Cost-effectiveness of targeted vaccination to protect new-borns against pertussis: comparing neonatal, maternal, and cocooning vaccination strategies

Vaccine. 2013 Nov 4;31(46):5392-7. doi: 10.1016/j.vaccine.2013.09.028. Epub 2013 Sep 27.

Abstract

Pertussis (whooping cough) is a severe infectious disease in infants less than 6 months old. Mass vaccination programmes have been unable to halt transmission effectively. Strategies to protect new-borns against infection include vaccination of the neonate or the mother directly after birth (cocooning), or the mother during pregnancy (maternal). Here we investigate the cost-effectiveness of these three strategies in the Netherlands. Costs for health care utilization and productivity losses, as well as impact on quality of life were calculated for a 10-year vaccination programme, assuming that vaccine-induced immunity lasts 5 years. Cocooning was the most attractive option from a cost-effectiveness viewpoint (€89,000/QALY). However, both cocooning and maternal vaccination would reduce the disease burden in infants and mothers vaccinated (about 17-20 QALY/year). Specifically, with a persistent epidemic as seen in 2012, there is need for reconsidering the vaccination schedules against pertussis in order to increase protection of the vulnerable new-borns.

Keywords: Cost-utility; Infants; Vaccination; Whooping cough.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cost-Benefit Analysis
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Models, Statistical
  • Netherlands / epidemiology
  • Pertussis Vaccine / administration & dosage*
  • Pertussis Vaccine / economics*
  • Pregnancy
  • Vaccination / economics*
  • Vaccination / methods*
  • Whooping Cough / economics*
  • Whooping Cough / epidemiology
  • Whooping Cough / prevention & control*

Substances

  • Pertussis Vaccine