Impact of 13Valent Vaccine for Prevention of Pneumococcal Diseases in Children and Adults at Risk: Possible Scenarios in Campania Region

Page: [403 - 408] Pages: 6

  • * (Excluding Mailing and Handling)

Abstract

Background: Pneumonias are the most frequent infectious diseases, characterized by a high prevalence especially among children and adults at risk. The socio-economic impact caused by Streptococcus pneumoniae is evaluated in terms of morbidity, death rate and hospitalizations.

Objective: The aim of the study was to demonstrate the potential economic advantages by implementation of an active anti-pneumococcal 13-valent vaccine strategy in Campania region (Southern Italy) in two different categories of subjects, children (aged 0-12), and adults (aged 50- 79) at risk (hypertension, nephropathies, COPD and heart diseases).

Methods: Vaccination costs were compared with costs necessary to treat avoidable diseases in the presence and absence of a vaccination program.

Results: Offering anti-pneumococcal 13-valent vaccine to the paediatric population was quantified as saving one million euros for Italian national health service in two years. In addition, offering anti-pneumococcal vaccine to adults at risk would generate a return of around 29 million euros.

Conclusion: In both cases, offering anti-pneumococcal 13-valent vaccine was proven to be a helpful political health strategy, not only in consideration of a reduction of cases but also in view of the favourable economic impacts.

Keywords: Pneumococcal disease, 13-valent vaccine, budget impact analysis, Streptococcus pneumoniae, bacterium, etiologic agent.

