Cost-effectiveness of targeted vaccination to protect new-borns against pertussis: comparing neonatal, maternal, and cocooning vaccination strategies.
Pertussis (whooping cough) is a severe infectious disease in infants less than 6 months old. Mass vaccination programmes have been unable to halt transmission effectively. Strategies to protect new-borns against infection include vaccination of the neonate or the mother directly after birth (cocooning), or the mother during pregnancy (maternal). Here we investigate the cost-effectiveness of these three strategies in the Netherlands. Costs for health care utilization and productivity losses, as well as impact on quality of life were calculated for a 10-year vaccination programme, assuming that vaccine-induced immunity lasts 5 years. Cocooning was the most attractive option from a cost-effectiveness viewpoint (€89,000/QALY). However, both cocooning and maternal vaccination would reduce the disease burden in infants and mothers vaccinated (about 17-20 QALY/year). Specifically, with a persistent epidemic as seen in 2012, there is need for reconsidering the vaccination schedules against pertussis in order to increase protection of the vulnerable new-borns.
Epidemiology and Surveillance Unit, National Institute for Public Health and the Environment, Bilthoven, The Netherlands. Electronic address: anna.lugner@rivm.nl.
Anna K
AK
Lugnér
Nicoline
N
van der Maas
Michiel
M
van Boven
Frits R
FR
Mooi
Hester E
HE
de Melker
D000328:Adult; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015233:Models, Statistical; D009426:Netherlands / Q000453:epidemiology; D010567:Pertussis Vaccine / Q000008:administration & dosage* / Q000191:economics*; D011247:Pregnancy; D014611:Vaccination / Q000191:economics* / Q000379:methods*; D014917:Whooping Cough / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control*
D010567:Pertussis Vaccine
Cost-utility; Infants; Vaccination; Whooping cough