Estimating costs and health outcomes of publicly funded tick-born encephalitis vaccination: A cost-effectiveness analysis

Shedrawy, Jad; Henriksson, Martin; Hergens, Maria-Pia; Askling, Helena H.

doi:10.1016/j.vaccine.2018.10.086

Cited by 19 publications

(11 citation statements)

References 29 publications

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“…While I. canisuga is not important regarding disease transmission, both I. ricinus and I. hexagonus are confirmed vectors for spirochetes of the Borrelia burgdorferi sensu lato complex and, as well as D. reticulatus , for tick-borne encephalitis (TBE) virus. These two pathogens represent the most important tick-borne diseases in Europe, substantially impacting Health systems (Khatchikian et al 2015 ; Lohr et al 2015 ; Shedrawy et al 2018 ). Additionally, dogs and horses may suffer from both pathogens (Klaus et al 2013 ; Pfeffer and Dobler 2011 ; Waldvogel et al 1981 ).…”

Section: Discussionmentioning

confidence: 99%

Predators in northern Germany are reservoirs for parasites of One Health concern

et al. 2021

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Urbanisation and invasion of wildlife into urban areas as well as human leisure activities create diverse wildlife-domestic animal-human interfaces, increasing the risk of (zoonotic) parasite spillover from sylvatic to domestic and synanthropic cycles. This study investigated the endo- and ectoparasite fauna, emphasising on parasites of One Health Concern, of the most common predators in northern Germany between November 2013 and January 2016. Eighty red foxes (Vulpes vulpes), 18 stone martens (Martes foina) and nine raccoon dogs (Nyctereutes procyonoides) were available for the study. Overall, 79 (73.8%) of the examined predators (n=107) harboured at least one endoparasite. The most frequently detected endoparasites in red foxes were Toxocara canis (43.8% positive individuals), Capillaria spp. (36.3%), Alaria alata (25.0%), Echinococcus multilocularis (26.3%) and Uncinaria stenocephala (25.0%). Furthermore, Toxascaris leonina, Trichuris vulpis, Taenia ssp., Mesocestoides spp. and coccidian oocysts were observed. The endoparasite species richness in raccoon dogs was comparable to red foxes, while in stone martens, only Capillaria spp. were found. Muscle digestion for detection of Trichinella spp. and antigen testing for Giardia spp. did not show positive results. Ectoparasite analyses revealed infestations with ticks species of the genus Ixodes as well as Dermacentor reticulatus. Scabies mites were not present in digested skin samples, while Demodex spp. mites were observed by faecal flotation in one red fox. Furthermore, fleas (Archaeopsylla erinacei and Chaetopsylla globiceps) were observed in the fur of red foxes, while lice were not present in any predator species. However, infestation frequency with ectoparasites was with 19.2% generally low in available predator skins (n=99). Overall, the present study showed that predators in northern Germany serve as reservoirs for parasites of One Health concern, with four of the five most frequent endoparasites being zoonotic, highlighting the need of parasite surveillance in wildlife predators in order to implement measures avoiding spillovers to domestic animals and humans.

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Section: Discussionmentioning

confidence: 99%

Predators in northern Germany are reservoirs for parasites of One Health concern

et al. 2021

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“…In Europe, only Austria has implemented a national universal TBE vaccination program targeting the entire population, resulting in a pronounced decrease in TBE incidence ( 18 , 19 ). The growing incidence of TBE has stimulated discussion regarding the need for public vaccination programs in Sweden ( 20 , 21 ) and other countries in Europe ( 22 – 24 ), but thorough data concerning the burden of TBE are needed to determine cost-effectiveness.…”

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confidence: 99%

Burden of Tick-Borne Encephalitis, Sweden

Slunge¹,

Boman²,

Studahl³

2022

Emerg. Infect. Dis.

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In recent decades, the incidence of tick-borne encephalitis (TBE) in Sweden has increased. To calculate the burden of disease over a 17-year period, we analyzed data from the Swedish National Health Data Register for TBE cases diagnosed during 1998–2014. We compared healthcare use and sick leave associated with 2,429 persons with TBE with a referent cohort of 7,287 persons without TBE. Patients with TBE were hospitalized for significantly more days during the first year after disease onset (11.5 vs. 1.1 days), logged more specialist outpatient visits (3.6 vs. 1.2 visits), and logged more sick leave days (66 vs. 10.7 days). These differences generally increased over time. The case-fatality rate for TBE was 1.1%. Our calculated cost of TBE to society provides a baseline for decisions on immunization programs. Analyzing register data, our study adds to clinical studies of smaller cohorts and model-based studies that calculate disease burden.

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“…Since antibody levels decrease faster in the elderly (236,237,240), some countries recommend shorter booster intervals for several routine vaccines (diphtheria, tetanus, pertussis, hepatitis B, tick-borne encephalitis) for older adults (238). However, primary vaccination schedules are usually not adapted for older adults, with the exception of a 3 + 1 scheme for tick-borne encephalitis vaccination in Sweden for those over 50 years (239). Additionally, more data are required on how primary and booster vaccinations perform in older patients with underlying chronic diseases that could result in lower vaccine responses and therefore protection.…”

Section: Discussionmentioning

confidence: 99%

Vaccines to Prevent Infectious Diseases in the Older Population: Immunological Challenges and Future Perspectives

Wagner

Weinberger

2020

Front. Immunol.

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Infectious diseases are a major cause for morbidity and mortality in the older population. Demographic changes will lead to increasing numbers of older persons over the next decades. Prevention of infections becomes increasingly important to ensure healthy aging for the individual, and to alleviate the socioeconomic burden for societies. Undoubtedly, vaccines are the most efficient health care measure to prevent infections. Age-associated changes of the immune system are responsible for decreased immunogenicity and clinical efficacy of most currently used vaccines in older age. Efficacy of standard influenza vaccines is only 30-50% in the older population. Several approaches, such as higher antigen dose, use of MF59 as adjuvant and intradermal administration have been implemented in order to specifically target the aged immune system. The use of a 23-valent polysaccharide vaccine against Streptococcus pneumoniae has been amended by a 13-valent conjugated pneumococcal vaccine originally developed for young children several years ago to overcome at least some of the limitations of the T cell-independent polysaccharide antigens, but still is only approximately 50% protective against pneumonia. A liveattenuated vaccine against herpes zoster, which has been available for several years, demonstrated efficacy of 51% against herpes zoster and 67% against post-herpetic neuralgia. Protection was lower in the very old and decreased several years after vaccination. Recently, a recombinant vaccine containing the viral glycoprotein gE and the novel adjuvant AS01B has been licensed. Phase III studies demonstrated efficacy against herpes zoster of approx. 90% even in the oldest age groups after administration of two doses and many countries now recommend the preferential use of this vaccine. There are still many infectious diseases causing substantial morbidity in the older population, for which no vaccines are available so far. Extensive research is ongoing to develop vaccines against novel targets with several vaccine candidates already being clinically tested, which have the potential to substantially reduce health care costs and to save many lives. In addition to the development of novel and improved vaccines, which specifically target the aged immune system, it is also important to improve uptake of the existing vaccines in order to protect the vulnerable, older population.

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Estimating costs and health outcomes of publicly funded tick-born encephalitis vaccination: A cost-effectiveness analysis

Cited by 19 publications

References 29 publications

Predators in northern Germany are reservoirs for parasites of One Health concern

Predators in northern Germany are reservoirs for parasites of One Health concern

Burden of Tick-Borne Encephalitis, Sweden

Vaccines to Prevent Infectious Diseases in the Older Population: Immunological Challenges and Future Perspectives

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