Economic evaluation of adolescents and adults’ pertussis vaccination: A systematic review of current strategies

Abstract

The reemergence of pertussis in the last two decades led to the introduction of adolescents and adults immunization strategies of tetanus-diphtheria-acellular pertussis vaccines (Tdap) in several countries. The health authorities must consider economic aspects when deciding to recommend and fund new programs. Here we present a systematic review of worldwide full economic evaluations of pertussis vaccination targeting adolescents or adults published from 2000. Studies were identified by searching MEDLINE, Excerpta Medica, CRD, and Lilacs databases. Twenty-seven economic evaluations of different strategies with Tdap were identified. Booster vaccination for adolescents and adults were the most frequent, followed by cocooning and pregnant women vaccination. Strategies performance varied considerably among different studies. Assumptions regarding underreporting correction, herd protection and vaccine coverage were crucial to cost-effectiveness results. Understanding the model and the parameters used is essential to understand the results, and identify the major issues important to public health decisions.

Modeling the cost-effectiveness of maternal acellular pertussis immunization (aP) in different socioeconomic settings: A dynamic transmission model of pertussis in three Brazilian states

“…In agreement with other modeling and economic studies of pertussis resurgence and alternative vaccination strategies [14] , [46] , we found the reporting probability to be the most influential parameter. An analysis from the United States found that differences in the reporting probability (or reporting rate as it is usually denominated) implied a change in the decision whether or not to adopt maternal vaccination [8] .…”

“…In addition, some aspects of pertussis natural history and the impact of vaccines, such as boosting or blunting of immunity from maternal antibodies, were not considered. Importantly, and following the recommendations highlighted in three reviews of economic analyses of pertussis vaccination strategies [46] , [56] , [57] , limited understanding of important aspects of pertussis epidemiology suggests caution when extrapolating our results. More studies are needed to better inform the relationship between infection and case notification, the duration of immunity conferred by infection and vaccines, and how boosting of immunity may result from silent infections.…”

Recommending immunizations to adolescents in Turkey: a study of the knowledge, attitude, and practices of physicians

“…24 A review of 27 studies found that the vaccine was also cost-effective in this population. 26 The present study found that nearly half of family physicians and pediatricians did not routinely recommend the Tdap vaccine for adolescents. The three most common reasons for not recommending the vaccine were a lack of knowledge, the conviction that childhood immunization against pertussis was sufficient, and the belief that pertussis was not seen in adolescents.…”

Knowledge, Attitude and Practice Regarding Pertussis among a Public University Students in Malaysia

“…One Malaysian study reported that reduced availability of information and awareness about adult booster dose of pertussis vaccination might be because such a vaccine program has not funded and subsidized by the Malaysian government [37]. On the contrary, there are several rich countries subsidizes adult pertussis booster vaccine programs [38][39][40], as subsidy for vaccine ensures vaccine awareness and vaccination.…”