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Mihm S, Schelling J, Wölle R, Suck A, Häckl D, Weinke T, Böllinger T. [Pneumococcal Vaccination Coverage Rates (VCRs) Among Persons with Vaccine-Relevant Underlying Conditions and Persons Aged 60 Years and Older - An Analysis of Secondary Data from the Statutory Health Insurance (SHI) System]. Dtsch Med Wochenschr 2024; 149:e1-e10. [PMID: 37875123 PMCID: PMC10756767 DOI: 10.1055/a-2178-8306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023]
Abstract
BACKGROUND In addition to standard vaccination for patients aged 60 and older, the Standing Committee on Vaccination (STIKO) recommends immunization against pneumococci for anyone at increased risk, including patients with chronic vaccine-relevant underlying conditions. In Germany, the Robert Koch Institute (RKI) regularly publishes vaccination coverage rates (VCRs) for these patient groups, without stratifying by other parameters. This study examines VCRs of patients with underlying chronic diseases, stratified by disease groups and entities, the re-vaccination rate, and VCRs in patients aged 60 years and older. METHODS This descriptive retrospective cohort study is based on a sample of about 4 million SHI-insured patients aged 16 years and older for the years 2014 to 2019, from the Institute for Applied Health Research (InGef) database. The sample is representative of age and sex distribution in the German population. RESULTS Extrapolated to the total SHI-population, the overall pneumococcal VCR in patients aged 60 years and older was 45.9 % (of n= InGef standard vaccination cohort: 1 009 763). Among all at-risk patients aged 16 years and older with chronic underlying diseases, only 17.1 % had received an indicated vaccination (InGef indicated vaccination cohort: 1 379 680). Stratified by disease entity, those with underlying pulmonary emphysema had the highest VCR, at 39.0 % (of n= 28 121). Of those who received a vaccination due to an underlying chronic disease, only 23.9 % were re-vaccinated after 6 years (InGef re-vaccination cohort: 12 328). Across all vaccination cohorts, VCRs increased with age. DISCUSSION The recommendations made by STIKO for pneumococcal vaccination based on age or an underlying chronic condition are not being implemented adequately in Germany. Although STIKO explicitly recommends vaccination from 60 years of age, the 60 to 64-year-old age group had a strikingly low VCR (13.0 % of n=268 862). Fewer than one in five patients aged 16 years and older with an underlying chronic condition had received the recommended indicated vaccination. To adequately prevent potential disease, higher vaccination rates should be targeted. This could probably be achieved through more stringent vaccination management, appropriate software solutions with vaccination reminders, monetary incentives for achieving higher vaccination rates and documentation of vaccination status in disease management programs.
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Affiliation(s)
- Sarah Mihm
- MSD SHARP & DOHME GmbH, München, Deutschland,
| | | | | | | | - Dennis Häckl
- WIG2 GmbH, Leipzig, Deutschland,
- Universität Leipzig, Institut für öffentliche Finanzen und Public Management, Leipzig, Deutschland,
| | - Thomas Weinke
- Klinikum Ernst von Bergmann, Klinik für Gastroenterologie und Infektiologie, Potsdam, Deutschland,
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Huang M, Hu T, Weaver J, Owusu-Edusei K, Elbasha E. Cost-Effectiveness Analysis of Routine Use of 15-Valent Pneumococcal Conjugate Vaccine in the US Pediatric Population. Vaccines (Basel) 2023; 11:vaccines11010135. [PMID: 36679980 PMCID: PMC9861214 DOI: 10.3390/vaccines11010135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/15/2022] [Accepted: 12/22/2022] [Indexed: 01/11/2023] Open
Abstract
This study evaluated the clinical and economic impact of routine pediatric vaccination with the 15-valent pneumococcal conjugate vaccine (PCV15, V114) compared with the 13-valent PCV (PCV13) from a societal perspective in the United States (US). A Markov decision-analytic model was constructed to estimate the outcomes for the entire US population over a 100-year time horizon. The model estimated the impact of V114 versus PCV13 on pneumococcal disease (PD) incidence, post meningitis sequalae, and deaths, taking herd immunity effects into account. V114 effectiveness was extrapolated from the observed PCV13 data and PCV7 clinical trials. Costs (2021$) included vaccine acquisition and administration costs, direct medical costs for PD treatment, direct non-medical costs, and indirect costs, and were discounted at 3% per year. In the base case, V114 prevented 185,711 additional invasive pneumococcal disease, 987,727 all-cause pneumonia, and 11.2 million pneumococcal acute otitis media cases, compared with PCV13. This led to expected gains of 90,026 life years and 96,056 quality-adjusted life years with a total saving of $10.8 billion. Sensitivity analysis showed consistent results over plausible values of key model inputs and assumptions. The findings suggest that V114 is a cost-saving option compared to PCV13 in the routine pediatric vaccination program.
