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The choice of analytical methodology can alter conclusions regarding herd effects of paediatric pneumococcal vaccination programmes.
Vaccine. 2018 11 12; 36(46):6933-6943.V

Abstract

BACKGROUND

Estimation of the magnitude of the herd effect on invasive pneumococcal disease (IPD) is important when evaluating health benefits and cost-effectiveness of paediatric pneumococcal conjugate vaccine (PCV) programmes and may influence policy makers' decisions on PCV use. Several epidemiological, programmatic, and immunological factors can affect the magnitude of the PCV herd effect. We investigated to what extent the choice of analytical methodology may also influence herd effect estimates.

METHODS

To estimate the magnitude of the herd effect from paediatric PCV programmes, we examined overall IPD incidence rates in ≥65-year-olds from Finland, Australia, England/Wales, and the United States under different analytical scenarios. We used two different statistical methods: before/after comparison of average IPD incidence rates and interrupted time series (ITS) analysis accounting for underlying time trends. We also investigated how varying the length of the pre- and post-PCV analysis periods influenced the outcomes.

RESULTS

The estimated impact of paediatric PCV programmes on IPD incidence rates in adults ≥65 years varied substantially across the different scenarios within each country. The choice of statistical method and analysis periods contributed to this variation, and their influence varied by setting. For the datasets from England/Wales and the United States, the different scenarios produced relatively minor variation in estimated impact. For the Australian and Finnish datasets, differences were more prominent. In particular, for Finland, opposite conclusions could be drawn depending on the methodology: while no estimated herd effect was seen with the before/after method, a herd effect was evident with the ITS method.

CONCLUSIONS

The choice of statistical method and analysis periods can substantially influence the magnitude of estimated herd effects from paediatric PCV programmes. It is important to consider the reliability and presence of pre-PCV patterns in the IPD surveillance data used for analysis, the methodology and associated assumptions used to estimate herd effects.

Authors+Show Affiliations

GSK, Avenue Fleming 20, 1300 Wavre, Belgium. Electronic address: Jean-Yves.x.Pircon@gsk.com.GSK, 14200 Shady Grove Rd, Rockville, MD 20850, USA. Electronic address: Carla.A.Talarico@gsk.com.P95 Pharmacovigilance and Epidemiology Services, Koning Leopold III Laan 1, 3001 Leuven, Belgium. Electronic address: Kaatje.Bollaerts@p-95.com.Faculty of Medicine, Université Libre de Bruxelles, Avenue Franklin Roosevelt 50, 1050 Brussels, Belgium. Electronic address: billhausdorff@hotmail.co.uk.GSK, Avenue Fleming 20, 1300 Wavre, Belgium. Electronic address: Christopher.J.Clarke@gsk.com.

Pub Type(s)

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

Language

eng

PubMed ID

30316530

Citation

Pirçon, Jean-Yves, et al. "The Choice of Analytical Methodology Can Alter Conclusions Regarding Herd Effects of Paediatric Pneumococcal Vaccination Programmes." Vaccine, vol. 36, no. 46, 2018, pp. 6933-6943.
Pirçon JY, Talarico CA, Bollaerts K, et al. The choice of analytical methodology can alter conclusions regarding herd effects of paediatric pneumococcal vaccination programmes. Vaccine. 2018;36(46):6933-6943.
Pirçon, J. Y., Talarico, C. A., Bollaerts, K., Hausdorff, W. P., & Clarke, C. J. (2018). The choice of analytical methodology can alter conclusions regarding herd effects of paediatric pneumococcal vaccination programmes. Vaccine, 36(46), 6933-6943. https://doi.org/10.1016/j.vaccine.2018.10.003
Pirçon JY, et al. The Choice of Analytical Methodology Can Alter Conclusions Regarding Herd Effects of Paediatric Pneumococcal Vaccination Programmes. Vaccine. 2018 11 12;36(46):6933-6943. PubMed PMID: 30316530.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The choice of analytical methodology can alter conclusions regarding herd effects of paediatric pneumococcal vaccination programmes. AU - Pirçon,Jean-Yves, AU - Talarico,Carla A, AU - Bollaerts,Kaatje, AU - Hausdorff,William P, AU - Clarke,Christopher J, Y1 - 2018/10/11/ PY - 2018/06/07/received PY - 2018/09/25/revised PY - 2018/10/02/accepted PY - 2018/10/15/pubmed PY - 2019/1/22/medline PY - 2018/10/15/entrez KW - Adults KW - Herd effect KW - Invasive pneumococcal disease KW - Pneumococcal conjugate vaccine KW - Statistical method SP - 6933 EP - 6943 JF - Vaccine JO - Vaccine VL - 36 IS - 46 N2 - BACKGROUND: Estimation of the magnitude of the herd effect on invasive pneumococcal disease (IPD) is important when evaluating health benefits and cost-effectiveness of paediatric pneumococcal conjugate vaccine (PCV) programmes and may influence policy makers' decisions on PCV use. Several epidemiological, programmatic, and immunological factors can affect the magnitude of the PCV herd effect. We investigated to what extent the choice of analytical methodology may also influence herd effect estimates. METHODS: To estimate the magnitude of the herd effect from paediatric PCV programmes, we examined overall IPD incidence rates in ≥65-year-olds from Finland, Australia, England/Wales, and the United States under different analytical scenarios. We used two different statistical methods: before/after comparison of average IPD incidence rates and interrupted time series (ITS) analysis accounting for underlying time trends. We also investigated how varying the length of the pre- and post-PCV analysis periods influenced the outcomes. RESULTS: The estimated impact of paediatric PCV programmes on IPD incidence rates in adults ≥65 years varied substantially across the different scenarios within each country. The choice of statistical method and analysis periods contributed to this variation, and their influence varied by setting. For the datasets from England/Wales and the United States, the different scenarios produced relatively minor variation in estimated impact. For the Australian and Finnish datasets, differences were more prominent. In particular, for Finland, opposite conclusions could be drawn depending on the methodology: while no estimated herd effect was seen with the before/after method, a herd effect was evident with the ITS method. CONCLUSIONS: The choice of statistical method and analysis periods can substantially influence the magnitude of estimated herd effects from paediatric PCV programmes. It is important to consider the reliability and presence of pre-PCV patterns in the IPD surveillance data used for analysis, the methodology and associated assumptions used to estimate herd effects. SN - 1873-2518 UR - https://www.unboundmedicine.com/medline/citation/30316530/The_choice_of_analytical_methodology_can_alter_conclusions_regarding_herd_effects_of_paediatric_pneumococcal_vaccination_programmes_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0264-410X(18)31355-0 DB - PRIME DP - Unbound Medicine ER -