   
© Caldwell et al. 2015. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.