Policy analysis of the use of hepatitis B, Haemophilus influenzae type b‐, Streptococcus pneumoniae‐conjugate and rotavirus vaccines in national immunization schedules

Abstract

SUMMARYAfter the development of national vaccine programmes to deliver six vaccines to infants, new vaccine adoption has been limited. Analysis of the health and economic implications of new vaccination options can help national policy-makers.Country specific quantitative policy analyses were conducted to estimate the impact of vaccination against hepatitis B (HB), Haemophilus influenzae type b (Hib), Streptococcus pneumoniae (SP) and rotavirus. Disease burden, programme costs and the potential reduction of disease from vaccination was assessed for each vaccine.Without vaccination, these four vaccine preventable diseases contribute up to 4.1 million deaths in each successive birth cohort. Routine scheduled use of HB and Hib vaccines could prevent up to 1.7 million deaths; SP and rotavirus vaccines, an additional 1.4 million deaths, annually. The global cost per life-year saved ranged from $29 to $150 with great variation by income and economic groups.With a few exceptions for a few countries, these vaccines would cost a fraction of average per-capita gross domestic product to save a life-year. The addition of HB and Hib vaccines, should be considered for integration in all national immunization programmes. SP and rotavirus vaccines, with the given assumptions, would also be cost-effective. Proactive analysis of the economic and epidemiologic impact of these vaccines can hasten their introduction into national vaccination schedules.

Explaining global network emergence and nonemergence: Comparing the processes of network formation for tuberculosis and pneumonia

“…Without strong and coordinated voices to advocate on its behalf, pneumonia remained overlooked in the development and creation of Millennium Development Goal 4, failed to factor into global efforts against HIV/AIDs, and was even mostly overlooked during the first 4 years of Global Alliance for Vaccines and Immunizations (Interviews P4, P8, P22). Left out of these major changes in global health attention and funding, despite new evidence of pneumonia's severity and tractability (Black et al, ; Black, Morris, & Bryce, ; Bryce et al, ; Miller & McCann, ; Pio, ; Sazawal & Black, ), individuals concerned with pneumonia saw a need to establish themselves as a network (Interviews P1, P10, P14). Almost a decade after the global TB network re‐formed, WHO and UNICEF re‐emerged from their focus on integrated programs (Interviews P9, P20, P22) to take pneumonia leadership roles via a joint statement (UNICEF and WHO, ), report (UNICEF, ), and informal consultations to develop a global action plan (WHO et al, ; WHO and UNICEF, ; Interviews P1, P2, P3, P4, P12, P19, P22).…”

The cost of treatment for child pneumonias and meningitis in the Northern Areas of Pakistan

“…In addition to length of stay, diagnostic procedures, and personnel time also contribute to higher costs. The high cost for hospitalization also argues for the introduction of cost-effective vaccines to prevent the specific agents responsible for causing pneumonia in this area (Levine et al, 1993;Hussey et al, 1995;Miller and McCann, 2000;Limcangco et al, 2001). The cost-effectiveness of Hib immunization programs has been estimated to be $1,448 per life saved in low-income countries.…”

Relación costo-efectividad de la vacuna contra Haemophilus influenzae tipo b en niños menores de dos años de edad en Colombia

“…Por ello, al utilizar el número de años de vida salvados como medida de efectividad en el caso de enfermedades inmunoprevenibles de baja letalidad, se puede subestimar la relación costoefectividad de dicho programa. La vacuna contra Hib ha sido evaluada económicamente utilizando esta medida de efectividad, en especial en países desarrollados (29)(30)(31)(32)(33).…”