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THE IMPACT AND COST EFFECTIVENESS OF VACCINE PROGRAMS IN ELDERLY: UNDERSTANDING THE INTERACTION BETWEEN INFANT AND ELDERLY VACCINATION.
Abstract
Objectives
In February 2012, the Advisory Committee on Immunization Practices (ACIP) advised that all adults aged ≥65 years receive a single dose of reduced-antigen-content tetanus, diphtheria, and acellular pertussis (Tdap), expanding on a 2010 recommendation for adults >65 that was limited to those with close contact with infants. We evaluated clinical and economic outcomes of adding Tdap booster of adults aged ≥65 to “baseline” practice [full-strength DTaP administered from 2 months to 4–6 years, and one dose of Tdap at 11–64 years replacing decennial Td booster] , using a dynamic model.
Methods
We constructed a population-level disease transmission model to evaluate the cost-effectiveness of supplementing baseline practice by vaccinating 10% of eligible adults aged ≥65 with Tdap replacing the decennial Td booster. US population effects, including indirect benefits accrued by unvaccinated persons, were estimated during a 1-year period after disease incidence reached a new steady state, with consequences of deaths and long-term pertussis sequelae projected over remaining lifetimes. Model outputs include: cases by severity, encephalopathy, deaths, costs (of vaccination and pertussis care) and quality-adjusted life-years (QALYs) associated with each strategy. Results in terms of incremental cost/QALY gained are presented from payer and societal perspectives. Sensitivity analyses vary key parameters within plausible ranges.
TABLE OF CONTENT
Chapter One Introduction
1.1 Background of the study
1.2 Statement of the problem
1.3 Purpose of the study
1.4 Significance of study
1.5 Research questions
1.6 Scope of study
1.7 Limitation of study
1.8 Definition of terms
Chapter Two
2.0 Literature Review
Chapter Three
3.0 Methodology
Chapter Four
4.0 Data Analysis
Chapter Five
5.0 Summary, Conclusion and Recommendations
References Questionnaires