[1]
Askim, Å.; Mehl, A.; Paulsen, J.; DeWan, A.T.; Vestrheim, D.F.; Åsvold, B.O.; Damås, J.K.; Solligård, E. Epidemiology and outcome of sepsis in adult patients with Streptococcus pneumoniae infection in a Norwegian county 1993-2011: an observational study. BMC Infect. Dis., 2016, 16(1), 223.
[http://dx.doi.org/10.1186/s12879-016-1553-8] [PMID: 27216810]
[2]
Weycker, D.; Farkouh, R.A.; Strutton, D.R.; Edelsberg, J.; Shea, K.M.; Pelton, S.I. Risk of exacerbation following pneumonia in adults with heart failure or chronic obstructive pulmonary disease. PLoS One, 2017, 12(10)e0184877
[http://dx.doi.org/10.1371/journal.pone.0184877] [PMID: 29028810]
[3]
Lepoutre, A.; Varon, E.; Georges, S.; Dorléans, F.; Janoir, C.; Gutmann, L.; Lévy-Bruhl, D. Microbiologists of Epibac ORP Networks. Impact of the pneumococcal conjugate vaccines on invasive pneumococcal disease in France, 2001-2012. Vaccine, 2015, 33(2), 359-366.
[http://dx.doi.org/10.1016/j.vaccine.2014.11.011] [PMID: 25448105]
[4]
Palmu, A.A.; Kilpi, T.M.; Rinta-Kokko, H.; Nohynek, H.; Toropainen, M.; Nuorti, J.P.; Jokinen, J. Pneumococcal Conjugate Vaccine and Clinically Suspected Invasive Pneumococcal Disease. Pediatrics, 2015, 136(1), e22-e27.
[http://dx.doi.org/10.1542/peds.2015-0458] [PMID: 26077477]
[5]
Papadatou, I.; Spoulou, V. Pneumococcal vaccination in high-risk individuals: are we doing it right? Clin. Vaccine Immunol., 2016, 23(5), 388-395.
[http://dx.doi.org/10.1128/CVI.00721-15]
[6]
Crisinel, P.A. Impact of vaccination on the epidemiology of childhood pneumonia. Rev. Med. Suisse, 2016, 12 (506), 354-, 356-357.
[PMID: 27039460]
[7]
Sayıner, A.; Mirici, A.; Çilli, A.; Uzaslan, E.; Akova, M.; Özhan, M.H.; Kilinç, O. The risk of pneumococcal diseases in lung diseases and the importance of adult vaccination. Tuberk. Toraks, 2014, 62(2), 154-159.
[http://dx.doi.org/10.5578/tt.5926] [PMID: 25038386]
[8]
Chalmers, J.D.; Campling, J.; Dicker, A.; Woodhead, M.; Madhava, H. A systematic review of the burden of vaccine preventable pneumococcal disease in UK adults. BMC Pulm. Med., 2016, 16(1), 77.
[http://dx.doi.org/10.1186/s12890-016-0242-0] [PMID: 27169895]
[9]
Kim, D.K.; Bridges, C.B. Harriman KH on behalf of the Advisory Committee on Immunization Practices. Advisory Committee on Immunization Practices Recommended Immunization Schedule for Adults Aged 19 Years or Older: United States, 2015. Ann. of Intern. Med., 2015, 162(N.3), 214-225.http://annals.org/on 02/20/2015
[10]
Frenck, R.W., Jr; Fiquet, A.; Gurtman, A.; van Cleeff, M.; Davis, M.; Rubino, J.; Smith, W.; Sundaraiyer, V.; Sidhu, M.; Emini, E.A.; Gruber, W.C.; Scott, D.A. Schmoele-Thoma, B Immunogenicity and safety of a second administration of 13-valent pneumococcal conjugate vaccine 5 years after initial vaccination in adults 50 years and older. Vaccine, 2016, 34(30), 3454-3462.
[http://dx.doi.org/10.1016/j.vaccine.2016.04.093]
[11]
Le Polain De Waroux, O.; Flasche, S.; Prieto-Merino, D.; Goldblatt, D.; Edmunds, W.J. The Efficacy and Duration of Protection of Pneumococcal Conjugate Vaccines Against Nasopharyngeal Carriage: A Meta-regression Model. Pediatr. Infect. Dis. J., 2015, 34(8), 858-864.
[http://dx.doi.org/10.1097/INF.0000000000000717] [PMID: 26075814]
[12]
Weinberger, D.M.; Grant, L.R.; Weatherholtz, R.C.; Warren, J.L.; O’Brien, K.L.; Hammitt, L.L. Relating pneumococcal carriage among children to disease rates among adults before and after the introduction of conjugate vaccines. Am. J. Epidemiol., 2016, 183(11), 1055-1062.
[http://dx.doi.org/10.1093/aje/kwv283] [PMID: 27188949]
[13]
van Werkhoven, C.H.; Hollingsworth, R.C.; Huijts, S.M.; Bolkenbaas, M.; Webber, C.; Patterson, S.; Sanders, E.A.; Bonten, M.J. Pneumococcal conjugate vaccine herd effects on non-invasive pneumococcal pneumonia in elderly. Vaccine, 2016, 34(28), 3275-3282.
