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Evaluation of pre-school pertussis booster vaccination in Shanghai, China: A cost-effectiveness analysis
Jia Ren1, Zhuoying Huang1, Jie Tian2
1Department of Immunization, Shanghai Municipal Center of Disease Control and Prevention, Shanghai 200336, China.
Insights
A booster dose of acellular pertussis vaccine for 6-year-olds is a cost-saving strategy. This immunization improves health outcomes and reduces overall healthcare expenses in Shanghai.
Area of Science:
- Public Health
- Vaccinology
- Health Economics
Background:
- Rising pertussis cases in China necessitate immunization strategy optimization.
- Pertussis poses a significant public health concern, especially for young children.
- Evaluating cost-effectiveness of pertussis vaccination is crucial for public health policy.
Purpose of the Study:
- To determine the cost-effectiveness of different pertussis immunization strategies.
- To compare a 6-year-old acellular pertussis booster vaccine with no booster.
- To inform immunization policy for pre-school children in Shanghai.
Main Methods:
- A Markov-decision tree model was employed for analysis.
- Two strategies were evaluated: a 6-year-old acellular pertussis (aP) booster vs. no booster.
- The study adopted a societal perspective over a 14-year period, measuring QALYs and costs.
Main Results:
- The aP booster strategy resulted in cost savings of CNY 814.16 per individual.
- This strategy also increased quality-adjusted life years (QALYs) by 0.00066 per person.
- Overall, the booster strategy led to significant cost reductions and utility gains for Shanghai.
Conclusions:
- Administering an acellular pertussis booster at age 6 is a cost-saving immunization strategy.
- This approach offers both economic benefits and improved health outcomes.
- The findings support optimizing pertussis vaccination schedules for pre-school children.
Background:
In recent years, notified pertussis cases have been increasingly documented in China. It raised a new public health concern of potential optimization in immunization strategy. This study was aimed to determine the cost-effectiveness of different immunization strategies against pertussis-containing vaccines for 6-year-old pre-school children in Shanghai.
Methods:
A Markov-decision tree model was applied to evaluate two pertussis immunization strategies for 6-year-old pre-school children as following: (1) 1 dose of acellular pertussis (aP) contained vaccine (DTaP or Tdap) booster vaccinated at 6 years of age, and (2) no booster at 6 years of age regimen. Primary outcomes included quality-adjusted life years (QALYs), costs, and incremental cost-utility ratios (ICUR). Sensitivity analyses were performed. The analysis was conducted over a study period of 14 years from a societal perspective.
Results:
Compared to no booster immunization strategy, administering 1 dose of acellular pertussis (aP) contained vaccine (DTaP or Tdap) booster at 6 years of age, resulted in an average cost reduction of CNY 814.16 (USD 116) per individual, an increase in QALYs by 0.00066, and a rise in per capita net monetary benefit (NMB) by CNY 933.51 (USD 132). The total costs over the study period were reduced by CNY 160.59 million (USD 23 million), utility increased by 130.49 QALYs, and NMB increased by CNY 184.14 million (USD 26 million).
Conclusions:
Implementing acellular pertussis booster immunization for 6-year-old pre-school children in Shanghai emerges as a cost-saving immunization strategy, with both cost savings and utility gains.
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