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Patikorn C, Kategeaw W, Perdrizet J, Li X, Chaiyakunapruk N. Implementation challenges and real-world impacts of switching pediatric vaccines: A global systematic literature review. Hum Vaccin Immunother 2023; 19:2177459. [PMID: 36880656 PMCID: PMC10026932 DOI: 10.1080/21645515.2023.2177459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
Switching a vaccine for another on a pediatric national immunization program is often done for the betterment of society. However, if poorly implemented, switching vaccines could result in suboptimal transitions with negative effects. A systematic review was conducted to evaluate the existing knowledge from identifiable documents on implementation challenges of pediatric vaccine switches and the real-world impact of those challenges. Thirty-three studies met the inclusion criteria. We synthesized three themes: vaccine availability, vaccination program deployment, and vaccine acceptability. Switching pediatric vaccines can pose unforeseen challenges to health-care systems worldwide and additional resources are often required to overcome those challenges. Yet, the magnitude of the impact, especially economic and societal, was frequently under-researched with variability in reporting. Therefore, an efficient vaccine switch requires a thorough consideration of the added benefits of replacing the existing vaccine, preparation, planning, additional resource allocation, implementation timing, public-private partnerships, outreach campaigns, and surveillance for program evaluation.
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Affiliation(s)
- Chanthawat Patikorn
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, USA
- Department of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Warittakorn Kategeaw
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, USA
| | - Johnna Perdrizet
- Global Health Economics and Outcomes Research, Pfizer Inc, New York, NY, USA
| | - Xiuyan Li
- Global Health Economics and Outcomes Research, Pfizer Inc, New York, NY, USA
| | - Nathorn Chaiyakunapruk
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, USA
- IDEAS Center, Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, UT, USA
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Lalwani SK, Ramanan PV, Sapru A, Sundaram B, Shah BH, Kaul D, Karthik Nagesh N, Kalina WV, Chand R, Ding M, Suroju S, Scott DA, Lockhart SP. Safety and immunogenicity of a multidose vial formulation of 13-valent pneumococcal conjugate vaccine administered with routine pediatric vaccines in healthy infants in India: A phase 4, randomized, open-label study. Vaccine 2021; 39:6787-6795. [PMID: 34656378 DOI: 10.1016/j.vaccine.2021.09.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 09/07/2021] [Accepted: 09/09/2021] [Indexed: 11/17/2022]
Abstract
PURPOSE This phase 4, randomized, open-label, multicenter study in healthy Indian infants and toddlers evaluated the safety, tolerability, and immunogenicity of the 13-valent pneumococcal conjugate vaccine (PCV13) formulated in a multidose vial (MDV) or single prefilled syringe (PFS). METHODS Healthy Indian infants (6 weeks of age) were randomized 1:1 to receive either PCV13-MDV or PCV13-PFS concomitant with routine pediatric vaccines. Subjects received a single dose of either PCV13-MDV or PCV13-PFS as a 4-dose schedule (infant series: 1 dose at 6, 10, and 14 weeks of age; toddler dose: 12 months of age). Safety was assessed, including local reactions, systemic events, and adverse events (AEs). Immunogenicity 1 month after both the infant series and toddler dose was measured by concentrations of serotype-specific immunoglobulin G (IgG) antibodies and opsonophagocytic activity titers. RESULTS Rates and severities of local reactions and systemic events up to 7 days after each dose of either PCV13-MDV or PCV13-PFS were generally similar, with the majority being of mild or moderate severity. PCV13-MDV had a safety profile comparable with PCV13-PFS; both groups experienced a similar frequency of AEs. PCV13-MDV elicited immune responses comparable with those induced by PCV13-PFS. Clear boosting of immune responses after the PCV13-MDV toddler dose was observed; ≥96% of subjects showed serotype-specific IgG concentrations at or above the defined thresholds 1 month after the PCV13-MDV toddler dose. CONCLUSIONS PCV13-MDV was safe, well tolerated, and immunogenic in healthy Indian infants and toddlers when coadministered with routine pediatric vaccinations. Safety and immunogenicity of PCV13-MDV was comparable with PCV13-PFS. CLINICAL TRIAL REGISTRATION Clinicaltrials.gov: NCT03548337.