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Affiliation(s)
- Min Huang
- Correspondence: ; Tel.: +1 215-652-5974
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Tajima A, Abe M, Weaver J, Huang M. Cost-effectiveness analysis of pediatric immunization program with 15-valent pneumococcal conjugate vaccine in Japan. J Med Econ 2023; 26:1034-1046. [PMID: 37555281 DOI: 10.1080/13696998.2023.2245291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/18/2023] [Accepted: 07/20/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND The 15-valent pneumococcal conjugate vaccine (PCV15 or V114) has recently been approved for pediatric vaccination against pneumococcal diseases (PDs) in Japan. The study aims to evaluate the cost-effectiveness of pediatric vaccination with V114 versus 13-valent PCV (PCV13) in Japan. METHODS The study used a decision analytical Markov model to estimate the cost and effectiveness outcomes for a birth cohort in Japan over a 10-year time horizon. The model tracked the occurrences of acute PD events, including invasive PD (IPD), non-bacteremic pneumococcal pneumonia (NBPP) and pneumococcal acute otitis media (AOM) and the long-term impact of post-meningitis sequalae. Vaccine effectiveness was estimated based on literature and assumptions, and accounted for indirect effects and vaccine waning. The base case took the societal perspective, including both direct and indirect costs, while a healthcare payer perspective was modeled in a scenario analysis. Additional scenario analyses and sensitivity analyses were conducted. RESULTS In the base case, V114 was associated with an incremental gain of 24 quality-adjusted life years and a reduction of ¥365,610,955 in total costs compared to PCV13. It was expected to reduce the number of pneumococcal AOM, NBPP, and IPD cases by 1,832, 1,333 and 25, respectively. All scenario analyses and most sensitivity analyses showed that V114 was a dominant strategy compared to PCV13. CONCLUSIONS Pediatric vaccination with V114 is expected to lead to cost savings and more health benefits compared to PCV13 in Japan from both societal and healthcare payer perspectives. The findings are robust under plausible assumptions and inputs.
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Affiliation(s)
- Atsushi Tajima
- MSD K.K., Outcomes Research, Market Access, Tokyo, Japan
| | - Machiko Abe
- MSD K.K., Outcomes Research, Market Access, Tokyo, Japan
| | - Jessica Weaver
- Center for Observational and Real-World Evidence (CORE), Merck & Co., Inc., Rahway, NJ, USA
| | - Min Huang
- Center for Observational and Real-World Evidence (CORE), Merck & Co., Inc., Rahway, NJ, USA
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Bertran M, Amin-Chowdhury Z, Sheppard CL, Eletu S, Zamarreño DV, Ramsay ME, Litt D, Fry NK, Ladhani SN. Increased Incidence of Invasive Pneumococcal Disease among Children after COVID-19 Pandemic, England. Emerg Infect Dis 2022; 28:1669-1672. [PMID: 35876698 PMCID: PMC9328924 DOI: 10.3201/eid2808.220304] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
During July–December 2021, after COVID-19 restrictions were removed in England, invasive pneumococcal disease incidence in children <15 years of age was higher (1.96/100,000 children) than during the same period in 2020 (0.7/100,000 children) and in prepandemic years 2017–2019 (1.43/100,000 children). Childhood vaccine coverage should be maintained to protect the population.
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Jimbo-Sotomayor R, Watts E, Armijos L, Sriudomporn S, Sánchez X, Echeverria A, Whittembury A, Patenaude B. Return on Investment of 10-Valent Pneumococcal Conjugate Vaccine in Ecuador From 2010 to 2030. Value Health Reg Issues 2022; 31:148-54. [PMID: 35753214 DOI: 10.1016/j.vhri.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 04/08/2022] [Accepted: 05/09/2022] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Ecuador introduced the pneumococcal conjugate vaccine in 2010. A recent time series analysis has demonstrated the impact of 10-valent pneumococcal conjugate vaccine (PCV10) on hospitalized pneumococcal disease in children. We leveraged these estimates to calculate the return on investment (ROI) of PCV10 in Ecuador from 2010 to 2030 at the national and regional levels. METHODS We used 2 approaches to estimate the economic benefits: (1) cost of illness, which includes treatment, transportation, and productivity loss averted, (2) and the value of statistical life, which reflects society's average willingness to pay to save one life. Costs of the immunization program include vaccine costs (doses, syringes, injection supplies) and immunization delivery costs (personnel, cold chain equipment and maintenance, transportation, distribution services, and other recurrent costs). We estimated the ROI by dividing the net benefits by costs. RESULTS The ROI using the cost-of-illness approach was slightly negative in the introduction year. From 2011 to 2020, we estimated the ROI to be 0.45 (0.15-0.73). For the future decade, the ROI is estimated at 0.37 (-0.03 to 1.03). Using the value-of-statistical-life approach, the ROI was 1.46 (0.82-2.17) in the introduction year. In the first decade, the ROI was 1.01 (0.49-1.60); in the second decade, the ROI fell to 0.83 (0.23-1.78). CONCLUSIONS The results of this study demonstrate the total economic benefits of PCV10 in Ecuador exceed immunization program costs after the introduction year. Estimates from this study will inform country policy makers and will contribute to efforts to mobilize resources for immunization.
