Cost-effectiveness of targeted vaccination to protect new-borns against pertussis…

Volume 31, Issue 46, Pages 5297-5494 (4 November 2013)

Cost-effectiveness of targeted vaccination to protect new-borns against pertussis: Comparing neonatal, maternal, and cocooning vaccination strategies
Original Research Article
Pages 5392-5397
Anna K. Lugnér, Nicoline van der Maas, Michiel van Boven, Frits R. Mooi, Hester E. de Melker

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.