Related Experiment Video
Updated: Feb 7, 2026
Investigating the Effects of Probiotics on Pneumococcal Colonization Using an In Vitro Adherence Assay
Published on: April 28, 2014
Estimating the cost-effectiveness of an infant 13-valent pneumococcal conjugate vaccine national immunization program
Kunling Shen1, Matthew Wasserman2, Dongdong Liu3
1Department of Respiratory Diseases, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
Insights
Introducing the 13-valent pneumococcal conjugate vaccine (PCV13) into China's national immunization program offers significant clinical and economic benefits. This vaccine is cost-effective, preventing numerous deaths and improving quality of life through herd protection.
Area of Science:
- Public Health
- Vaccinology
- Health Economics
Background:
- Pneumococcal disease poses a significant health burden in China.
- The 13-valent pneumococcal conjugate vaccine (PCV13) is approved for infants in China.
- Broad availability via a national immunization program (NIP) is crucial for maximizing societal benefits.
Purpose of the Study:
- To estimate the clinical and economic advantages of integrating PCV13 into China's NIP.
- To account for vaccine uptake variations and indirect (herd protection) effects.
- To utilize local cost data for a comprehensive analysis.
Main Methods:
- A population model was developed to simulate PCV13 introduction in China.
- Health states included meningitis, bacteremia, pneumonia, otitis media, death, and sequelae.
- Data on disease incidence and healthcare costs were sourced from Chinese databases and literature.
Main Results:
- PCV13 introduction is projected to gain substantial quality-adjusted life years (QALYs) and avert thousands of deaths.
- Inclusion of indirect effects (herd protection) significantly amplifies these benefits.
- Net costs are favorable, with cost reductions from prevented diseases offsetting vaccination expenses.
- Cost-effectiveness ratios are well below the 2x China GDP threshold across various vaccine prices.
Conclusions:
- Implementing a PCV13 NIP in China involves initial investment but offers excellent value for money.
- The program is expected to substantially reduce disease incidence in both vaccinated children and unvaccinated individuals.
- Widespread PCV13 adoption is a sound public health and economic strategy for China.
Background:
The burden of pneumococcal disease in China is high, and a 13-valent pneumococcal conjugate vaccine (PCV13) recently received regulatory approval and is available to Chinese infants. PCV13 protects against the most prevalent serotypes causing invasive pneumococcal disease (IPD) in China, but will not provide full societal benefits until made broadly available through a national immunization program (NIP).
Objective:
To estimate clinical and economic benefits of introducing PCV13 into a NIP in China using local cost estimates and accounting for variability in vaccine uptake and indirect (herd protection) effects.
Methods:
We developed a population model to estimate the effect of PCV13 introduction in China. Modeled health states included meningitis, bacteremia, pneumonia (PNE), acute otitis media, death and sequelae, and no disease. Direct healthcare costs and disease incidence data for IPD and PNE were derived from the China Health Insurance and Research Association database; all other parameters were derived from published literature. We estimated total disease cases and associated costs, quality-adjusted life years (QALYs), and deaths for three scenarios from a Chinese Payer Perspective: (1) direct effects only, (2) direct+indirect effects for IPD only, and (3) direct+indirect effects for IPD and inpatient PNE.
Results:
Scenario (1) resulted in 370.3 thousand QALYs gained and 12.8 thousand deaths avoided versus no vaccination. In scenarios (2) and (3), the PCV13 NIP gained 383.2 thousand and 3,580 thousand QALYs, and avoided 13.1 thousand and 147.5 thousand deaths versus no vaccination, respectively. In all three scenarios, the vaccination cost was offset by cost reductions from prevented disease yielding net costs of ¥29,362.32 million, ¥29,334.29 million, and ¥13,524.72 million, respectively. All resulting incremental cost-effectiveness ratios fell below a 2x China GDP cost-effectiveness threshold across a range of potential vaccine prices.
Discussion:
Initiation of a PCV13 NIP in China incurs large upfront costs but is good value for money, and is likely to prevent substantial cases of disease among children and non-vaccinated individuals.
Related Concept Videos
01:51Vaccinations
02:50Conjugated Proteins
Nucleoproteins are protein complexes that contain nucleic acids, categorized as deoxyribonucleoproteins (DNPs) or ribonucleoproteins (RNPs) respectively. The nucleosome is a typical example of a DNP where nuclear DNA is associated with histone proteins. The major antigen for the Covid-19 virus SARS-CoV is an RNP that is critical...
01:26National Nursing Organizations I
01:30National Nursing Organizations II
The AACN emphasizes a healthy work environment through six standards to achieve an optimal patient outcome. The standards are appropriate staffing, meaningful recognition, collaboration, authentic leadership, effective communication, and decision-making. In addition, AACN provides certification programs, webinars, journals, and...
01:38What is the Immune System?
02:19Buffer Effectiveness
The buffer capacity is the amount of acid or base that can be added to a given volume...