title: Cost-effectiveness of the pneumococcal vaccine in the United States Navy and Marine Corps.
abstract: Vaccination for Streptococcus pneumoniae has been recommended for its efficacy and cost-effectiveness in elderly and immunocompromised populations. However, its use in active-duty military personnel has not been analyzed. We developed a Markov model to evaluate health and economic outcomes of vaccinating or not vaccinating all members of the active-duty cohort, measuring quality-adjusted life years (QALYs) gained, costs, and marginal cost-effectiveness. Pneumococcal pneumonia vaccination increased each person's life expectancy by 0. 03 days and decreased costs by $9.88 per person. The magnitude of the benefit of immunization is moderately sensitive to the rate of serious side effects caused by the vaccine, the incidence of pneumonia, the length of protection, and the efficacy of the vaccine. Vaccinating all 575,000 active-duty US Navy and Marine Corps members could save $5.7 million during the time the members are alive and on active duty and could provide a total gain of 54 QALYs. On the basis of these results, the military should consider expanding current guidelines to include pneumococcal vaccine immunization for all active-duty members of the military.
authors.affiliation: Department of General Internal Medicine, Naval Medical Center San Diego, San Diego, CA 92134-5000, USA. pvpepper@nmcsd.med.navy.mil
authors.forename: P
authors.initials: P
authors.lastname: Vold Pepper
authors.forename: D K
authors.initials: DK
authors.lastname: Owens
mesh_terms: D000328:Adult; D001428:Bacterial Vaccines / Q000008:administration & dosage* / Q000191:economics / Q000276:immunology; D003362:Cost-Benefit Analysis; D003658:Decision Making, Computer-Assisted; D006801:Humans; D008390:Markov Chains; D008889:Military Personnel; D011008:Pneumococcal Infections / Q000517:prevention & control*; D019057:Quality-Adjusted Life Years; D013296:Streptococcus pneumoniae / Q000276:immunology*; D014481:United States; D014611:Vaccination / Q000191:economics*
chemical_list: D001428:Bacterial Vaccines