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Cost-effectiveness of heptavalent conjugate pneumococcal vaccine (Prevenar) in Germany: considering a high-risk population and herd immunity effects

Cost-effectiveness of heptavalent conjugate pneumococcal vaccine (Prevenar) in Germany: considering a high-risk population and herd immunity effects
Cost-effectiveness of heptavalent conjugate pneumococcal vaccine (Prevenar) in Germany: considering a high-risk population and herd immunity effects

In Germany, the seven-valent conjugate vaccine Prevenar is recommended for use in children at high risk of pneumococcal disease. Recent data suggest that giving conjugate vaccine to all children may lead to a decline in pneumococcal disease in unvaccinated adults, a phenomenon known as herd immunity. This analysis evaluated the cost and economic consequences in Germany of vaccinating (1) children at high risk, (2) all children when considering only benefits for vaccinated individuals and (3) all children when also considering herd immunity benefits. Costs in the model included vaccination, management of meningitis, bacteraemia, pneumonia and acute otitis media, insurance payments to parents and the costs of care for long-term disabilities. The model estimated that the cost-effectiveness of vaccination would be 38,222 euros per life year gained in children at high risk and 100,636 euros per life year gained in all children when not considering herd immunity. When considering herd immunity effects, the model estimated that offering vaccination for all children would reduce adult deaths by 3,027 per year, and vaccination would be broadly cost neutral. The findings are sensitive to the effect of conjugate vaccine on the rates of pneumonia and invasive disease in the elderly. If the herd immunity effect of conjugate vaccination in Germany is similar to that observed elsewhere, offering vaccine to all children will be more attractive than the current policy of restricting vaccination to children at high risk of pneumococcal disease.

Adolescent, Adult, Aged, Child, Child, Preschool, Cohort Studies, Cost-Benefit Analysis, Germany/epidemiology, Heptavalent Pneumococcal Conjugate Vaccine, Humans, Immunity, Herd/immunology, Immunization Programs/economics, Infant, Meningococcal Vaccines/administration & dosage, Middle Aged, Models, Economic, Pneumococcal Infections/drug therapy, Pneumococcal Vaccines/administration & dosage, Risk Assessment
1618-7598
7-15
Lloyd, Adam
a7274aaf-5c15-4485-bb9a-52806c919647
Patel, Nishma
5189eb0a-75e7-49fa-ad1b-d610df75b67e
Scott, David A
19b5fd34-9974-4ae4-8be0-27a693639e20
Runge, Claus
baeab4ac-3332-4f61-b77d-ef660f43b776
Claes, Christa
2352a0db-35d9-4a6f-a1e4-e1f034f64043
Rose, Markus
ee565d36-e825-4582-99b8-92989d8b718b
Lloyd, Adam
a7274aaf-5c15-4485-bb9a-52806c919647
Patel, Nishma
5189eb0a-75e7-49fa-ad1b-d610df75b67e
Scott, David A
19b5fd34-9974-4ae4-8be0-27a693639e20
Runge, Claus
baeab4ac-3332-4f61-b77d-ef660f43b776
Claes, Christa
2352a0db-35d9-4a6f-a1e4-e1f034f64043
Rose, Markus
ee565d36-e825-4582-99b8-92989d8b718b

Lloyd, Adam, Patel, Nishma, Scott, David A, Runge, Claus, Claes, Christa and Rose, Markus (2007) Cost-effectiveness of heptavalent conjugate pneumococcal vaccine (Prevenar) in Germany: considering a high-risk population and herd immunity effects. The European Journal of Health Economics, 9 (1), 7-15. (doi:10.1007/s10198-006-0013-6).

Record type: Article

Abstract

In Germany, the seven-valent conjugate vaccine Prevenar is recommended for use in children at high risk of pneumococcal disease. Recent data suggest that giving conjugate vaccine to all children may lead to a decline in pneumococcal disease in unvaccinated adults, a phenomenon known as herd immunity. This analysis evaluated the cost and economic consequences in Germany of vaccinating (1) children at high risk, (2) all children when considering only benefits for vaccinated individuals and (3) all children when also considering herd immunity benefits. Costs in the model included vaccination, management of meningitis, bacteraemia, pneumonia and acute otitis media, insurance payments to parents and the costs of care for long-term disabilities. The model estimated that the cost-effectiveness of vaccination would be 38,222 euros per life year gained in children at high risk and 100,636 euros per life year gained in all children when not considering herd immunity. When considering herd immunity effects, the model estimated that offering vaccination for all children would reduce adult deaths by 3,027 per year, and vaccination would be broadly cost neutral. The findings are sensitive to the effect of conjugate vaccine on the rates of pneumonia and invasive disease in the elderly. If the herd immunity effect of conjugate vaccination in Germany is similar to that observed elsewhere, offering vaccine to all children will be more attractive than the current policy of restricting vaccination to children at high risk of pneumococcal disease.

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More information

Published date: 2 March 2007
Keywords: Adolescent, Adult, Aged, Child, Child, Preschool, Cohort Studies, Cost-Benefit Analysis, Germany/epidemiology, Heptavalent Pneumococcal Conjugate Vaccine, Humans, Immunity, Herd/immunology, Immunization Programs/economics, Infant, Meningococcal Vaccines/administration & dosage, Middle Aged, Models, Economic, Pneumococcal Infections/drug therapy, Pneumococcal Vaccines/administration & dosage, Risk Assessment

Identifiers

Local EPrints ID: 441391
URI: http://eprints.soton.ac.uk/id/eprint/441391
ISSN: 1618-7598
PURE UUID: 0b2907fa-f4b0-435b-ae19-e38f77e472f9
ORCID for David A Scott: ORCID iD orcid.org/0000-0001-6475-8046

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Date deposited: 11 Jun 2020 16:30
Last modified: 17 Mar 2024 04:02

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Contributors

Author: Adam Lloyd
Author: Nishma Patel
Author: David A Scott ORCID iD
Author: Claus Runge
Author: Christa Claes
Author: Markus Rose

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