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Sun X, Guo X, Qiu J, Zhao G, Xu X, Wagner AL, Jiang H, Huang Z, Ren J, Ma X, Liang X, Yao Y, Wu J, Lu Y. Effectiveness of 23-Valent Pneumococcal Polysaccharide Vaccine Against Pneumococcal Diseases Among the Elderly Aged 60 Years or Older: A Matched Test Negative Case-Control Study in Shanghai, China. Front Public Health 2021; 9:620531. [PMID: 34616702 PMCID: PMC8488431 DOI: 10.3389/fpubh.2021.620531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 08/23/2021] [Indexed: 11/23/2022] Open
Abstract
Background:Streptococcus pneumoniae infection among adults, especially in adults over 60 years old in China results in a large number of hospitalizations and a substantial financial burden. This study assessed the vaccine effectiveness (VE) of 23-valent pneumococcal polysaccharide vaccine (PPV23) against pneumococcal diseases among the elderly aged 60 years or older in Shanghai, China. Methods: We conducted a test-negative case–control study among the elderly aged 60 years or older who sought care at hospitals in 13 districts of Shanghai from September 14, 2013 to August 31, 2019. A case was defined as pneumococcal disease and testing positive for Streptococcus pneumoniae. Controls had symptoms congruent with pneumococcal disease but were negative for Streptococcus pneumoniae. We conducted 1:2 matching by gender, age, hospital and admission date. Vaccination status was verified from the immunization system database. VE was calculated with conditional logistic regression according to the formula (1–OR) ×100%. Results: Overall, 603 adults aged 60 years or older with pneumococcal disease and positive for Streptococcus pneumoniae were included as cases, and 19.6% (118 persons) had a recorded PPV23 vaccination. The controls included 1,206 adults, whose vaccination rate was 23.8% (287 persons). The VE against pneumococcal diseases among the whole population was 24% (95% CI: 2%, 40%) and among women 44% (95% CI: 6%, 67%). After adjusting for multiple variables, the effectiveness of PPV23 against pneumococcal diseases was still statistically significant with VE for all of 25% (95% CI: 3%, 42%) and VE for women of 49% (95% CI: 11%, 71%). Conclusion: PPV23 was effective against pneumococcal diseases in adults aged 60 years or older in Shanghai, China. Its relatively high effectiveness among women warrants this group to be particularly targeted for vaccination, with further research on why vaccination effectiveness is less among men.
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Affiliation(s)
- Xiaodong Sun
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Xiang Guo
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Jing Qiu
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Genming Zhao
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Xinxin Xu
- Shanghai Municipal Center for Health Promotion, Shanghai, China
| | - Abram L Wagner
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Hongli Jiang
- Department of Health Economics, School of Public Health, Fudan University, Shanghai, China
| | - Zhuoying Huang
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Jia Ren
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Xiaoying Ma
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Xiufang Liang
- Yangpu District Center for Disease Control and Prevention, Shanghai, China
| | - Yao Yao
- Chongming District Center for Disease Control and Prevention, Shanghai, China
| | - Jialing Wu
- Songjiang District Center for Disease Control and Prevention, Shanghai, China
| | - Yihan Lu
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
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Riccò M, Vezzosi L, Gualerzi G, Odone A, Signorelli C. Knowledge, attitudes, and practices of influenza and pneumococcal vaccines among agricultural workers: results of an Italian a cross-sectional study. Acta Biomed 2019; 90:439-450. [PMID: 31910168 PMCID: PMC7233756 DOI: 10.23750/abm.v90i4.7631] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 09/27/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Working age is increasing across Europe. Seasonal influenza (SID) and pneumococcal disease (PND) immunization programmes might be successfully implemented at the workplace. We conducted a cross-sectional survey among to assess SID and PND vaccine status, as well as knowledge, attitudes and practices (KAP) in a representative sample of agricultural workers (AWs) aged ≥55 years in North-Eastern Italy. METHODS A structured questionnaire was administered in person by trained personnel. Bivariate and multivariate logistic regression analyses were carried out to identify behavioral and work-related factors associated with SID and PND vaccine uptake. RESULTS Among 707 participants, 238 were aged 55 years or more (33.7% of total). Of them, 39.1% had an up-to-date immunization status towards influenza, and 17.6% towards pneumococcus. Factors associated with inadequate immunization were doubts about influenza vaccine safety (40.0%) and the confidence in natural immunity towards pneumococcus (30.8%). Attitude towards vaccinations was somehow favorable in 44.5% of participants for SID, and 37.8% for PND. Overall, 37.4% and 21.8% workers were aware of national recommendations on SID and PND immunization, respectively. This factor was characterized as a significant predictor for SID vaccination (multivariated Odds Ratio, OR 32.688 95%CI 12.015-88.930), as well as the perception of SID as a severe disease (OR 7.539 95%CI 3.312-17.164), and the perceived value of preventing new infections (OR 3.215 95%CI 1.205-8.578). A somehow favorable attitude towards vaccinations was the main predictor (OR 39.214 95%CI 10.179-151.1) for PND vaccination. CONCLUSIONS Our study indicates that older workers lack appropriate knowledge of national recommendations and correct risk perception of SID and PND infections, but also vaccines' side effects. As the latter has been recognized as predictive factor for SID vaccination, our results stress the importance for tailored informative interventions in the workplaces aimed to increase risk perception and vaccine acceptance. (www.actabiomedica.it).
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Affiliation(s)
- Matteo Riccò
- Azienda USL di Reggio EmiliaV.le Amendola n.2 - 42122 REServizio di Prevenzione e Sicurezza negli Ambienti di Lavoro (SPSAL)Dip. di Prevenzione.
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Namkoong H, Ishii M, Funatsu Y, Kimizuka Y, Yagi K, Asami T, Asakura T, Suzuki S, Kamo T, Fujiwara H, Tasaka S, Betsuyaku T, Hasegawa N. Theory and strategy for Pneumococcal vaccines in the elderly. Hum Vaccin Immunother 2016; 12:336-43. [PMID: 26406267 PMCID: PMC5049722 DOI: 10.1080/21645515.2015.1075678] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Pneumonia is the fourth-leading cause of death globally, and Streptococcus pneumoniae is the most important causative pathogen. Because the incidence of pneumococcal diseases is likely to increase with the aging society, we should determine an optimal strategy for pneumococcal vaccination. While consensus indicates that 23-valent pneumococcal polysaccharide vaccine prevents invasive pneumococcal diseases (IPD), its effects on community-acquired pneumonia (CAP) remain controversial. Recently, a 13-valent pneumococcal conjugate vaccine (PCV13) was released. The latest clinical study (CAPiTA study) showed that PCV13 reduced vaccine-type CAP and IPD. Based on these results, the Advisory Committee on Immunization Practices recommended initial vaccination with PCV13 for the elderly. Scientific evidence regarding immunosenescence is needed to determine a more ideal vaccination strategy for the elderly with impaired innate and adaptive immunity. Continuing research on the cost effectiveness of new vaccine strategies considering constantly changing epidemiology is also warranted.
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Affiliation(s)
- Ho Namkoong
- a Division of Pulmonary Medicine Department of Medicine ; Keio University School of Medicine ; Tokyo , Japan
| | - Makoto Ishii
- a Division of Pulmonary Medicine Department of Medicine ; Keio University School of Medicine ; Tokyo , Japan
| | - Yohei Funatsu
- a Division of Pulmonary Medicine Department of Medicine ; Keio University School of Medicine ; Tokyo , Japan
| | - Yoshifumi Kimizuka
- a Division of Pulmonary Medicine Department of Medicine ; Keio University School of Medicine ; Tokyo , Japan
| | - Kazuma Yagi
- a Division of Pulmonary Medicine Department of Medicine ; Keio University School of Medicine ; Tokyo , Japan
| | - Takahiro Asami
- a Division of Pulmonary Medicine Department of Medicine ; Keio University School of Medicine ; Tokyo , Japan
| | - Takanori Asakura
- a Division of Pulmonary Medicine Department of Medicine ; Keio University School of Medicine ; Tokyo , Japan
| | - Shoji Suzuki
- a Division of Pulmonary Medicine Department of Medicine ; Keio University School of Medicine ; Tokyo , Japan
| | - Testuro Kamo
- a Division of Pulmonary Medicine Department of Medicine ; Keio University School of Medicine ; Tokyo , Japan
| | - Hiroshi Fujiwara
- b Center for Infectious Diseases and Infection Control; Keio University School of Medicine ; Tokyo , Japan
| | - Sadatomo Tasaka
- a Division of Pulmonary Medicine Department of Medicine ; Keio University School of Medicine ; Tokyo , Japan
| | - Tomoko Betsuyaku
- a Division of Pulmonary Medicine Department of Medicine ; Keio University School of Medicine ; Tokyo , Japan
| | - Naoki Hasegawa
- b Center for Infectious Diseases and Infection Control; Keio University School of Medicine ; Tokyo , Japan
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Boccalini S, Varone O, Chellini M, Pieri L, Sala A, Berardi C, Bonanni P, Bechini A. Hospitalizations for pneumonia, invasive diseases and otitis in Tuscany (Italy), 2002-2014: Which was the impact of universal pneumococcal pediatric vaccination? Hum Vaccin Immunother 2016; 13:428-434. [PMID: 27925848 PMCID: PMC5328206 DOI: 10.1080/21645515.2017.1264796] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Streptococcus pneumoniae is the main causative organism of acute media otitis in children and meningitis and bacterial pneumonia in the community. Since 2008 in Tuscany, central Italy, the pneumococcal conjugate vaccine (7-valent vaccine, switched to 13-valent vaccine in 2010) was actively offered free of charge to all newborns. Aim of the study is to evaluate the impact of pneumococcal pediatric vaccination in the Tuscan population on hospitalizations potentially caused by S. pneumoniae, during pre-vaccination (PVP, 2002–2007) and vaccination period (VP, 2009–2014). We analyzed hospital discharge records (HDRs) of all hospitals in Tuscany from 2002 to 2014. Hospitalizations potentially due to pneumococcal diseases were 347, 221. The general hospitalization rate was 716/100,000 inhabitants during PVP and 753/100,000 in VP, with a decrease of 29.1% in the age-group 0–9 y (“target” of the vaccination program) and an increase of 75.7% in subjects >64 y of age. During VP, admission days and hospitalization costs increased (6.2% and 24.2%, respectively), especially in patients >64 y (12.9% and 33.8%, respectively); in children <10 y decreased by 21.2% and 12.8%, respectively. The pneumococcal pediatric vaccination resulted in the decrease of hospitalizations in younger but the expected indirect effect in the elderly was not reported, justifying the Tuscan recommendation to extend the vaccination to subjects > 64 y.
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Affiliation(s)
- Sara Boccalini
- a Department of Health Sciences , University of Florence , Florence , Italy
| | - Ornella Varone
- b Specialization Medical School of Hygiene and Preventive Medicine, University of Florence , Florence , Italy
| | - Martina Chellini
- b Specialization Medical School of Hygiene and Preventive Medicine, University of Florence , Florence , Italy
| | - Luca Pieri
- b Specialization Medical School of Hygiene and Preventive Medicine, University of Florence , Florence , Italy
| | - Antonino Sala
- b Specialization Medical School of Hygiene and Preventive Medicine, University of Florence , Florence , Italy
| | - Cesare Berardi
- a Department of Health Sciences , University of Florence , Florence , Italy
| | - Paolo Bonanni
- a Department of Health Sciences , University of Florence , Florence , Italy
| | - Angela Bechini
- a Department of Health Sciences , University of Florence , Florence , Italy
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Ceyhan M, Dagan R, Sayiner A, Chernyshova L, Dinleyici EÇ, Hryniewicz W, Kulcsár A, Mad'arová L, Pazdiora P, Sidorenko S, Streinu-Cercel A, Tambić-Andrašević A, Yeraliyeva L. Surveillance of pneumococcal diseases in Central and Eastern Europe. Hum Vaccin Immunother 2016; 12:2124-2134. [PMID: 27096714 PMCID: PMC4994721 DOI: 10.1080/21645515.2016.1159363] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Pneumococcal infection is a major cause of morbidity and mortality worldwide. The burden of disease associated with S. pneumoniae is largely preventable through routine vaccination. Pneumococcal conjugate vaccines (e.g. PCV7, PCV13) provide protection from invasive pneumococcal disease as well as non-invasive infection (pneumonia, acute otitis media), and decrease vaccine-type nasopharyngeal colonisation, thus reducing transmission to unvaccinated individuals. PCVs have also been shown to reduce the incidence of antibiotic-resistant pneumococcal disease. Surveillance for pneumococcal disease is important to understand local epidemiology, serotype distribution and antibiotic resistance rates. Surveillance systems also help to inform policy development, including vaccine recommendations, and monitor the impact of pneumococcal vaccination. National pneumococcal surveillance systems exist in a number of countries in Central and Eastern Europe (such as Croatia, Czech Republic, Hungary, Poland, Romania and Slovakia), and some have introduced PCVs (Czech Republic, Hungary, Kazakhstan, Russia, Slovakia and Turkey). Those countries without established programs (such as Kazakhstan, Russia and Ukraine) may be able to learn from the experiences of those with national surveillance systems. The serotype distributions and impact of PCV13 on pediatric pneumococcal diseases are relatively similar in different parts of the world, suggesting that approaches to vaccination used elsewhere are also likely to be effective in Central and Eastern Europe. This article briefly reviews the epidemiology of pneumococcal disease, presents the latest surveillance data from Central and Eastern Europe, and discusses any similarities and differences in these data as well the potential implications for vaccination policies in the region.
