Pneumococcal Vaccination for Children in Asian Countries: A Systematic Review of Economic Evaluation Studies

Zakiyah, Neily; Insani, Widya N.; Suwantika, Auliya A.; Schans, Jurjen van der; Postma, Maarten

doi:10.3390/vaccines8030426

Cited by 11 publications

(11 citation statements)

References 63 publications

(382 reference statements)

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“…Obviously, this study also confirmed that PCV13 is more cost-effective than PCV10 with both prices. Our finding that pneumococcal vaccine would be cost-effective to be introduced in countries with high burden PD is linear with several previous studies that specifically focused in the Asia region [ 9 , 16 , 26 , 41 – 57 ]. Another finding, which confirmed that PCV13 is more cost-effective to be implemented than PCV10, is also in line with other studies that compared the use of PCV10 and PCV13 [ 16 , 26 , 49 , 53 ].…”

Section: Discussionsupporting

confidence: 88%

“…Several studies reported that vaccination was the most cost-effective intervention in reducing the incidence rate of PD [ 8 ]. In Asia, the children pneumococcal vaccination program was confirmed to be cost-effective and even cost saving in certain conditions [ 9 ]. The firstly developed pneumococcal conjugate vaccine (PCV), a 7-valent PCV (PCV7), has proven to reduce the incidence rate of PD significantly [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Cost-Effectiveness and Budget Impact Analyses of Pneumococcal Vaccination in Indonesia

Suwantika

Zakiyah

Abdulah

et al. 2021

Journal of Environmental and Public Health

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As a country with the high number of deaths due to pneumococcal disease, Indonesia has not yet included pneumococcal vaccination into the routine program. This study aimed to analyse the cost-effectiveness and the budget impact of pneumococcal vaccination in Indonesia by developing an age-structured cohort model. In a comparison with no vaccination, the use of two vaccines (PCV10 and PCV13) within two pricing scenarios (UNICEF and government contract price) was taken into account. To estimate the cost-effectiveness value, a 5-year time horizon was applied by extrapolating the outcome of the individual in the modelled cohort until 5 years of age with a 1-month analytical cycle. To estimate the affordability value, a 6-year period (2019–2024) was applied by considering the government’s strategic plan on pneumococcal vaccination. In a comparison with no vaccination, the results showed that vaccination would reduce pneumococcal disease by 1,702,548 and 2,268,411 cases when using PCV10 and PCV13, respectively. Vaccination could potentially reduce the highest treatment cost from the payer perspective at $53.6 million and $71.4 million for PCV10 and PCV13, respectively. Applying the UNICEF price, the incremental cost-effectiveness ratio (ICER) from the healthcare perspective would be $218 and $162 per QALY-gained for PCV10 and PCV13, respectively. Applying the government contract price, the ICER would be $987 and $747 per QALY-gained for PCV10 and PCV13, respectively. The result confirmed that PCV13 was more cost-effective than PCV10 with both prices. In particular, introduction cost per child was estimated to be $0.91 and vaccination cost of PCV13 per child (3 doses) was estimated to be $16.61 and $59.54 with UNICEF and government contract prices, respectively. Implementation of nationwide vaccination would require approximately $73.3–$75.0 million (13–14% of routine immunization budget) and $257.4-$263.5 million (45–50% of routine immunization budget) with UNICEF and government contract prices, respectively. Sensitivity analysis showed that vaccine efficacy, mortality rate, and vaccine price were the most influential parameters affecting the ICER. In conclusion, pneumococcal vaccination would be a highly cost-effective intervention to be implemented in Indonesia. Yet, applying PCV13 with UNICEF price would give the best cost-effectiveness and affordability values on the routine immunization budget.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Cost-Effectiveness and Budget Impact Analyses of Pneumococcal Vaccination in Indonesia

Suwantika

Zakiyah

Abdulah

et al. 2021

Journal of Environmental and Public Health

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“…Since vaccine hesitancy is already recognized by the World Health Organization as one of the 10 biggest threads to global health [ 112 ], identification of factors that enhance individuals’ intention to accept vaccination is crucial to increase vaccine uptake. Several systematic reviews suggest that vaccination against a variety of diseases (i.e., pneumococcal disease, varicella, tuberculosis) is a cost-effective or cost-saving intervention [ 113 , 114 , 115 , 116 ]. Additionally, a recent systematic review showed that the COVID-19 vaccination program appears to be a cost-effective or cost-saving intervention [ 117 ].…”