[http://dx.doi.org/10.1016/j.vaccine. 2016.05.002.]
[14]
Flego, M.; Frau, A.; Accardi, L.; Mallano, A.; Ascione, A.; Gellini, M.; Fanunza, E.; Vella, S.; Di Bonito, P.; Tramontano, E. Intracellular human antibody fragments recognizing the VP35 protein of Zaire Ebola filovirus inhibit the protein activity. BMC Biotechnol., 2019, 19, 64.
[15]
Rubin, J.L.; McGarry, L.J.; Strutton, D.R.; Klugman, K.P.; Pelton, S.I.; Gilmore, K.E.; Weinstein, M.C. Public health and economic impact of the 13-valent pneumococcal conjugate vaccine (PCV13) in the United States. Vaccine, 2010, 28(48), 7634-7643.
[http://dx.doi.org/10.1016/j.vaccine.2010.09.049] [PMID: 20883739]
[16]
Dirmesropian, S.; Wood, J.G.; MacIntyre, C.R.; Newall, A.T. A review of economic evaluations of 13-valent pneumococcal conjugate vaccine (PCV13) in adults and the elderly. Hum. Vaccin. Immunother., 2015, 11(4), 818-825.
[http://dx.doi.org/10.1080/21645515.2015.1011954] [PMID: 25933180]
[17]
van Hoek, A.J.; Miller, E. Cost-effectiveness of vaccinating immunocompetent ≥65-year-olds with the 13-valent pneumococcal conjugate vaccine in England. PLoS One, 2016, 11(2)e0149540
[http://dx.doi.org/10.1371/journal.pone.0149540] [PMID: 26914907]
[18]
Rodríguez González-Moro, J.M.; Menéndez, R.; Campins, M.; Lwoff, N.; Oyagüez, I.; Echave, M.; Rejas, J.; Antoñanzas, F. Cost effectiveness of the 13-valent pneumococcal conjugate vaccination program in chronic obstructive pulmonary disease inpatients aged 50+ years in Spain. Clin. Drug Investig., 2016, 36(1), 41-53.
[http://dx.doi.org/10.1007/s40261-015-0345-z] [PMID: 26547199]
[19]
World Health Organization. Pneumococcal conjugate vaccine for childhood immunization--WHO position paper. Wkly. Epidemiol. Rec., 2007, 82(12), 93-104.
[PMID: 17380597]
[20]
Strutton, D.R.; Farkouh, R.A.; Earnshaw, S.R.; Hwang, S.; Theidel, U.; Kontodimas, S.; Klok, R.; Papanicolaou, S. Cost-effectiveness of 13-valent pneumococcal conjugate vaccine: Germany, Greece, and The Netherlands. J. Infect., 2012, 64(1), 54-67.
[http://dx.doi.org/10.1016/j.jinf.2011.10.015] [PMID: 22085813]
[21]
Iori, I.; Gussoni, G.; Blasi, F.R.; Bulfoni, A.; Costantino, S.; Legnani, D.; Gruppo di Studio, F.A.S.T.C.A.P. Linee guida e gestione ospedaliera delle polmoniti acquisite in comunità: l’esperienza italiana dello studio FASTCAP. Int. J. Med. (Dubai), 2008, 2(1), 5-18.
[22]
Huang, S.S.; Johnson, K.M.; Ray, G.T.; Wroe, P.; Lieu, T.A.; Moore, M.R.; Zell, E.R.; Linder, J.A.; Grijalva, C.G.; Metlay, J.P.; Finkelstein, J.A. Healthcare utilization and cost of pneumococcal disease in the United States. Vaccine, 2011, 29(18), 3398-3412.
[http://dx.doi.org/10.1016/j.vaccine.2011.02.088] [PMID: 21397721]
[23]
Weycker, D.; Strutton, D.; Edelsberg, J.; Sato, R.; Jackson, L.A. Clinical and economic burden of pneumococcal disease in older US adults. Vaccine, 2010, 28(31), 4955-4960.
[http://dx.doi.org/10.1016/j.vaccine.2010.05.030] [PMID: 20576535]
[24]
Welte, T.; Torres, A.; Nathwani, D. Clinical and economic burden of community-acquired pneumonia among adults in Europe. Thorax, 2012, 67(1), 71-79.
[http://dx.doi.org/10.1136/thx.2009.129502] [PMID: 20729232]
[25]
Italian Ministry of Health. National Vaccine Plan 2012-2014. www.salute.gov.it
[26]
Italian Ministry of Health. National Vaccine Plan 2016-2018. www.salute.gov.it
[27]
Pantosti, A. Lo scenario epidemiologico post-vaccinazione in Italia. Il futuro della vaccinazione pneumococcica; Firenze. , 2009.
[28]
Liguori, G.; Parlato, A.; Scaletti, A.; Belfiore, P.; Russo, P.; Gallé, F.; D’Ausilio, A.; Granata, M.R.; Pecci, F. Ital. J. Public Health, 2012, 9(1), 13-19.
[29]
Liguori, G.; Parlato, A.; Zamparelli, A.S.; Belfiore, P.; Gallé, F.; Di Onofrio, V.; Riganti, C.; Zamparelli, B. Società Italiana di Health Horizon Scanning (SIHHS). Adult immunization with 13-valent pneumococcal vaccine in Campania region, South Italy: an economic evaluation. Hum. Vaccin. Immunother., 2014, 10(2), 492-497.
