title: Pneumonia prevention: Cost-effectiveness analyses of two vaccines among refugee children aged under two years, Haemophilus influenzae type b-containing and pneumococcal conjugate vaccines, during a humanitarian emergency, Yida camp, South Sudan.
abstract: By September 2013, war between Sudan and South Sudan resulted in >70,000 Sudanese refugees and high pneumonia incidence among the 20,000 refugees in Yida camp, South Sudan. Using Médecins Sans Frontières (MSF)-provided data and modifying our decision-tree models, we estimated if administering Haemophilus influenzae type b (Hib)-containing (pentavalent vaccine, also with diphtheria pertussis and tetanus [DPT] and hepatitis B) and pneumococcal conjugate (PCV) vaccines were cost-effective against hospitalized pneumonia. Among children <2years old, compared with no vaccination, one- and two-doses of combined Hib-containing and PCV would avert an estimated 118 and 125 pneumonia cases, and 8.5 and 9.1 deaths, respectively. The cost per Disability-Adjusted-Life-Year averted for administering combined one- and two-doses was US$125 and US$209, respectively. MSF demonstrated that it was possible to administer these vaccines during an emergency and our analysis found it was highly cost-effective, even with just one-dose of either vaccine. Despite unknown etiology, there is strong field and now economic rationale for administering Hib and PCV during at least one humanitarian emergency.
authors.affiliation: Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, United States.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Gargano
authors.affiliation: Division of Bacterial Diseases, National Center of Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States.
authors.forename: Rana
authors.initials: R
authors.lastname: Hajjeh
authors.affiliation: Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, United States. Electronic address: sgc0@cdc.gov.
authors.forename: Susan T
authors.initials: ST
authors.lastname: Cookson
mesh_terms: D003362:Cost-Benefit Analysis; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000008:administration & dosage / Q000191:economics* / Q000276:immunology*; D018073:Haemophilus Vaccines / Q000008:administration & dosage / Q000191:economics* / Q000276:immunology*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage / Q000191:economics* / Q000276:immunology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D022242:Pneumococcal Vaccines / Q000008:administration & dosage / Q000191:economics* / Q000276:immunology*; D018410:Pneumonia, Bacterial / Q000191:economics* / Q000517:prevention & control*; D012036:Refugees; D000068037:South Sudan; D018074:Vaccines, Conjugate / Q000008:administration & dosage / Q000191:economics / Q000276:immunology
chemical_list: D015721:Diphtheria-Tetanus-Pertussis Vaccine; D018073:Haemophilus Vaccines; D017325:Hepatitis B Vaccines; D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate; C122182:diphtheria-tetanus-acellular pertussis-Hib-hepatitis B vaccine
keywords: Cost-effectiveness; Haemophilus influenzae type b; Hib vaccine; Humanitarian emergency; PCV; Routine immunization; South Sudan; Streptococcus pneumoniae; Supplemental immunization activity