Age,revaccination, and tolerance effects on pneumococcal vaccination strategies in the elderly: A cost-effectiveness analysis |
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| Authors: | Kenneth J. Smith Richard K. Zimmerman Mary Patricia Nowalk Mark S. Roberts |
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| Affiliation: | 1. Section of Decision Sciences and Clinical Systems Modeling, University of Pittsburgh, Pittsburgh, PA, USA;2. Department of Family Medicine and Clinical Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA;3. School of Medicine, Department of Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, PA, USA;4. Department of Health Policy and Management, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA;5. Department of Industrial Engineering, University of Pittsburgh, Pittsburgh, PA, USA |
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| Abstract: | ![]()
Optimal pneumococcal polysaccharide vaccination (PPV) policy is unknown for cohorts aged ≥65 years. Using a Markov model, we estimated the cost-effectiveness of single- and multiple-dose PPV strategies in 65-, 75-, and 80-year-old cohorts. PPV at age 65 cost $26,100 per QALY (quality adjusted life years) gained. Vaccination at ages 75 and 80 cost $71,300–75,800 per QALY; revaccination strategies cost more. When prior vaccination and loss of vaccine effectiveness due to tolerance are assumed, cost-effectiveness ratios increase substantially. Single-dose PPV is worth considering in patients aged 65–80 from clinical and economic standpoints. Revaccination strategies for the elderly are less cost-effective, particularly when prior vaccination and vaccine tolerance are considered. |
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| Keywords: | Pneumococcal vaccines Pneumococcal infections Cost-effectiveness analysis |
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