583Maschio, MBM, Balbino AP, De Souza PFR, Kalinke LP. Sexualidade na terceira idade: medidas de prevenção para doenças sexualmente transmissí-veis e AIDS. Rev Gaúcha Enferm., Porto Alegre (RS) 2011 set;32(3):583-9.

Objectives: In 2010, the US Advisory Committee on Immunization Practices recommended 7-valent pneumococcal conjugate vaccine (PCV7) be replaced by 13-valent vaccine (PCV13) for routine use in a four-dose series at 2, 4, 6, and 12-15 months of age. Published analyses estimated that PCV13 implementation would be cost-saving in aggregate, but the net economic impact on particular payers is unknown. We disaggregated the expected costs and savings by payer to determine the net costs for public and private payers over a 10-year horizon. MethOds: A Markov model was used to simulate vaccination and pneumococcal disease events and their related costs with PCV13 compared to PCV7 from 2010 to 2019. The PCV13 strategy included a one-time catch-up dose in 2010 for children who had completed the PCV7 series. Disease reductions both in vaccinated and other age groups were modeled based on PCV7 efficacy and effectiveness data. Medical costs related to pneumococcal disease were allocated to public (Medicare; Medicaid; military) or private payers using age-specific health care insurance coverage survey data. Vaccine program costs were allocated based on sales data. All costs were measured in 2013 US dollars. Results: In the simulation, 40.3 million(M) children participated in routine vaccination while 5.8M received a catch-up dose in the PCV13 strategy. The PCV13 strategy prevented an additional 121,300 cases of invasive pneumococcal disease, 3.3M of pneumonia and 17.6M of acute otitis media compared to PCV7 over 10 years.