title: Value Added by the Prevnar 13 Childhood Immunization Program in Alberta, Canada (2010-2015).
abstract: BACKGROUND
  Streptococcus pneumoniae is a pathogen causing acute respiratory infections, as well as meningitis and bacteremia. The province of Alberta, Canada, began vaccinating infants against seven S. pneumoniae serotypes in 2002 using Prevnar 7 (PCV7). However, a 13-valent conjugate vaccine (PCV13) was introduced in 2010 to address changes in the distribution of serotypes causing disease. PCV13 targets 13 serotypes including six additional serotypes to the previously adopted PCV7.
  
  
  OBJECTIVE
  In this study, we estimate the impact of the new PCV13 immunization program on the burden of disease and related healthcare costs in Alberta.
  
  
  METHODS
  Serotype-specific passive surveillance invasive pneumococcal disease (IPD) data were drawn from the Alberta Public Health Laboratory. These data were used to estimate average annual IPD incidence of the six additional serotypes included in PCV13 during the PCV7 era (2000-2009), and after the introduction of PCV13 (2011-2015). The difference in estimated cases pre-/post-PCV13 was used to estimate associated changes in direct health service costs.
  
  
  RESULTS
  Following the replacement of PCV7 with PCV13 in 2010, the number of cases of IPD caused by the additional serotypes contained in PCV13 has declined significantly across all ages. The expected number of IPD cases prevented annually is an estimated 1.6 per 100,000. Direct health service costs are expected to be averted as a result of the implementation of PCV13 universal vaccination in Alberta. Indirect benefits are experienced by ages >20 years as IPD incidence significantly declines following the PCV13 infant immunization in Alberta.
  
  
  CONCLUSIONS
  The impact on direct healthcare costs of replacing PCV7 with PCV13 in Alberta's public immunization program are estimated to be CAN$3.5 million as of 2015.
authors.affiliation: Institute of Health Economics, 1200 10405 Jasper Avenue, Edmonton, AB, T5J 3N4, Canada. awaye@ihe.ca.
authors.forename: Arianna
authors.initials: A
authors.lastname: Waye
authors.affiliation: Institute of Health Economics, 1200 10405 Jasper Avenue, Edmonton, AB, T5J 3N4, Canada.|Department of Medicine, University of Alberta, Edmonton, AB, Canada.
authors.forename: Anderson W
authors.initials: AW
authors.lastname: Chuck