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Affiliation(s)
- Mehmet Ceyhan
- a Department of Pediatric Infectious Diseases , School of Medicine, Hacettepe University , Ankara , Turkey
| | - Ron Dagan
- b Pediatric Infectious Disease Unit, Ben-Gurion University of the Negev , Beer-Sheva , Israel
| | - Abdullah Sayiner
- c Department of Chest Diseases , Ege University Faculty of Medicine , Izmir , Turkey
| | - Liudmyla Chernyshova
- d Department of Pediatric Infectious Diseases and Immunology , National Medical Academy for Postgraduate Education , Kiev , Ukraine
| | | | - Waleria Hryniewicz
- f National Medicines Institute, Division of Clinical Microbiology and Infection Prevention , Warsaw , Poland
| | - Andrea Kulcsár
- g Department of Infectology , Joint Hospital Saint László and Saint István , Budapest , Hungary
| | - Lucia Mad'arová
- h National Reference Centre for Pneumococcal and Haemophilus Diseases, Regional Authority of Public Health , Banská Bystrica , Slovak Republic
| | - Petr Pazdiora
- i Department of Epidemiology , Charles University Faculty Hospital , Pilsen , Czech Republic
| | - Sergey Sidorenko
- j Research Institute of Children's Infection , St. Petersburg , Russia
| | | | - Arjana Tambić-Andrašević
- l Department of Clinical Microbiology , University Hospital for Infectious Diseases , Zagreb , Croatia
| | - Lyazzat Yeraliyeva
- m Research Institute of Fundamental and Applied Medicine, Asfendiyarov Kazakh National Medical University , Almaty , Kazakhstan
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Kawaguchiya M, Urushibara N, Aung MS, Morimoto S, Ito M, Kudo K, Sumi A, Kobayashi N. Emerging non-PCV13 serotypes of noninvasive Streptococcus pneumoniae with macrolide resistance genes in northern Japan. New Microbes New Infect 2015; 9:66-72. [PMID: 26909157 PMCID: PMC4735479 DOI: 10.1016/j.nmni.2015.11.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 11/02/2015] [Accepted: 11/02/2015] [Indexed: 01/20/2023] Open
Abstract
In Japan, the 7-valent pneumococcal conjugate vaccine (PCV7) was introduced to the nation's routine immunization program in April 2013 and was replaced by the 13-valent pneumococcal conjugate vaccine (PCV13) in November 2013. Distribution of serotypes and macrolide resistance genotypes was investigated for a total of 1097 (975 children, 122 adults) and 960 (873 children, 87 adults) clinical isolates of Streptococcus pneumoniae from noninvasive infections in Hokkaido (northern main island of Japan) in the routine immunization periods for PCV7 and PCV13 (April–October 2013 and November 2013–November 2014, respectively). Serotype was determined by sequential multiplex PCR and additional genetic analyses. Macrolide resistance genes erm(B) and mef(A/E) were detected by multiplex PCR. Although the most prevalent serotypes in children were 23A and 6C in the PCV7 period, after replacement with PCV13, 19A became the most common, followed by 6C, 15A and 23A. Among adults, serotype 3 was consistently the most frequent throughout the study periods. Compared with values from the pre-PCV7 routine immunization period, PCV7 serotypes decreased from 48.3 to 3.3% in the PCV13 period among children, while the rates of non-PCV13 serotypes (particularly 15A, 23A, 11A, 10A and 35B) increased from 39.7 to 75.1% (p < 0.001). In the PCV13 period, erm(B), mef(A/E) and both of these genes were detected in 75.8, 31.6 and 11.3% of all isolates, respectively. Serotype 19A accounted for 76.9% of the isolates with both the macrolide resistance genes, and emerging non-PCV13 serotypes 15A, 15C and 23A mostly harboured erm(B).
