PMU57 - COST-EFFECTIVENESS OF VACCINATION STRATEGIES TO PREVENT INFECTIOUS DISEASES: A SYSTEMATIC LITERATURE REVIEW

Abstract

Objectives: Vaccination is a crucial public health strategy, particularly when considering paediatric immunisation programmes. Cost-effectiveness, in conjunction with clinical effectiveness, are key criteria for determining population access to vaccination programmes. Our aim was to provide an overview of recent economic analyses around vaccines against diphtheria, tetanus, pertussis, hepatitis B (Hep B), poliomyelitis and Haemophilus influenzae type b (Hib). Method(s): Systematic searches for publications on economic analyses around vaccinations for the diseases listed were conducted in September 2017, in Embase, MEDLINE, Cochrane Library, four key conferences (2015-2017), by hand-searching references of included publications, and additional sources/websites. English-language publications from 2012 onwards, without country-restriction, were included. Result(s): Of the 7,659 publications identified, 43 fulfilled the inclusion criteria. Sixteen publications were on Hib, 14 on Hep B, 12 on pertussis, and one on poliomyelitis vaccines. Four studies (US, Asia, and Africa) found that a birth dose of Hep B vaccine, or of Hep B immunoglobulin, were cost-effective measures to prevent perinatal transmission. Infant, adult, and catch-up Hep B vaccination schemes were found to be cost-effective in five studies (Asia). To prevent infant pertussis infections, cocooning or vaccination of pregnant women was only cost-effective under specific circumstances (n=4). For pertussis vaccination in adolescents, evidence is conflicting: a Japanese and US study found it only cost-effective under certain conditions, whereas a Dutch study came to a favourable conclusion. US studies in adults/older adults, found booster vaccinations to be cost-effective. In low- and middle-income countries, childhood Hib vaccination is considered cost-effective or cost-saving (n=7). Conclusion(s): The cost-effectiveness of childhood vaccinations has been tested in different settings and regions and is consistently considered to be highly cost-effective. The cost-effectiveness of additional doses (birth doses, catch-up doses, or adult doses) is dependent on the setting. The findings herein highlight the important value of vaccination as part of wider public health strategies.Copyright © 2018