Table 3.
Projected health outcomes and costs of pneumococcal conjugate vaccination in a cohort of Chinese infants on lifetime disease burden compared with no vaccination
| Disease type/health outcome | No vaccination | PCV-7 Vaccination | Differences* |
|---|---|---|---|
| Cases for birth cohort |
|
|
|
| Pneumococcal bacteremia |
7,402 |
4,587 |
-2,815 |
| Pneumococcal meningitis |
3,701 |
2,293 |
-1,407 |
| Pneumococcal AOM |
12,616,500 |
8,554,976 |
-4,061,524 |
| Pneumococcal pneumonia |
780,407 |
307,880 |
-472,527 |
| Disability caused by pneumococcal meningitis |
255 |
158 |
-97 |
| Deafness caused by pneumococcal meningitis |
474 |
294 |
-180 |
| Tube insertion caused by pneumococcal AOM |
732,905 |
497,086 |
-235,819 |
| Death caused by pneumococcal disease |
4,674 |
1,993 |
-2,682 |
| Death caused by pneumococcal bacteremia |
335 |
207 |
-128 |
| Death caused by pneumococcal meningitis |
302 |
188 |
-114 |
| Death caused by pneumococcal pneumonia |
4,037 |
1,597 |
-2,439 |
| Efficacy of herd immunity |
|
|
|
| Pneumococcal bacteremia |
28,310 |
23,562 |
-4,748 |
| Pneumococcal meningitis |
19,088 |
7,817 |
-11,270 |
| Disability caused by pneumococcal meningitis |
3,627 |
1,485 |
-2,141 |
| Deafness caused by pneumococcal meningitis |
4,963 |
2,033 |
-2,930 |
| Death caused by pneumococcal invasive disease |
5,449 |
3,934 |
-1,515 |
| Costs for birth cohort ($, discounted) |
|
|
|
| vaccine cost (including administration) |
0 |
6,438,882,934 |
6,438,882,934 |
| Meningitis medical cost |
13,275,258 |
8,226,631 |
-5,048,627 |
| Bacteremia medical cost |
19,739,872 |
12,232,718 |
-7,507,154 |
| Pneumonia medical cost |
473,942,531 |
186,976,189 |
-286,966,342 |
| AOM medical cost |
1,401,833,288 |
950,552,900 |
-451,280,388 |
| Long-term cost of sequelae |
6,428,514 |
3,974,969 |
-2,453,545 |
| Nonmedical cost |
1,581,876,301 |
1,144,173,592 |
-437,702,709 |
| Subtotal |
3,497,095,763 |
8,745,019,933 |
5,247,924,169 |
| Costs in herd immunity |
323,840,533 |
169,576,767 |
-154,263,765 |
| Total |
3,820,936,296 |
8,914,596,700 |
5,093,660,404 |
| QALYs loss (without herd immunity) |
2,310,183 |
2,300,288 |
43,543# |
| QALYs loss (with herd immunity) |
112,072,439 |
112,019,001 |
53,438# |
| ICER without heard immunity ($/QALY gained) |
|
530,354 |
|
| ICER with heard immunity ($/QALY avoided) | 95,319 |
*PCV-7 vaccination strategy compared with no vaccination.
#The incremental QALYs gained by PCV-7 vaccination strategy.