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Value of pneumococcal vaccination in controlling the development of antimicrobial resistance (AMR): Case study using
Sachiko Ozawa1, Hui-Han Chen2, Gauri G Rao3
1Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA; Department of Maternal and Child Health, UNC Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
Background:
Antimicrobial resistance (AMR) poses an imminent threat to global health security. Pneumococcal vaccination reduces disease incidence, prevents antibiotic use, and decreases antibiotic-resistant infections. However, the benefit of vaccination in reducing AMR has been poorly quantified to date.
Methods:
We developed an agent-based model, DREAMR (Dynamic Representation of the Economics of AMR) to evaluate the economic value of childhood immunization with the pneumococcal conjugate vaccine (PCV) in mitigating the development of AMR. Our model incorporates vaccination coverage, disease incidence, care seeking, and antibiotic use. Accumulation of AMR is simulated based on antibiotic exposure through pharmacokinetics and resulting pharmacodynamics. The model was applied to Ethiopia.
Results:
Introduction of PCV vaccination has helped slow the development of AMR by 14.77% for amoxicillin and 0.59% for ceftriaxone in Ethiopia since 2011. In addition to the benefit of reduction in disease incidence, PCV vaccination has averted approximately 718,100 antibiotic treatment failures and 9,520 AMR-related deaths (27.8% reduction) in Ethiopia between 2011 and 2017, resulting in savings of $32.7 million. Maintaining current PCV immunization coverage will contribute an additional $7.67 million in annual AMR cost savings over five years compared to no vaccination scenario, which could increase to $11.43 million by increasing PCV coverage to 85% by 2022.
Conclusions:
This study is the first to demonstrate the broader economic value of pneumococcal vaccination in controlling the development of AMR in Africa. Vaccination not only saves lives by preventing illnesses, but also benefits society by reducing antibiotic utilization and treatment failures due to AMR.
Insights
Pneumococcal conjugate vaccine (PCV) significantly slows antimicrobial resistance (AMR) development and averts millions in healthcare costs. This vaccination strategy is crucial for global health security by reducing antibiotic use and AMR-related deaths.
Area of Science:
- Global Health Security
- Infectious Disease Epidemiology
- Health Economics
Background:
- Antimicrobial resistance (AMR) presents a critical global health threat.
- Pneumococcal vaccination is known to reduce disease incidence, antibiotic use, and resistant infections, but its impact on AMR has been underestimated.
- Quantifying the precise benefit of vaccination in mitigating AMR is essential for public health policy.
Purpose of the Study:
- To evaluate the economic value of childhood immunization with the pneumococcal conjugate vaccine (PCV) in mitigating AMR development.
- To quantify the impact of PCV on AMR accumulation and associated healthcare costs.
- To assess the cost-effectiveness of maintaining and increasing PCV coverage in Ethiopia.
Main Methods:
- Development of an agent-based model, DREAMR (Dynamic Representation of the Economics of AMR).
- Incorporation of key parameters: vaccination coverage, disease incidence, care-seeking behavior, and antibiotic utilization.
- Simulation of AMR accumulation based on antibiotic exposure, pharmacokinetics, and pharmacodynamics, applied to the Ethiopian context.
Main Results:
- PCV introduction slowed AMR development by 14.77% for amoxicillin and 0.59% for ceftriaxone in Ethiopia since 2011.
- PCV vaccination averted approximately 718,100 antibiotic treatment failures and 9,520 AMR-related deaths between 2011 and 2017, saving $32.7 million.
- Maintaining current PCV coverage offers projected annual AMR cost savings of $7.67 million, potentially increasing to $11.43 million with 85% coverage by 2022.
Conclusions:
- This study provides the first evidence of the extensive economic value of pneumococcal vaccination in controlling AMR in Africa.
- Vaccination offers dual benefits: preventing illness and reducing antibiotic consumption and treatment failures linked to AMR.
- Pneumococcal vaccination is a vital strategy for enhancing health security and economic well-being by combating AMR.
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