title: Pneumococcal pneumonia in the UK--how herd immunity affects the cost-effectiveness of 7-valent pneumococcal conjugate vaccine (PCV).
abstract: This study examines the potential clinical and economic benefits for adults arising from paediatric pneumococcal vaccination in the UK. A UK birth cohort model with a 10-year horizon and using a primary 4-dose paediatric 7-valent pneumococcal conjugate vaccine (PCV) schedule was populated with 1999 morbidity and mortality data scaled up to the UK population. Herd immunity effects on adult pneumococcal hospital-treated pneumonia, meningitis and septicaemia, but not on community-treated pneumonia, were calculated using the lower end of the confidence intervals published for the effects in the US. Universal paediatric pneumococcal immunisation would prevent 1168 deaths (1141 adults) and 7147 cases (1791 adults constituted by 32 meningitis, 37 septicaemia and 1722 pneumonia) of serious pneumococcal infection (meningitis, septicaemia, pneumonia) with a resultant direct (payor) cost per life year gained of 4360 pounds. The 7-valent PCV appears to be highly cost effective.
authors.affiliation: Wyeth, Huntercombe Lane South, Taplow, Maidenhead, Berkshire SL6 0PH, UK. mcintod@wyeth.com
authors.forename: E D G
authors.initials: ED
authors.lastname: McIntosh
authors.forename: P
authors.initials: P
authors.lastname: Conway
authors.forename: J
authors.initials: J
authors.lastname: Willingham
authors.forename: R
authors.initials: R
authors.lastname: Hollingsworth
authors.forename: A
authors.initials: A
authors.lastname: Lloyd
mesh_terms: D000328:Adult; D000368:Aged; D003362:Cost-Benefit Analysis; D005260:Female; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D006801:Humans; D032521:Immunity, Herd / Q000276:immunology*; D008297:Male; D022401:Meningococcal Vaccines / Q000191:economics* / Q000627:therapeutic use; D008875:Middle Aged; D022242:Pneumococcal Vaccines / Q000191:economics* / Q000627:therapeutic use; D011018:Pneumonia, Pneumococcal / Q000191:economics* / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control; D006113:United Kingdom / Q000453:epidemiology; D018074:Vaccines, Conjugate / Q000191:economics / Q000627:therapeutic use
chemical_list: D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D022401:Meningococcal Vaccines; D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate