Several studies have shown a 13-50% reduction in the use of antibiotics by children who have received influenza vaccine compared with unvaccinated controls. This is due to a decline in febrile illnesses causes by influenza — for which antibiotics are often prescribed inappropriately — as well as a decline in secondary bacterial infections requiring antibiotic treatment, such as pneumonia and middle ear infections, that are triggered by influenza.
Pneumococcal disease/PCV/PPSV
Vaccination of infants against pneumonia greatly reduces hospitalizations, saving millions in healthcare costs
In a study using actual data on hospitalizations and costs before and after PCV-10 vaccine was introduced in Brazil, an estimated 463,000 hospitalizations from all causes of pneumonia were prevented in persons less than 65 years of age over 5 years following introduction of the vaccine — saving an estimated US$147 million in hospitalization costs. Half of the costs averted were due to fewer hospitalizations in children under five, who were targeted for the vaccine, while the remaining half were due to fewer hospitalizations in persons 5-49 years of age, as a result of herd protection.
Vaccinating infants with PCV also reduced disease and hospitalizations in older individuals
The cost-effectiveness of vaccinating infants with PCV-13 in China was estimated to be 21 times greater when the indirect effects of vaccination in reducing invasive pneumococcal disease and hospitalized cases of pneumonia in older (unvaccinated) individuals was taken into account — with costs per quality of life-year gained (QALY) of around US$564 (Y3,777) vs. $11,836 (Y79,204) when only the direct impact on vaccinated children is considered.
Vaccinating infants significantly reduces hospitalizations from pneumonia
According to a study using local epidemiological data in China, vaccinating infants with pneumococcal conjugate vaccine (PCV-13), using a 3+1 schedule, would prevent more than 10 times as many deaths from invasive pneumococcal disease and pneumonia in unvaccinated individuals (147,500 per year) than it would prevent directly in those vaccinated (12,800 per year). This would be due mainly to a reduction in hospitalizations for pneumonia.
Immunization with PCV reduced antibiotic prescriptions for children and slowed antibiotic resistance
In Iceland, a study of all children born over an 11-year period, before and after the introduction of pneumococcal conjugate vaccine (PCV) into the national immunization program, found a 6% decrease in all antibiotic prescriptions for children during their first four years of life and a 22% reduction in prescriptions for otitis media after the vaccine was introduced. Thus, in addition to reducing the burden of pneumococcal disease, PCV may also slow the spread of antibiotic resistance.
Catch-up vaccination can protect unvaccinated individuals, reducing disease burden across communities
A study in rural Kenya, over a 4-year period following the introduction of the 10-strain pneumococcal conjugate vaccine for infants, that included a catch-up vaccination campaign for children 12-59 months of age, suggests that the catch-up vaccination for older birth cohorts may have been a key factor in protecting unvaccinated individuals and speeding up the reduction of the disease in the community. In contrast, a study in The Gambia, where no catch-up campaign took place, found no herd effects during the first three years following the introduction of PCV-13 for infants.
The Gambia study publication referenced can be found at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4909992/
Immunizing children against pneumonia also provides protection for unvaccinated people through herd immunity
A study of the 10-strain pneumococcal conjugate vaccine in rural Kenya demonstrated herd protection. Over a 4-year period following the introduction of the vaccine for infants, coupled with a “catch-up” campaign for all children 12-59 months of age, the incidence of invasive pneumococcal disease (IPD) caused by the strains in the vaccine fell by 100% in infants less than two months of age who were too young to be vaccinated. In adults (≥ 15 years old) the incidence of IPD fell by 81% and in 5-14 year olds the incidence fell by nearly 75%. The chances of unvaccinated persons becoming ill with any strain of the disease also fell significantly – by 87% in infants under two months old, by nearly half (47%) in 5-14 year olds, and by more than one-third (37%) in adults.
Immunization can prevent costly hospitalizations for childhood pneumonia, saving money and improving health outcomes
In a global review of the costs of treating childhood pneumonia, the average costs of a hospitalized case of pneumonia in children under five years of age was US$243 in primary or secondary hospitals in low- and middle-income countries (ranging from US$40 – US$563) and US$559 in tertiary hospitals (ranging from US$20 – US$1,474). In high-income countries, the cost of hospitalized cases averaged US$2,800 in primary or secondary hospitals and more than US$7,000 in tertiary hospitals. Note that in most of these studies, only direct medical costs were included and thus total costs – including non-medical costs and lost wages – would be considerably higher.
Hospitalization for pneumonia in children causes financial burdens for families beyond medical treatment
Three studies in Bangladesh and India found that the direct medical costs for children hospitalized with pneumonia were 27% to 116% of the average monthly income of households. And, while these costs represent a major portion of a family’s monthly income, they don’t include non-medical costs, such as transport and food costs, nor the lost wages of family members who miss work to care for the child.
Vaccines reduce hospital admissions and free up more resources to treat and prevent other illnesses
One of the first studies of real-world use of pneumococcal conjugate vaccine (PCV) in Africa, found 48% fewer cases of pneumonia in children confirmed by x-ray after PCV introductoin. The results show the vaccine greatly reduced childhood pneumonia hospital admissions in Kenya: Hospital admissions for pneumonia went down 27%.The vaccine led to 329 fewer pneumonia cases per 100,000 kids each year.