Section: Discussionmentioning

confidence: 99%

Psychosocial Predictors of COVID-19 Vaccine Uptake among Pregnant Women: A Cross-Sectional Study in Greece

et al. 2023

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An understanding of the factors associated with the COVID-19 vaccine uptake in pregnant women is paramount to persuade women to get vaccinated against COVID-19. We estimated the vaccination rate of pregnant women against COVID-19 and evaluated psychosocial factors associated with vaccine uptake among them. We conducted a cross-sectional study with a convenience sample. In particular, we investigated socio-demographic data of pregnant women (e.g., age, marital status, and educational level), COVID-19 related variables (e.g., previous COVID-19 diagnosis and worry about the side effects of COVID-19 vaccines), and stress due to COVID-19 (e.g., danger and contamination fears, fears about economic consequences, xenophobia, compulsive checking and reassurance seeking, and traumatic stress symptoms about COVID-19) as possible predictors of COVID-19 vaccine uptake. Among pregnant women, 58.6% had received a COVID-19 vaccine. The most important reasons that pregnant women were not vaccinated were doubts about the safety and effectiveness of the COVID-19 vaccines (31.4%), fear that COVID-19 vaccines could be harmful to the fetus (29.4%), and fear of adverse side effects of COVID-19 vaccines (29.4%). Increased danger and contamination fears, increased fears about economic consequences, and higher levels of trust in COVID-19 vaccines were related with vaccine uptake. On the other hand, increased compulsive checking and reassurance seeking and increased worry about the adverse side effects of COVID-19 vaccines reduced the likelihood of pregnant women being vaccinated. An understanding of the psychosocial factors associated with increased COVID-19 vaccine uptake in pregnant women could be helpful for policy makers and healthcare professionals in their efforts to persuade women to get vaccinated against COVID-19. There is a need for targeted educational campaigns to increase knowledge about COVID-19 vaccines and reduce vaccine hesitancy in pregnancy.

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“…In children younger than 5 years of age, the number of PD cases in China ranks second in the world, accounting for 12% of the total cases worldwide [3]. Evidence shows significant vaccine effectiveness against PD [4][5][6][7][8][9],and economic evaluation studies show that vaccination is cost-effective [10][11][12][13]. Immunisation by pneumonia vaccine may reduce the increasing incidence of multidrug-resistance and cross-resistance due to the widespread use of antibiotics [14].…”

Section: Introductionmentioning

confidence: 99%

Pneumococcal vaccination coverage and willingness in mainland China

Shao

Chen

Zheng

et al. 2022

Tropical Med Int Health

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Objectives To estimate the coverage and willingness of pneumococcal vaccination and further explore the influencing factors of vaccination willingness among people in mainland China. Methods Literature searches were conducted independently by two researchers in English‐ and Chinese‐language databases from database inception to 6 October 2021. A random‐effects meta‐analysis model was used to derive summary vaccination coverage and willingness. Predefined subgroup analysis and meta‐regression were performed to explore the sources of heterogeneity. Results A total of 97 studies were included in this meta‐analysis. The summary vaccination coverage in 76 included studies was 21.7% (95% confidence interval [CI]: 17.2%–26.5%). Subgroup analysis shows that the summary coverage was 29.0% (95% CI, 20.4%–39.1%) among the permanent residents and 20.7% (95% CI, 12.4%–35.9%) among the floating residents. The eastern and central regions presented higher coverage than the western region. Notable differences were observed between the various study populations. A total of 27 studies provided an estimation of vaccination willingness, with a summary willingness of 51.2% (95% CI, 40.4%–61.9%). In subgroup analysis, the summary willingness was 57.9% (95% CI, 48.3%–67.2%) in urban areas and 52.3% (95% CI, 40.8%–63.8%) in rural areas. Parents with children and people with a history of pneumonia were more willing to be vaccinated than the elderly. Recommendations by family members and physicians, previous pneumococcal and influenza vaccination, perceived vaccination effectiveness and severity of disease and a history of pneumonia contributed to vaccination willingness. Conclusions Compared to global estimates and other countries, pneumococcal vaccination coverage and willingness are at a lower level in mainland China. Recommendations for vaccination by family members and doctors, a history of vaccination and the perception of pneumonia and vaccination are associated with greater willingness to be vaccinated.

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Pneumococcal Vaccination for Children in Asian Countries: A Systematic Review of Economic Evaluation Studies

Cited by 11 publications

References 63 publications

Cost-Effectiveness and Budget Impact Analyses of Pneumococcal Vaccination in Indonesia

Cost-Effectiveness and Budget Impact Analyses of Pneumococcal Vaccination in Indonesia

Psychosocial Predictors of COVID-19 Vaccine Uptake among Pregnant Women: A Cross-Sectional Study in Greece

Pneumococcal vaccination coverage and willingness in mainland China

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