Capturing the value of vaccination: impact of vaccine-preventable disease on hospitalization

Abstract

Evidence from epidemiological studies suggests that vaccine-preventable disease (VPD) such as influenza or herpes zoster contribute significantly to the increased risk of older adults for cardiovascular, cerebrovascular, neurological, and renal complications in the period after illnesses. However, since the period of elevated risk can persist well beyond the duration of the acute illness, the connection is not always recognized. To obtain insights into the relationship between diagnoses for vaccine-preventable disease and for other conditions, we analyzed principal and secondary diagnoses for 3,127,768 inpatient admissions of adults 50 years and older in the United States, using medical insurance claims drawn from the IBM® MarketScan® Research Databases (Marketscan). The Marketscan data indicated that overall, 3.1% of these hospitalizations had a principal diagnosis of VPD with variation by month of admission, and age. However, hospitalizations with a principal non-VPD diagnosis but secondary VPD diagnoses were 2.8 times more frequent, with particularly high rates in those whose principal diagnoses were non-VPD respiratory or circulatory disease. Hospitalized patients with a secondary VPD diagnosis tended to have poorer discharge outcomes, and longer length of stay in comparison to hospitalized patients without a secondary VPD diagnosis. In total, these data are consistent with suggestions that VPDs play a significant and potentially under-estimated role in hospitalization and outcomes, which may be potentially preventable by improved vaccination coverage.

Rule of Prevention: a potential framework to evaluate preventive interventions for rare diseases

“…Inclusion of a broad range of value elements in HTA/CEA frameworks is likely to introduce uncertainty surrounding the supporting evidence available, given the current lack of data or quantification methods for some value elements. Thirdly, challenges exist relating to the valuation of prevention versus treatment, especially prevention of rare diseases, e.g., there is residual and variable uncertainty regarding the consequences of failing to prevent disease, including impacts on long-term individual health, increases in antimicrobial resistance, reductions in hospital capacity to treat illnesses, and others [ 32 , 33 ].…”

The Burden of Cervical Conization in Privately Insured Young and Mid-Adult Women in the United States

“…Following individuals longitudinally across decades requires them to be continuously enrolled in an insurance plan with the same employer for the entire duration. However, this is hardly the case and thus presents a limitation inherent to database studies-the lack of complete medical histories [58]. Our study would have greatly benefitted from the information on the HPV vaccination status and, consequently, the vaccine's impact on the conization burden.…”

Dementia, infections and vaccines: 30 years of controversy

“…Finally, considering the unanswered questions highlighted by current research, we suggest some avenues for future research in elucidating the link between infection and dementia. Without a doubt, improving uptake of vaccination against key vaccine-preventable diseases is an attractive and inexpensive means to lower the burden of infectious disease, and its attendant consequences, in older populations [ 1 – 4 ].…”