Meningococcal Serogroup A, C, W-135 and Y Conjugated Vaccine:A Cost-Effectiveness Analysis in the Netherlands

Background: In 2002, vaccination with a serogroup C meningococcal conjugate vaccine (MenC) was introduced in the Netherlands for all children aged 14 months. Despite its success, herd immunity may wane over time. Recently, a serogroup A,C,W-135, Y meningococcal conjugate vaccine (MenACWY) was licensed for use in subjects of 12 months of age and above. Objectives: To evaluate the cost-effectiveness of meningococcal vaccination at 14 months and an additional vaccination at the age of 12 years, both with the MenACWY vaccine. Methods: A decision analysis cohort model, with 185,000 Dutch newborns,... Mehr ...

Verfasser: Hepkema, Hiltsje
Pouwels, Koen B.
van der Ende, Arie
Westra, Tjalke A.
Postma, Maarten J.
Dokumenttyp: Artikel
Erscheinungsdatum: 2013
Reihe/Periodikum: Hepkema , H , Pouwels , K B , van der Ende , A , Westra , T A & Postma , M J 2013 , ' Meningococcal Serogroup A, C, W-135 and Y Conjugated Vaccine : A Cost-Effectiveness Analysis in the Netherlands ' , PLoS ONE , vol. 8 , no. 5 , e65036 . https://doi.org/10.1371/journal.pone.0065036
Schlagwörter: HERD-IMMUNITY / UNITED-STATES / DISEASE / IMMUNIZATION / PROGRAMS / IMPACT / CARRIAGE / ENGLAND / AGE
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-29192895
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : https://hdl.handle.net/11370/fad413e3-c35d-4148-a95b-e15c9c676a82

Background: In 2002, vaccination with a serogroup C meningococcal conjugate vaccine (MenC) was introduced in the Netherlands for all children aged 14 months. Despite its success, herd immunity may wane over time. Recently, a serogroup A,C,W-135, Y meningococcal conjugate vaccine (MenACWY) was licensed for use in subjects of 12 months of age and above. Objectives: To evaluate the cost-effectiveness of meningococcal vaccination at 14 months and an additional vaccination at the age of 12 years, both with the MenACWY vaccine. Methods: A decision analysis cohort model, with 185,000 Dutch newborns, was used to evaluate the cost-effectiveness of different immunization strategies. For strategies including a vaccination at 12 years of age, an additional cohort with adolescents aged 12 years was followed. The incremental cost-effectiveness ratio (ICER) was estimated for the current disease incidence and for a scenario when herd immunity is lost. Results: Vaccination with MenACWY at 14 months is cost-saving. Vaccinating with MenACWY at 14 months and at 12 years would prevent 7 additional cases of meningococcal serogroup A, C, W-135, Y disease in the birth cohort and adolescent cohort followed for 99 years compared to the current vaccine schedule of a single vaccination with MenC at 14 months. With the current incidence, this strategy resulted in an ICER of (sic)635,334 per quality adjusted life year. When serogroup C disease incidence returns to pre-vaccination levels due to a loss of vaccine-induced herd-immunity, vaccination with MenACWY at 14 months and at 12 years would be cost-saving. Conclusions: Routine vaccination with MenACWY is cost-saving. With the current epidemiology, a booster-dose with MenACWY is not likely cost-effective. When herd immunity is lost, a booster-dose has the potential of being cost-effective. A dynamic model should be developed for more precise estimation of the cost-effectiveness of the prevention of disappearance of herd immunity.