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Affiliation(s)
| | | | - Amita Sapru
- Department of Pediatrics, KEM Hospital Research Centre, Pune, Maharashtra, India
| | | | - Bela Hasmukh Shah
- Department of Pediatrics, B.J. Medical College and Civil Hospital, Ahmedabad, Gujarat, India
| | - Dinesh Kaul
- Department of Pediatrics, Sir Ganga Ram Hospital, New Delhi, India
| | - N Karthik Nagesh
- Department of Pediatrics, Manipal Hospital, Bengaluru, Karnataka, India
| | - Warren V Kalina
- Vaccine Research and Development, Pfizer Inc, Pearl River, New York, USA
| | - Rohit Chand
- Global Site and Study Operations, Pfizer Ltd, Mumbai, India
| | - Meichun Ding
- Vaccine Research and Development, Pfizer Inc, Pearl River, New York, USA
| | - Suresh Suroju
- Vaccine Clinical Research and Development, Pfizer Ltd, Hurley, UK
| | - Daniel A Scott
- Vaccine Clinical Research and Development, Pfizer Inc, Collegeville, PA, USA
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Suwantika AA, Zakiyah N, Abdulah R, Sitohang V, Tandy G, Anartati A, Hidayatullah T, Herliana P, Hadinegoro SR. Cost-Effectiveness and Budget Impact Analyses of Pneumococcal Vaccination in Indonesia. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2021; 2021:7494965. [PMID: 33995536 PMCID: PMC8096558 DOI: 10.1155/2021/7494965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 04/09/2021] [Accepted: 04/17/2021] [Indexed: 11/18/2022]
Abstract
As a country with the high number of deaths due to pneumococcal disease, Indonesia has not yet included pneumococcal vaccination into the routine program. This study aimed to analyse the cost-effectiveness and the budget impact of pneumococcal vaccination in Indonesia by developing an age-structured cohort model. In a comparison with no vaccination, the use of two vaccines (PCV10 and PCV13) within two pricing scenarios (UNICEF and government contract price) was taken into account. To estimate the cost-effectiveness value, a 5-year time horizon was applied by extrapolating the outcome of the individual in the modelled cohort until 5 years of age with a 1-month analytical cycle. To estimate the affordability value, a 6-year period (2019-2024) was applied by considering the government's strategic plan on pneumococcal vaccination. In a comparison with no vaccination, the results showed that vaccination would reduce pneumococcal disease by 1,702,548 and 2,268,411 cases when using PCV10 and PCV13, respectively. Vaccination could potentially reduce the highest treatment cost from the payer perspective at $53.6 million and $71.4 million for PCV10 and PCV13, respectively. Applying the UNICEF price, the incremental cost-effectiveness ratio (ICER) from the healthcare perspective would be $218 and $162 per QALY-gained for PCV10 and PCV13, respectively. Applying the government contract price, the ICER would be $987 and $747 per QALY-gained for PCV10 and PCV13, respectively. The result confirmed that PCV13 was more cost-effective than PCV10 with both prices. In particular, introduction cost per child was estimated to be $0.91 and vaccination cost of PCV13 per child (3 doses) was estimated to be $16.61 and $59.54 with UNICEF and government contract prices, respectively. Implementation of nationwide vaccination would require approximately $73.3-$75.0 million (13-14% of routine immunization budget) and $257.4-$263.5 million (45-50% of routine immunization budget) with UNICEF and government contract prices, respectively. Sensitivity analysis showed that vaccine efficacy, mortality rate, and vaccine price were the most influential parameters affecting the ICER. In conclusion, pneumococcal vaccination would be a highly cost-effective intervention to be implemented in Indonesia. Yet, applying PCV13 with UNICEF price would give the best cost-effectiveness and affordability values on the routine immunization budget.
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Affiliation(s)
- Auliya A. Suwantika
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung 45363, Indonesia
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung 45363, Indonesia
| | - Neily Zakiyah
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung 45363, Indonesia
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung 45363, Indonesia
| | - Rizky Abdulah
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung 45363, Indonesia
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung 45363, Indonesia
| | - Vensya Sitohang
- Directorate of Health Surveillance and Quarantine, Directorate General of Disease Prevention and Control, Ministry of Health, Jakarta 12750, Indonesia
| | - Gertrudis Tandy
- Directorate of Health Surveillance and Quarantine, Directorate General of Disease Prevention and Control, Ministry of Health, Jakarta 12750, Indonesia
| | - Atiek Anartati
- Clinton Health Access Initiative, Jakarta 10450, Indonesia
| | | | - Putri Herliana
- Clinton Health Access Initiative, Jakarta 10450, Indonesia
| | - Sri R. Hadinegoro
- Department of Child Health, Faculty of Medicine, Universitas Indonesia, Jakarta 10440, Indonesia
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Ali M, Adlia A, Suwantika AA. The Effect of E-Learning on the Attitude Toward Dengue Prevention and the Acceptance of Dengue Vaccination. Patient Prefer Adherence 2021; 15:785-792. [PMID: 33883886 PMCID: PMC8055251 DOI: 10.2147/ppa.s296758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 03/19/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND A community's attitude toward dengue prevention and its acceptance of dengue vaccine and vaccination play an essential role in the success of the dengue infection prevention program. To develop their attitude and acceptance, the implementation of learning media is required. OBJECTIVE The objective of the study was to examine the effectiveness of e-learning for developing the community's attitude toward dengue prevention and its acceptance of dengue vaccine and vaccination. METHODS This study employed a quasi-experimental method with pre- and post-test design by involving 85 subjects that were purposively selected from the low-prevalence area of dengue infection in the City of Bandung, West Java Province, Indonesia. A valid and reliable questionnaire was delivered during pre- (day 1) and post-test (day 7). For the e-learning, it was given on day 1 after completing the pre-test. A descriptive statistical method was applied to describe the research variables, to analyze the correlation between the subjects' attitude and acceptance, and to examine the significant differences (pre- and post-test) between the subjects' attitude toward dengue prevention and their acceptance of dengue vaccine and vaccination. RESULTS Approximately 88.24% and 11.76% of subjects have good and fair knowledge about dengue disease, respectively. Concerning knowledge about dengue vaccine, 44.71% and 55.29% of them them have good and fair knowledge, respectively. In particular, there is an increase in their attitude toward dengue prevention (p-value <0.05), their acceptance of dengue vaccine (p-value <0.05) and their acceptance of dengue vaccination program (p-value <0.05) after they got information from e-learning. CONCLUSION E-learning could have significant effects to increase the community's attitude toward dengue prevention and their acceptance of dengue vaccine and vaccination.
