Pertussis vaccination cost effective in pregnant women

Abstract

. . . in three socioeconomic settings The first study used three dynamic models of pertussis transmission (Susceptible-Infectious-Recovered [SIR; assumes lifelong immunity], SIRS [assumes secondary infections are as symptomatic and infectious as the primary infection] and SIRSIs [assumes secondary infections are as infectious but less symptomatic than the primary infection] to evaluate the cost effectiveness of aP vaccination in pregnant women plus whole-cell pertussis (wP) vaccination in their infants (3 dose series of DTwP-Hib-HB followed by 2 boosters of DTwP), versus wP vaccination in infants only, in Bahia, Parana and Sao Paulo, Brazil. The gross domestic product per capita for the regions was $6273,* $13 310 and $17 881, respectively. Cost effectiveness was assessed from the perspective of the Brazilian National Health System (NHS) over a 16-year time horizon (from 2014 to 2029). In all three states, maternal aP vaccination was estimated to save more lives of infants and increase disabilityadjusted life years (DALYs) averted compared with infant vaccination only, but was associated with higher costs, resulting in estimated incremental cost-effectiveness ratios (ICERs) of $2022 per DALY averted in Bahia, $2962 per DALY averted in Parana, and $3068 per DALY averted in Sao Paulo. We have shown that the SIRSIs model structure fit best the pertussis epidemiology of three settings that represent diverse socio-demographic conditions, said the authors. We also found that immunization of pregnant women with aP is cost-effective in diverse Brazilian states, they said.