Public health and economic impact of vaccination with 7-valent pneumococcal vaccine (PCV7) in the context of the annual influenza epidemic and a severe influenza pandemic.

Abstract

BACKGROUND:

Influenza pandemic outbreaks occurred in the US in 1918, 1957, and 1968. Historical evidence suggests that the majority of influenza-related deaths during the 1918 US pandemic were attributable to bacterial pneumococcal infections. The 2009 novel influenza A (H1N1) outbreak highlights the importance of interventions that may mitigate the impact of a pandemic.

METHODS:

A decision-analytic model was constructed to evaluate the impact of 7-valent pneumococcal conjugate vaccine (PCV7) on pneumococcal disease incidence and mortality during a typical influenza season (13/100) and a severe influenza pandemic (30/100). Outcomes were compared for current PCV7 vaccination practices vs. no vaccination. The model was estimated using published sources and includes indirect (herd) protection of non-vaccinated persons.

RESULTS:

The model predicts that PCV7 vaccination in the US is cost saving for a normal influenza season, reducing pneumococcal-related costs by $1.6 billion. In a severe influenza pandemic, vaccination would save $7.3 billion in costs and prevent 512,000 cases of IPD, 719,000 cases of pneumonia, 62,000 IPD deaths, and 47,000 pneumonia deaths; 84% of deaths are prevented due to indirect (herd) protection in the unvaccinated.

CONCLUSIONS:

PCV7 vaccination is highly effective and cost saving in both normal and severe pandemic influenza seasons. Current infant vaccination practices may prevent >1 million pneumococcal-related deaths in a severe influenza pandemic, primarily due to herd protection.

• Authors: Jaime L Rubin, Lisa J McGarry, Keith P Klugman, David R Strutton, Kristen E Gilmore, Milton C Weinstein
• Journal: BMC infectious diseases (BMC Infect Dis) Vol. 10 Pg. 14 (Jan 21 2010) ISSN: 1471-2334 [Electronic] England
• PMID: 20092638 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Heptavalent Pneumococcal Conjugate Vaccine
• Pneumococcal Vaccines

Topics

• Adolescent
• Adult
• Aged
• Child
• Child, Preschool
• Costs and Cost Analysis
• Heptavalent Pneumococcal Conjugate Vaccine
• Humans
• Immunity, Herd
• Incidence
• Infant
• Influenza A Virus, H1N1 Subtype
• Influenza, Human (economics, epidemiology)
• Middle Aged
• Models, Economic
• Pneumococcal Infections (economics, epidemiology, prevention & control)
• Pneumococcal Vaccines (administration & dosage, economics)
• Public Health (economics)
• Young Adult