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Affiliation(s)
- Mohammad Ali
- Department of Curriculum and Educational Technology, Faculty of Educational Sciences, Universitas Pendidikan Indonesia, Bandung, 40154, Indonesia
| | - Amirah Adlia
- Department of Pharmaceutics, School of Pharmacy, Bandung Institute of Technology, Bandung, 40132, Indonesia
| | - Auliya A Suwantika
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjajaran, Bandung, 40132, Indonesia
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, 40132, Indonesia
- Center for Health Technology Assessment, Universitas Padjadjaran, Bandung, 40132, Indonesia
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Zakiyah N, Insani WN, Suwantika AA, van der Schans J, Postma MJ. Pneumococcal Vaccination for Children in Asian Countries: A Systematic Review of Economic Evaluation Studies. Vaccines (Basel) 2020; 8:vaccines8030426. [PMID: 32751569 PMCID: PMC7564215 DOI: 10.3390/vaccines8030426] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 07/21/2020] [Accepted: 07/27/2020] [Indexed: 12/19/2022] Open
Abstract
Background: Evidence on costs and health benefits of pneumococcal conjugate vaccine (PCV) for children in Asian countries is limited but growing. As a region with a considerably high burden of pneumococcal disease, it is prominent to have a comprehensive overview on the cost-effectiveness of implementing and adopting a PCV vaccination program. Methods: We conducted a systematic review from Pubmed and Embase to identify economic evaluation studies of PCV for children in Asian countries up to May 2020. Data extraction included specific characteristics of the study, input parameters, cost elements, cost-effectiveness results, and key drivers of uncertainty. The Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) statement was followed for this systematic review. The reporting quality of the included studies was evaluated using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement. Results: After the screening process on both the title and abstract and full text of 518 records, a total of 25 studies fulfilled the inclusion criteria, and were included in the review. The majority of included studies demonstrates that PCV for children is cost-effective in most of the Asian region, and even cost-saving in some countries. Most of the included studies implemented cost utility analysis (CUA) using either quality-adjusted life years (QALYs) or disability-adjusted life years (DALYs). Overall, the main drivers affecting the cost effectiveness were vaccine price, burden regarding pneumonia-related parameters, and the inclusion of herd effects. Conclusion: The children pneumococcal vaccination program appears to be a cost-effective intervention in Asia, and even cost-saving in certain conditions. Vaccine price, pneumonia-related disease burden, and the inclusion of the herd effect are observed as important key drivers in estimating cost-effectiveness in this region. Incorporating PCV in vaccination programs in this region was found to be highly favorable.
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Affiliation(s)
- Neily Zakiyah
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Padjadjaran University, Bandung 40132, Indonesia; (W.N.I.); (A.A.S.)
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Padjadjaran University, Bandung 40132, Indonesia;
- Correspondence: ; Tel.: +62-22-7796200
| | - Widya N. Insani
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Padjadjaran University, Bandung 40132, Indonesia; (W.N.I.); (A.A.S.)
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Padjadjaran University, Bandung 40132, Indonesia;
- Research Department of Practice and Policy, School of Pharmacy, University College London, London WC1N 1AX, UK
| | - Auliya A. Suwantika
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Padjadjaran University, Bandung 40132, Indonesia; (W.N.I.); (A.A.S.)
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Padjadjaran University, Bandung 40132, Indonesia;
- Center for Health Technology Assessment, Universitas Padjadjaran, Bandung 40132, Indonesia
| | - Jurjen van der Schans
- Unit of Global Health, Department of Health Sciences, University Medical Center Groningen, University of Groningen, 9713 AV Groningen, The Netherlands;
- Unit of PharmacoTherapy, Epidemiology and Economics (PTE2), Department of Pharmacy, University of Groningen, 9713 AV Groningen, The Netherlands
- Department of Economics, Econometrics and Finance, Faculty of Economics and Business, University of Groningen, 9747 AE Groningen, The Netherlands
| | - Maarten J. Postma
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Padjadjaran University, Bandung 40132, Indonesia;
- Unit of Global Health, Department of Health Sciences, University Medical Center Groningen, University of Groningen, 9713 AV Groningen, The Netherlands;
- Unit of PharmacoTherapy, Epidemiology and Economics (PTE2), Department of Pharmacy, University of Groningen, 9713 AV Groningen, The Netherlands
- Department of Economics, Econometrics and Finance, Faculty of Economics and Business, University of Groningen, 9747 AE Groningen, The Netherlands
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