Pfizer Inc., Collegeville, PA 19426, USA.
J Infect. 2012 Jan;64(1):54-67. doi: 10.1016/j.jinf.2011.10.015. Epub 2011 Nov 4.
Seven-valent pneumococcal conjugate vaccine (PCV7) had profound public-health impacts and is considered cost-effective and potentially cost saving. Two new PCVs have been launched, a 10-valent vaccine (PCV10) and a 13-valent vaccine (PCV13). We examined public-health and economic impacts of PCV pediatric national immunization programs (NIPs) in Germany, Greece, and the Netherlands.
A decision-analytic model was developed to estimate the impact of PCV13, PCV7, and 10-valent pneumococcal conjugate vaccine (PCV10) on invasive pneumococcal disease (IPD), pneumonia (PNE), and acute otitis media (AOM). Using epidemiological data, we calculated the cases of IPD, PNE, and AOM, using country-specific incidence, serotype coverage, disease sequelae, mortality, vaccine effectiveness, indirect effects, costs, and utilities. Direct effects for PCV13- and PCV10-covered serotypes were assumed similar to PCV7. PCV13 was assumed to confer an indirect effect, while PCV10 was not. Assumptions were tested in sensitivity analyses.
In a NIP, PCV13 was estimated to eliminate 31.7%, 46.4%, and 33.8% of IPD in Germany, Greece, and the Netherlands, respectively. Compared with PCV7 and PCV10, PCV13 was found to be cost-effective or cost saving in all cases when PCV13 indirect effects were included.
Pediatric NIPs with PCV13 in Europe are expected to have dramatic public-health impacts and be cost-effective or cost saving.
七价肺炎球菌结合疫苗（PCV7）对公共卫生产生了深远影响，被认为具有成本效益，并且具有潜在的成本节约效果。两种新的 PCV 疫苗已推出，即 10 价疫苗（PCV10）和 13 价疫苗（PCV13）。我们研究了德国、希腊和荷兰开展儿童国家免疫规划（NIP）的肺炎球菌疫苗的公共卫生和经济效益。
我们开发了一个决策分析模型，以评估 13 价肺炎球菌结合疫苗（PCV13）、7 价肺炎球菌结合疫苗（PCV7）和 10 价肺炎球菌结合疫苗（PCV10）对侵袭性肺炎球菌病（IPD）、肺炎（PNE）和急性中耳炎（AOM）的影响。我们使用流行病学数据，根据国家特定的发病率、血清型覆盖率、疾病后遗症、死亡率、疫苗效力、间接效应、成本和效用，计算了 IPD、PNE 和 AOM 的病例数。我们假设 PCV13 和 PCV10 覆盖的血清型的直接效应与 PCV7 相似。假设 PCV13 具有间接效应，而 PCV10 没有。在敏感性分析中对假设进行了检验。
在 NIP 中，PCV13 估计分别在德国、希腊和荷兰消除了 31.7%、46.4%和 33.8%的 IPD。当包括 PCV13 间接效应时，与 PCV7 和 PCV10 相比，PCV13 在所有情况下都被认为具有成本效益或具有成本节约效果。
在欧洲开展儿童 NIP 并使用 PCV13 有望产生重大的公共卫生影响，并具有成本效益或成本节约效果。
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