VoICE Immunization Evidence: Cost effectiveness

Key Concept

Key Evidence: A multi-site study of cholera vaccination programs found that the vaccine was cost-effective in school- and community-based vaccination programs for children in India, Mozambique, and Indonesia.

Jeuland, M., Cook, J., Poulos, C., et al 2009. Cost-effectiveness of new-generation oral cholera vaccines: A multisite analysis. Value Health. 12:899–908.

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Key Evidence:A study assessing the cost-effectiveness of Pneumococcal Conjugate Vaccine (PCV) demonstrated that nealy 38,000 cases of invasive pneumococcal disease were averted in the first five years post introduction of PCV in the US. These results, based on active surveillance data also revealed that the costs averted translated to US $112,000 per life year saved.

Ray, G.T., Whitney, C., Fireman, B., et al 2006. Cost-effectiveness of pneumococcal conjugate vaccine: evidence from the first 5 years of use in the United States incorporating herd effects. Pediatric Infectious Disease Journal. 25:494-501.

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Key Evidence: PCV7 use in Argentina resulted in an estimated cost of US$5,599 per life year gained. The purchase of the 4 doses of vaccine for the entire cohort at a cost of US$26.5 per dose would required an investment of US$73,823,806.00. This investment would significantly reduce the number of deaths brought about by cases of meningitis, bacteremia, pneumonia, otitis media and meningitis sequelae. The resultant decrease in morbidity and mortality coupled with herd immunity offered by immunization would contribute substantially to national productivity making PCV immunization a highly cost effective strategy.

Giglio, N.D., Cane, A.D., Micone, P., et al 2010. Cost-effectiveness of the CRM-based 7-valent pneumococcal conjugated vaccine (PCV7) in Argentina. Vaccine. 28:2302–2310.

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Key Evidence: Assuming 90% coverage, a 9-valent PCV (PCV9) program in The Gambia would prevent approximately 630 hospitalizations, 40 deaths, and 1000 DALYs, for the birth cohort over the first 5 years of life. The estimated cost would be $670 per DALY averted in The Gambia.

Kim, S., Lee, G. and Goldie, S. 2010. Economic evaluation of pneumococcal conjugate vaccination in The Gambia. BMC Infectious Diseases. 10:260.

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Key Evidence: A study in Australia estimated that adding dTpa vaccination for pregnant women to the current pertussis immunization program for children would prevent an additional 8,800 symptomatic pertussis cases (mostly unreported) and 146 hospitalizations each year in all ages, including infants and their mothers, as well as one death every 22 months. The study found maternal pertussis vaccination to be cost-effective.

From the VoICE Editors: Note: The formulation used in this study is abbreviated dTpa.

Saul N, Wang, Bag S et al. 2018. Effectiveness of maternal pertussis vaccination in preventing infection and disease in infants: the NSW Public Health Network case-control study. Vaccine. 36(14).

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Key Evidence: An analysis in Kenya found that, although the government will need to more than double its current vaccine budget to continue using PCV after GAVI support ends, continuing the vaccination will prevent more than 101,000 cases of invasive pneumoccocal disease and pneumonia, more than 14,000 deaths over an 11-year period, and would be cost-effective (cost per DALY of $153 by 2032), even at the full GAVI price of US$3.05 per dose.

Ojal J, Griffiths U, Hammitt LI et al. 2019. Sustaining pneumococcal vaccination after transitioning from Gavi support: a modelling and cost-effectiveness study in Kenya. Lancet Global Health. 7(5).

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Key Evidence: In Argentina, universal vaccination for Hepatitis A in children, at 95% vaccine coverage, can prevent over 350,000 hepatitis A infections per year and 428 deaths. Benefits persist at coverage rates as low as 70% with over 290,000 prevented infections. At 95% coverage rates, this program would save almost $24,000 annually.

Lopez, E., Debbag, R., Coudeville, L., et al 2007. The cost-effectiveness of universal vaccination of children against hepatitis A in Argentina: results of a dynamic health-economic analysis. Journal of Gastroenterology. 42:152–160.

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