[http://dx.doi.org/10.4161/hv.26888] [PMID: 24185467]
[30]
Esposito, S.; Lizioli, A.; Lastrico, A.; Begliatti, E.; Rognoni, A.; Tagliabue, C.; Cesati, L.; Carreri, V.; Principi, N. Impact on respiratory tract infections of heptavalent pneumococcal conjugate vaccine administered at 3, 5 and 11 months of age. Respir. Res., 2007, 8, 12.
[http://dx.doi.org/10.1186/1465-9921-8-12] [PMID: 17313667]
[31]
La Torre, G.; de Waure, C.; Capizzi, S. Rapporto di healthtechnologyassessment della vaccinazione anti-pneumococcica con Prevenar 13. Ital. J. Public Health, 2010, 7(S1), 1-72.
[32]
Pavia, M.; Bianco, A.; Nobile, C.G.A.; Marinelli, P.; Angelillo, I.F. Efficacy of pneumococcal vaccination in children younger than 24 months: a meta-analysis. Pediatrics, 2009, 123(6), e1103-e1110.
[http://dx.doi.org/10.1542/peds.2008-3422] [PMID: 19482744]
[33]
Lucioni, C.; Alliata, E.; Mazzi, S.; Lizioli, A. I costi della malattia pneumococcica in età pediatrica. Pharmaco Economics Italian Research Articles, 2005, 7, 177-186.
[http://dx.doi.org/10.1007/BF03320548]
[34]
Giorgi-Rossi, P.; Merito, M.; Borgia, P. Cost-effectiveness of introducing the conjugated pneumococcal vaccine to routine free immunizations for infants in Lazio, Italy. Health Policy, 2009, 89(2), 225-238.
[http://dx.doi.org/10.1016/j.healthpol.2008.05.016] [PMID: 18639952]
[35]
Colombo, G.L. Cost-of-illness delle malattie pneumococciche nel bambino in Italia. Ann. Ig., 2002, 14(5), 373-388.
[PMID: 12508446]
[36]
Berto, P.; Gallio, D.; Principi, N. Valutazione economica di una strategia di prevenzione delle infezione da pneumococco sulla popolazione dei nuovi nati: un’analisi di impatto sul budget. Ann. Ig., 2007, 37, 303-308.
[37]
ISTAT. Censimento gennaio 2009 – Campania Regional data. www.istat.it
[38]
Boccalini, S.; Bechini, A.; Levi, M.; Tiscione, E.; Gasparini, R.; Bonanni, P. Cost-effectiveness of new adult pneumococcal vaccination strategies in Italy. Hum. Vaccin. Immunother., 2013, 9(3), 699-706.
[http://dx.doi.org/10.4161/hv.23268] [PMID: 23295824]
[39]
Viegi, G.; Maio, S.; Pistelli, F.; Baldacci, S.; Carrozzi, L. Epidemiology of chronic obstructive pulmonary disease: health effects of air pollution. Respirology, 2006, 11(5), 523-532.
[http://dx.doi.org/10.1111/j.1440-1843.2006.00886.x] [PMID: 16916323]
[40]
ARSAN (Campania Regional Agency Health Care), data 2010. 2011.
[41]
Bewick, T.; Sheppard, C.; Greenwood, S.; Slack, M.; Trotter, C.; George, R.; Lim, W.S. Serotype prevalence in adults hospitalised with pneumococcal non-invasive community-acquired pneumonia. Thorax, 2012, 67(6), 540-545.
[http://dx.doi.org/10.1136/thoraxjnl-2011-201092] [PMID: 22374921]
[42]
Schwarz, T.F.; Flamaing, J.; Rümke, H.C.; Penzes, J.; Juergens, C.; Wenz, A.; Jayawardene, D.; Giardina, P.; Emini, E.A.; Gruber, W.C.; Schmoele-Thoma, B. A randomized, double-blind trial to evaluate immunogenicity and safety of 13-valent pneumococcal conjugate vaccine given concomitantly with trivalent influenza vaccine in adults aged ≥65 years. Vaccine, 2011, 29(32), 5195-5202.
[http://dx.doi.org/10.1016/j.vaccine.2011.05.031] [PMID: 21619909]
[43]
Black, S.B.; Shinefield, H.R.; Ling, S.; Hansen, J.; Fireman, B.; Spring, D.; Noyes, J.; Lewis, E.; Ray, P.; Lee, J.; Hackell, J. Effectiveness of heptavalent pneumococcal conjugate vaccine in children younger than five years of age for prevention of pneumonia. Pediatr. Infect. Dis. J., 2002, 21(9), 810-815.
[http://dx.doi.org/10.1097/00006454-200209000-00005] [PMID: 12352800]
[45]
STAT 2010. Decessi e mortalità in Campania. www.istat.it
[46]
National Agency for Regional Health Services (Age.na.s.). Hospital admissions, the regional tariff systems in force in 2009. Campania Region. Available at. http://www.agenas.it/index.htm