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Affiliation(s)
- M Kawaguchiya
- Department of Hygiene, Sapporo Medical University School of Medicine, Japan
| | - N Urushibara
- Department of Hygiene, Sapporo Medical University School of Medicine, Japan
| | - M S Aung
- Department of Hygiene, Sapporo Medical University School of Medicine, Japan
| | - S Morimoto
- Sapporo Clinical Laboratory Inc., Sapporo, Hokkaido, Japan
| | - M Ito
- Sapporo Clinical Laboratory Inc., Sapporo, Hokkaido, Japan
| | - K Kudo
- Sapporo Clinical Laboratory Inc., Sapporo, Hokkaido, Japan
| | - A Sumi
- Department of Hygiene, Sapporo Medical University School of Medicine, Japan
| | - N Kobayashi
- Department of Hygiene, Sapporo Medical University School of Medicine, Japan
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12
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Ramdani-Bouguessa N, Ziane H, Bekhoucha S, Guechi Z, Azzam A, Touati D, Naim M, Azrou S, Hamidi M, Mertani A, Laraba A, Annane T, Kermani S, Tazir M. Evolution of antimicrobial resistance and serotype distribution of Streptococcus pneumoniae isolated from children with invasive and noninvasive pneumococcal diseases in Algeria from 2005 to 2012. New Microbes New Infect 2015; 6:42-8. [PMID: 26106481 PMCID: PMC4475694 DOI: 10.1016/j.nmni.2015.02.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 12/19/2014] [Accepted: 02/24/2015] [Indexed: 11/26/2022] Open
Abstract
Pneumococcal infections are a major cause of morbidity and mortality in developing countries. The introduction of pneumococcal conjugate vaccines (PCVs) has dramatically reduced the incidence of pneumococcal diseases. PCVs are not currently being used in Algeria. We conducted a prospective study from 2005 to 2012 in Algeria to determine antimicrobial drug resistance and serotype distribution of Streptococcus pneumoniae from children with pneumococcal disease. Among 270 isolated strains from children, 97 (36%) were invasive disease; of these, 48% were not susceptible to penicillin and 53% not susceptible to erythromycin. A high rate of antimicrobial nonsusceptibility was observed in strains isolated from children with meningitis. The serotype distribution from pneumococci isolated from children with invasive infections was (by order of prevalence): 14, 1, 19F, 19A, 6B, 5, 3, 6A and 23F. Multidrug resistance was observed in serotypes 14, 19F, 19A and 6B. The vaccine coverage of serotypes isolated from children aged <5 years was 55.3% for PCV7, 71.1% for PCV10 and 86.8% for PCV13. Our results highlight the burden of pneumococcal disease in Algeria and the increasing S. pneumoniae antibiotic resistance. The current pneumococcal vaccines cover a high percentage of the circulating strains. Therefore, vaccination would reduce the incidence of pneumococcal disease in Algeria.
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Affiliation(s)
- N. Ramdani-Bouguessa
- Service de Microbiologie, Centre Hospitalier Universitaire Mustapha Bacha, Algeria
| | - H. Ziane
- Service de Microbiologie, Centre Hospitalier Universitaire Mustapha Bacha, Algeria
| | - S. Bekhoucha
- Centre Hospitalier Universitaire d’Oran, Oran, Algeria
| | - Z. Guechi
- Centre Hospitalier Universitaire Nafissa Hamoud, Algeria
| | - A. Azzam
- Centre Hospitalier Universitaire Nedir Mohamed, Tizi Ouzou, Algeria
| | - D. Touati
- Centre Hospitalier Universitaire Issad Hassani, Béni-Messous, Algiers, Algeria
| | - M. Naim
- Hôpital Central de l’Armée Mohamed Seghir Nekkache, Algeria
| | - S. Azrou
- Hôpital de Boufarik, Blida, Algeria
| | | | - A. Mertani
- Service de Microbiologie, Centre Hospitalier Universitaire Mustapha Bacha, Algeria
| | - A. Laraba
- Centre Hospitalier Universitaire Lamine Debaghine, Algeria
| | - T. Annane
- Centre Hospitalier Universitaire Lamine Debaghine, Algeria
| | | | - M. Tazir
- Service de Microbiologie, Centre Hospitalier Universitaire Mustapha Bacha, Algeria
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13
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Liguori G, Parlato A, Zamparelli AS, Belfiore P, Gallé F, Di Onofrio V, Riganti C, Zamparelli B. Adult immunization with 13-valent pneumococcal vaccine in Campania region, South Italy: an economic evaluation. Hum Vaccin Immunother 2013; 10:492-7. [PMID: 24185467 PMCID: PMC4185884 DOI: 10.4161/hv.26888] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Pneumococcal pneumonia has a high clinical burden in terms of morbidity, mortality and hospitalization rate, with heavy implications for worldwide health systems. In particular, higher incidence and mortality rates of community-acquired pneumonia (CAP) cases, with related costs, are registered among elderly. This study aimed to an economic evaluation about the immunization with PCV13 in the adult population in Campania region, South Italy. For this purpose we performed, considering a period of 5 y, a budget impact analysis (BIA) and a cost-effectiveness analysis which considered 2 scenarios of immunization compared with lack of immunization for 2 targeted cohorts: first, the high risk subjects aged 50-79 y, and second the high risk individuals aged 50-64 y, together with all those aged 65 y. Regarding the first group, the decrease of pneumonia could give savings equal to €29,005,660, while the immunization of the second cohort could allow savings equal to €10,006,017. The economic evaluation of pneumococcal vaccine for adult groups represents an essential instrument to support health policies. This study showed that both hypothesized immunization strategies could produce savings. Obtained results support the use of pneumococcal conjugate vaccine for adults. This strategy could represent a sustainable and savings-producer health policy.
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Affiliation(s)
- Giorgio Liguori
- Chair of Hygiene and Epidemiology; Department of Studies of Institutions and Territorial Systems; University of Naples "Parthenope"; Naples, Italy
| | - Antonino Parlato
- Complex Operative Unit "Epidemiology and Prevention"; Local Health Authority NA2 Nord; Naples, Italy
| | - Alessandro Sanduzzi Zamparelli
- Complex Operative Unit of the hospital Monaldi "Second Division of Respiratory Diseases"; University of Naples Federico II; Naples, Italy
| | - Patrizia Belfiore
- Chair of Hygiene and Epidemiology; Department of Studies of Institutions and Territorial Systems; University of Naples "Parthenope"; Naples, Italy
| | - Francesca Gallé
- Chair of Hygiene and Epidemiology; Department of Studies of Institutions and Territorial Systems; University of Naples "Parthenope"; Naples, Italy
| | - Valeria Di Onofrio
- Chair of Hygiene and Epidemiology; Department of Studies of Institutions and Territorial Systems; University of Naples "Parthenope"; Naples, Italy
| | - Carla Riganti
- General Hospital "Federico II"-Institutional Relationships Hospitals and Local Health Authorities of Campania Region; Naples, Italy
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14
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Anh DD, Riewpaiboon A, Tho LH, Kim SA, Nyambat B, Kilgore P. Treatment costs of pneumonia, meningitis, sepsis, and other diseases among hospitalized children in Viet Nam. J Health Popul Nutr 2010; 28:436-42. [PMID: 20941894 PMCID: PMC2963765 DOI: 10.3329/jhpn.v28i5.6151] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The aim of this study was to estimate the costs of treatment of children who present with the signs and symptoms of invasive bacterial diseases in Khanh Hoa province, Viet Nam. The study was an incidence-based cost-of-illness analysis from the health system perspective. The hospital costs included labour, materials and capital costs, both direct and indirect. Costs were determined for 980 children, with an average age of 12.67 months (standard deviation +/- 11.38), who were enrolled in a prospective surveillance at the Khanh Hoa General Hospital during 2005-2006. Of them, 57% were male. By disease-category, 80% were suspected of having pneumonia, 8% meningitis, 3% very severe disease consistent with pneumococcal sepsis, and 9% other diseases. Treatment costs for suspected pneumonia, meningitis, very severe disease, and other diseases were US$ 31, US$ 57, US$ 73, and US$ 24 respectively. Costs ranged from US$ 24 to US$ 164 across different case-categories. Both type of disease and age of patient had statistically significant effects on treatment costs. The results showed that treatment costs for bacterial diseases in children were considerable and might differ by as much as seven times among invasive pneumococcal diseases. Changes in costs were sensitive to both age of patient and case-category. These cost-of-illness data will be an important component in the overall evidence base to guide the development of vaccine policy in Viet Nam.
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Affiliation(s)
- Dang Duc Anh
- National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam
| | - Arthorn Riewpaiboon
- Division of Social and Administrative Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
| | - Le Huu Tho
- Khanh Hoa Provincial Public Health Service, Nha Trang, Viet Nam
| | - Soon Ae Kim
- International Vaccine Institute, Seoul, South Korea
| | | | - Paul Kilgore
- International Vaccine Institute, Seoul, South Korea
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