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Use of models to identify cost-effective interventions: pertussis vaccination for pediatric health care workers.
Pediatrics. 2011 Sep; 128(3):e591-9.Ped

Abstract

OBJECTIVE

Acellular pertussis vaccine is safe and effective in adults. An explicit recommendation for pertussis booster vaccination in pediatric health care workers is based on the importance of health care workers as a potential source of infection for patients. However, limited information is available on the economic attractiveness of this intervention. We sought to evaluate the health-economic attractiveness of a diphtheria-tetanus-acellular pertussis booster vaccination program for health care workers in a pediatric intensive care setting.

METHODS

We developed a Markov model to calculate the cost-effectiveness of vaccinating NICU health care workers in different proportions ranging from the current strategy of no pertussis booster vaccination program to a vaccination program that achieves between 25% and 95% vaccine coverage.

RESULTS

Implementation of a vaccination program that achieves 25% coverage was projected to be cost-saving compared with no vaccine program. At all coverage levels the intervention reduced costs, increased life expectancy, and was cost-effective. Projections were most sensitive to the risk of a pertussis introduction via an infected health care worker. Once the monthly risk of an introduction exceeded ∼0.3%, implementation of an immunization program with at least 25% coverage provided both greater health and greater economic benefits than having no vaccine program.

CONCLUSIONS

The implementation of a hospital-based and funded diphtheria-tetanus-acellular pertussis vaccine program administered through an occupational health program is cost-effective or cost-saving in the context of pediatric health care facilities in which many of the patients are at risk of serious morbidity and mortality should they acquire pertussis while hospitalized.

Authors+Show Affiliations

Public Health Agency of Canada, 180 Queen St W, 11th floor, Toronto, Ontario, Canada M5V 3L7. amy.greer@phac.aspc.gc.caNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21844056

Citation

Greer, Amy L., and David N. Fisman. "Use of Models to Identify Cost-effective Interventions: Pertussis Vaccination for Pediatric Health Care Workers." Pediatrics, vol. 128, no. 3, 2011, pp. e591-9.
Greer AL, Fisman DN. Use of models to identify cost-effective interventions: pertussis vaccination for pediatric health care workers. Pediatrics. 2011;128(3):e591-9.
Greer, A. L., & Fisman, D. N. (2011). Use of models to identify cost-effective interventions: pertussis vaccination for pediatric health care workers. Pediatrics, 128(3), e591-9. https://doi.org/10.1542/peds.2010-0796
Greer AL, Fisman DN. Use of Models to Identify Cost-effective Interventions: Pertussis Vaccination for Pediatric Health Care Workers. Pediatrics. 2011;128(3):e591-9. PubMed PMID: 21844056.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of models to identify cost-effective interventions: pertussis vaccination for pediatric health care workers. AU - Greer,Amy L, AU - Fisman,David N, Y1 - 2011/08/15/ PY - 2011/8/17/entrez PY - 2011/8/17/pubmed PY - 2012/4/24/medline SP - e591 EP - 9 JF - Pediatrics JO - Pediatrics VL - 128 IS - 3 N2 - OBJECTIVE: Acellular pertussis vaccine is safe and effective in adults. An explicit recommendation for pertussis booster vaccination in pediatric health care workers is based on the importance of health care workers as a potential source of infection for patients. However, limited information is available on the economic attractiveness of this intervention. We sought to evaluate the health-economic attractiveness of a diphtheria-tetanus-acellular pertussis booster vaccination program for health care workers in a pediatric intensive care setting. METHODS: We developed a Markov model to calculate the cost-effectiveness of vaccinating NICU health care workers in different proportions ranging from the current strategy of no pertussis booster vaccination program to a vaccination program that achieves between 25% and 95% vaccine coverage. RESULTS: Implementation of a vaccination program that achieves 25% coverage was projected to be cost-saving compared with no vaccine program. At all coverage levels the intervention reduced costs, increased life expectancy, and was cost-effective. Projections were most sensitive to the risk of a pertussis introduction via an infected health care worker. Once the monthly risk of an introduction exceeded ∼0.3%, implementation of an immunization program with at least 25% coverage provided both greater health and greater economic benefits than having no vaccine program. CONCLUSIONS: The implementation of a hospital-based and funded diphtheria-tetanus-acellular pertussis vaccine program administered through an occupational health program is cost-effective or cost-saving in the context of pediatric health care facilities in which many of the patients are at risk of serious morbidity and mortality should they acquire pertussis while hospitalized. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/21844056/Use_of_models_to_identify_cost_effective_interventions:_pertussis_vaccination_for_pediatric_health_care_workers_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=21844056 DB - PRIME DP - Unbound Medicine ER -