Cost-effectiveness of pneumococcal polysaccharide vaccine among healthcare workers during an influenza pandemic.
OBJECTIVE
To assess the usefulness and cost-effectiveness of pneumococcal polysaccharide vaccine (PPV) among healthcare workers compared with nonuse of PPV during an influenza pandemic.


METHODS
Markov modeling was used to estimate the cost-effectiveness of PPV in previously unvaccinated healthcare workers during an influenza pandemic.


METHODS
Invasive pneumococcal disease (IPD) incidence rates were incorporated into the model, which assumed that IPD events occurred at twice the usual rate during a year of pandemic influenza. Societal and hospital perspectives were examined. Assumptions were that pneumococcal disease transmission from healthcare worker to patient did not occur, heightened IPD risk occurred for only 1 year, and PPV did not prevent noninvasive pneumonia, all of which potentially bias against vaccination.


RESULTS
From a societal standpoint, PPV of healthcare workers during an influenza pandemic is economically reasonable, costing $2935 per quality-adjusted life-year gained; results were robust to variation in multiple sensitivity analyses. However, from the hospital perspective, vaccinating healthcare workers was expensive, costing $1676 per employee absence day avoided, given an IPD risk that (although increased) would remain less than 1%.


CONCLUSIONS
Vaccinating all healthcare workers to protect against pneumococcal disease during a pandemic influenza outbreak is likely to be economically reasonable from the societal standpoint. However, PPV is expensive from the hospital perspective, which might prevent implementation of a PPV program unless it is externally subsidized.
Section of Decision Sciences and Clinical Systems Modeling, University of Pittsburgh, Pittsburgh, PA 15213, USA. smithkj2@upmc.edu
Kenneth J
KJ
Smith
Mahlon
M
Raymund
Mary Patricia
MP
Nowalk
Mark S
MS
Roberts
Richard K
RK
Zimmerman
D003362:Cost-Benefit Analysis; D004196:Disease Outbreaks; D005260:Female; D006282:Health Personnel; D006801:Humans; D017589:Immunization Programs / Q000191:economics*; D015994:Incidence; D007251:Influenza, Human / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D008297:Male; D008390:Markov Chains; D011008:Pneumococcal Infections / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage / Q000191:economics*; D019057:Quality-Adjusted Life Years
D022242:Pneumococcal Vaccines