Determining the cost-effectiveness of adult pneumococcal vaccination strategies. 2014

Kenneth J Smith
University of Pittsburgh, 200 Meyran Ave, Suite 200, Pittsburgh, PA 15213, USA.

The 23-valent pneumococcal polysaccharide vaccine is known to be economically reasonable in adults. With the 13-valent pneumococcal conjugate vaccine (PCV13) now available, the question is whether 23-valent pneumococcal polysaccharide vaccine offers sufficient protection in adults compared with PCV13. Our cost-effectiveness analyses favor adult PCV13 use, but results depend largely on assumptions regarding PCV13 effectiveness in preventing non-bacteremic pneumococcal pneumonia and on herd immunity effects from childhood PCV13 use, neither of which are well characterized at present. An ongoing randomized trial of adult PCV13 use and future surveillance data should clarify these issues for some population groups, but in others, such as the immunocompromised, modeling that rigorously accounts for uncertainty can and should be used to assist policymakers in their decisions.

UI MeSH Term Description Entries
D011018 Pneumonia, Pneumococcal A febrile disease caused by STREPTOCOCCUS PNEUMONIAE. Pneumococcal Pneumonia,Pneumococcal Pneumonias,Pneumonias, Pneumococcal
D003362 Cost-Benefit Analysis A method of comparing the cost of a program with its expected benefits in dollars (or other currency). The benefit-to-cost ratio is a measure of total return expected per unit of money spent. This analysis generally excludes consideration of factors that are not measured ultimately in economic terms. In contrast a cost effectiveness in general compares cost with qualitative outcomes. Cost and Benefit,Cost-Benefit Data,Benefits and Costs,Cost Benefit,Cost Benefit Analysis,Cost-Utility Analysis,Costs and Benefits,Economic Evaluation,Marginal Analysis,Analyses, Cost Benefit,Analysis, Cost Benefit,Analysis, Cost-Benefit,Analysis, Cost-Utility,Analysis, Marginal,Benefit and Cost,Cost Benefit Analyses,Cost Benefit Data,Cost Utility Analysis,Cost-Benefit Analyses,Cost-Utility Analyses,Data, Cost-Benefit,Economic Evaluations,Evaluation, Economic,Marginal Analyses
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000367 Age Factors Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time. Age Reporting,Age Factor,Factor, Age,Factors, Age
D014611 Vaccination Administration of vaccines to stimulate the host's immune response. This includes any preparation intended for active immunological prophylaxis. Immunization, Active,Active Immunization,Active Immunizations,Immunizations, Active,Vaccinations
D016867 Immunocompromised Host A human or animal whose immunologic mechanism is deficient because of an immunodeficiency disorder or other disease or as the result of the administration of immunosuppressive drugs or radiation. Immunosuppressed Host,Immunocompromised Patient,Host, Immunocompromised,Host, Immunosuppressed,Hosts, Immunocompromised,Hosts, Immunosuppressed,Immunocompromised Hosts,Immunocompromised Patients,Immunosuppressed Hosts,Patient, Immunocompromised,Patients, Immunocompromised
D022242 Pneumococcal Vaccines Vaccines or candidate vaccines used to prevent infections with STREPTOCOCCUS PNEUMONIAE. Pneumococcal Polysaccharide Vaccine,Pneumococcal Vaccine,Pneumovax,Pnu-Imune Vaccine,Pnu Imune Vaccine,PnuImune Vaccine,Polysaccharide Vaccine, Pneumococcal,Vaccine, Pneumococcal,Vaccine, Pneumococcal Polysaccharide,Vaccines, Pneumococcal
D032521 Immunity, Herd The state of a community in which a significant proportion of its population becomes immune to an infectious disease, and the risk of person-to-person transmission decreases. Individuals who are not immune and susceptible are indirectly protected because ongoing disease spread is very small. Community Immunity,Herd Immunity,Population Immunity,Community Immunities,Immunity, Community,Immunity, Population

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