title: Estimating the cost-effectiveness of pneumococcal conjugate vaccination in Brazil.
abstract: OBJECTIVE
  To compare the costs and benefits of pneumococcal conjugate vaccination compared with no vaccination from the perspectives of the health care system and society.
  
  
  METHODS
  Using data from established sources, we estimated the incidence and mortality due to invasive pneumococcal disease, pneumonia, and acute otitis media (AOM) for a hypothetical birth cohort of children from birth to 5 years.
  
  
  RESULTS
  A universal pneumococcal conjugate vaccination program was estimated capable of annually avoiding 1 047 cases of invasive disease, 58 226 cases of pneumonia, and 209 862 cases of AOM. When herd immunity effects were considered, the program prevented 1.3 million cases of pneumococcal disease and over 7 000 pneumococcal deaths. At a vaccination cost of R$ 51.12 (US$ 26.35) per dose, vaccination would cost annually R$ 4 289 (US$ 2,211) per disability-adjusted life years averted. This does not take into account herd immunity effects.
  
  
  CONCLUSIONS
  At the current vaccine price, conjugate vaccination could be a cost-effective investment compared to other options to control childhood diseases. Further analysis is required to determine whether vaccination at the current price is affordable to Brazil.
authors.affiliation: Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Glaucia
authors.initials: G
authors.lastname: Vespa
authors.forename: Dagna O
authors.initials: DO
authors.lastname: Constenla
authors.forename: Camila
authors.initials: C
authors.lastname: Pepe
authors.forename: Marco Aurélio
authors.initials: MA
authors.lastname: Safadi
authors.forename: Eitan
authors.initials: E
authors.lastname: Berezin
authors.forename: José Cássio
authors.initials: JC
authors.lastname: de Moraes
authors.forename: Carlos Alberto Herrerias
authors.initials: CA
authors.lastname: de Campos
authors.forename: Denizar Vianna
authors.initials: DV
authors.lastname: Araujo
authors.forename: Ana Lucia S S
authors.initials: AL
authors.lastname: de Andrade
mesh_terms: D001938:Brazil; D003362:Cost-Benefit Analysis; D006801:Humans; D015994:Incidence; D011008:Pneumococcal Infections / Q000453:epidemiology* / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000191:economics*; D013179:Spouse Abuse; D018074:Vaccines, Conjugate
chemical_list: D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate