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Capturing the value of vaccination within health technology assessment and health economics: Literature review and novel conceptual framework. Vaccine 2022; 40:4008-4016. [PMID: 35618559 DOI: 10.1016/j.vaccine.2022.04.050] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 04/14/2022] [Accepted: 04/14/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Vaccination provides significant health gains to individuals and society and can potentially improve health equity, healthcare systems and national economies. Policy decisions, however, are rarely informed by comprehensive economic evaluations (EE) including vaccination's wide-ranging value. The objective of this analysis was to focus on health technology assessment systems to identify relevant value concepts in order to improve current EE of non-pandemic vaccines. METHODS Following a literature review, a novel Value of Vaccination (VoV) framework was developed with experts in vaccine EE from developed countries with established health technology assessment systems. RESULTS Forty-four studies presenting value frameworks or concepts applicable to vaccination were included. Eighteen unique value concepts relevant to EE were identified and defined. These were categorised within the VoV framework using three dimensions, moving from a narrow payer perspective to a more expansive and societal perspective. The dimensions were: (I) conventional payer perspective concepts (e.g., health gains in vaccinees, direct medical costs); (II) conventional societal perspective concepts (e.g., indirect health/economic gains to caregivers/households, productivity in vaccinees); and (III) novel societal concepts (e.g., financial risk protection, peace of mind, societal health gains, healthcare systems security, political stability, social equity and macroeconomic gains). While good quality evidence and methods are available to support concepts in Dimensions I and II, further work is needed to generate the required evidence for vaccination impact on Dimension III concepts. CONCLUSIONS The devastating effect on nations of the COVID-19 pandemic has helped to highlight the potential far-reaching benefits that many vaccination programmes can offer. This VoV framework is particularly relevant to policy decisions considering EE, and the potential future expansion of non-pandemic vaccination value considerations. The framework helps to understand and compare current value considerations across countries and payer versus societal perspectives. It provides decision-makers with a transparent and logical path to broaden consideration of VoV in EE.
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de Souza AR, Yamin M, Gava D, Zanella JRC, Gatti MSV, Bonafe CFS, de Lima Neto DF. Porcine parvovirus VP1/VP2 on a time series epitope mapping: exploring the effects of high hydrostatic pressure on the immune recognition of antigens. Virol J 2019; 16:75. [PMID: 31159841 PMCID: PMC6547530 DOI: 10.1186/s12985-019-1165-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 04/17/2019] [Indexed: 11/24/2022] Open
Abstract
Porcine parvovirus (PPV) is a DNA virus that causes reproductive failure in gilts and sows, resulting in embryonic and fetal losses worldwide. Epitope mapping of PPV is important for developing new vaccines. In this study, we used spot synthesis analysis for epitope mapping of the capsid proteins of PPV (NADL-2 strain) and correlated the findings with predictive data from immunoinformatics. The virus was exposed to three conditions prior to inoculation in pigs: native (untreated), high hydrostatic pressure (350 MPa for 1 h) at room temperature and high hydrostatic pressure (350 MPa for 1 h) at − 18 °C, and was compared with a commercial vaccine produced using inactivated PPV. The screening of serum samples detected 44 positive spots corresponding to 20 antigenic sites. Each type of inoculated antigen elicited a distinct epitope set. In silico prediction located linear and discontinuous epitopes in B cells that coincided with several epitopes detected in spot synthesis of sera from pigs that received different preparations of inoculum. The conditions tested elicited antibodies against the VP1/VP2 antigen that differed in relation to the response time and the profile of structurally available regions that were recognized.
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Affiliation(s)
- Ancelmo Rabelo de Souza
- Departamento de Bioquímica e Biologia Tecidual, Universidade Estadual de Campimas (UNICAMP), Rua Monteiro Lobato, 255, Cidade Universitária Zeferino Vaz, Campinas, SP, 13083-862, Brazil
| | - Marriam Yamin
- Departamento de Bioquímica e Biologia Tecidual, Universidade Estadual de Campimas (UNICAMP), Rua Monteiro Lobato, 255, Cidade Universitária Zeferino Vaz, Campinas, SP, 13083-862, Brazil
| | - Danielle Gava
- Embrapa Suínos e Aves, Laboratório de Virologia de Suínos, Concórdia, SC, 89715-899, Brazil
| | | | - Maria Sílvia Viccari Gatti
- Departamento de Bioquímica e Biologia Tecidual, Universidade Estadual de Campimas (UNICAMP), Rua Monteiro Lobato, 255, Cidade Universitária Zeferino Vaz, Campinas, SP, 13083-862, Brazil
| | - Carlos Francisco Sampaio Bonafe
- Departamento de Bioquímica e Biologia Tecidual, Universidade Estadual de Campimas (UNICAMP), Rua Monteiro Lobato, 255, Cidade Universitária Zeferino Vaz, Campinas, SP, 13083-862, Brazil
| | - Daniel Ferreira de Lima Neto
- Departamento de Bioquímica e Biologia Tecidual, Universidade Estadual de Campimas (UNICAMP), Rua Monteiro Lobato, 255, Cidade Universitária Zeferino Vaz, Campinas, SP, 13083-862, Brazil. .,Departamento de Genética, Evolução e Bioagentes, Instituto de Biologia, Universidade Estadual de Campinas (UNICAMP), Rua Monteiro Lobato, 255, Cidade Universitária Zeferino Vaz, Campinas, SP, 13083-862, Brazil.
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Abstract
Credit This lesson is good for 0.2 CE units, with a passing grade of 70%. Objectives After completing this continuing education article, the pharmacist will be able to: 1. Describe the evolution of immunization over the past thousand years. 2. Discuss the impact of specific infectious diseases on world populations before the development of immunizations against them. 3. Understand the significance of immunization in increasing human lifespan. 3. Compare immunization policies of different eras in the 20th century. 4. Identify some potential new applications of immunological drugs in the 21st century.
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Thompson KM, Odahowski CL. Systematic Review of Health Economic Analyses of Measles and Rubella Immunization Interventions. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2016; 36:1297-1314. [PMID: 25545778 DOI: 10.1111/risa.12331] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Economic analyses for vaccine-preventable diseases provide important insights about the value of prevention. We reviewed the literature to identify all of the peer-reviewed, published economic analyses of interventions related to measles and rubella immunization options to assess the different types of analyses performed and characterize key insights. We searched PubMed, the Science Citation Index, and references from relevant articles for studies in English and found 67 analyses that reported primary data and quantitative estimates of benefit-cost or cost-effectiveness analyses for measles and/or rubella immunization interventions. We removed studies that we characterized as cost-minimization analyses from this sample because they generally provide insights that focused on more optimal strategies to achieve the same health outcome. The 67 analyses we included demonstrate the large economic benefits associated with preventing measles and rubella infections using vaccines and the benefit of combining measles and rubella antigens into a formulation that saves the costs associated with injecting the vaccines separately. Despite the importance of population immunity and dynamic viral transmission, most of the analyses used static models to estimate cases prevented and characterize benefits, although the use of dynamic models continues to increase. Many of the analyses focused on characterizing the most significant adverse outcomes (e.g., mortality for measles, congenital rubella syndrome for rubella) and/or only direct costs, and the most complete analyses present data from high-income countries.
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Affiliation(s)
- Kimberly M Thompson
- Kid Risk, Inc, 10524 Moss Park Rd., Ste. 204-364, Orlando, FL, 32832, USA
- College of Medicine, University of Central Florida, Orlando, FL, 32827, USA
| | - Cassie L Odahowski
- Kid Risk, Inc, 10524 Moss Park Rd., Ste. 204-364, Orlando, FL, 32832, USA
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Colombo GL, Nicosia V, Lesma A, Madera A, Caruggi M, Serra G. Analisi costi-benefici di una strategia vaccinale antinfluenzale condotta presso una società del gruppo ENI (Snamprogetti). ACTA ACUST UNITED AC 2013. [DOI: 10.1007/bf03320581] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Il costo sociale del morbillo in età pediatrica. L’epidemia a Palermo nel 1996–97. ACTA ACUST UNITED AC 2013. [DOI: 10.1007/bf03320516] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Grabenstein JD, Straus WL, Feinberg MB. Vaccines and vaccination. Infect Dis (Lond) 2010. [DOI: 10.1016/b978-0-323-04579-7.00003-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Grabenstein JD. Vaccines: worth paying for the value returned. Ann Pharmacother 2002; 36:1471-2. [PMID: 12229878 DOI: 10.1345/aph.1a125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Abstract
OBJECTIVE To review the rationale for requiring prescriptions to control vaccine access, in contrast to other medications. DATA SOURCES Literature on immunization delivery and health-service barriers was reviewed via MEDLINE search and relevant textbooks. Additional literature was obtained from reference lists of pertinent articles. DATA SYNTHESIS Society controls access to medications to protect consumers. Many medications have changed from prescription-only to over-the-counter (OTC) status. No parenteral drug has been switched, although insulin has long had OTC status. Limiting access to vaccines has advantages in record-keeping, storage, injection quality, and response to anaphylactic reactions. These advantages are outweighed by 600000 people who will die over the next decade for lack of pneumococcal and influenza immunizations. Physicians see most of those who die of these diseases, but many neglect to vaccinate them. Three options are offered to expand access to these vaccines. The most feasible one involves expanding prescribing authority for pneumococcal and influenza vaccines to all licensed healthcare professionals and paraprofessionals with physiologic and pharmacologic expertise to responsibly vaccinate. Community pharmacies offer advantages as immunization delivery sites, in terms of proximity, hours of operation, and knowledge of people at highest risk. Expanded professional training can ensure high levels of public safeguards while expanding immunization delivery. CONCLUSIONS Society decides the controls needed to protect the health of the people. If society restricts vaccine access too severely, people die needlessly. Increasing prescribing authority for pneumococcal and influenza vaccines to more health professionals will save many lives.
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Affiliation(s)
- J D Grabenstein
- US Army Medical Department, School of Pharmacy, University of North Carolina, Chapel Hill 27599, USA.
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Patel SS, Wagstaff AJ. A cellular pertussis vaccine (Infanrix-DTPa; SB-3). A review of its immunogenicity, protective efficacy and tolerability in the prevention of Bordetella pertussis infection. Drugs 1996; 52:254-75. [PMID: 8841742 DOI: 10.2165/00003495-199652020-00010] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
SB-3 (Infanrix-DTPa) is one of a new generation of vaccines for immunisation against pertussis (whooping cough), diphtheria and tetanus. It is a 3-component (pertussis toxin, filamentous haemagglutinin and pertactin) chemically inactivated acellular pertussis pertussis-diphtheria-tetanus toxoid (DTaP) vaccine, and it differs from conventional whole-cell pertussis-diphtheria-tetanus toxoid (DTwP) vaccines in that it comprises inactivated purified Bordetella pertussis antigens rather than whole cells of the bacillus. SB-3, like a number of other DTaP vaccines, elicits a similar or more often, a significantly greater immune response than various DTwP vaccines in healthy infants and young children. initial data from comparative studies indicate that SB-3 also remains immunogenic when given in combination with hepatitis B vaccine or concurrently administered with Haemophilus influenzae type b (HbOC) conjugate vaccine. A combination of SB-3 and H. influenzae type b tetanus (PRP-T) conjugate vaccine results in lower anti-PRP antibody response than when both vaccines are administered concurrently. Data from two large, multicentre, German and Italian studies in infants indicate that the protective efficacy of SB-3 against pertussis was significantly better than one DTwP (DTwP-CON) but similar to another one (DTwP-BW) under investigation. Compared with another DTaP vaccine (BIO-3), SB-3 was just as protective. Overall, the data from these 2 studies indicate that primary vaccination with SB-3 provides effective protection against pertussis, even under the stringent conditions of a household contact with typical pertussis. As the other DTaP vaccines, SB-3 is better tolerated than DTwP vaccines, with a significantly lower incidence of common adverse events such as local reactions (swelling, pain and a erythema), irritability, fever, persistent crying and local tenderness. Clinical experience with SB-3 thus far indicates that, like other DTaP vaccines, it is associated with significantly fewer common (non-serious) adverse events than DTwP vaccines. Less clear is whether it has any advantage over DTwP vaccines with respect to protective efficacy or over other DTaP vaccines with respect to tolerability and protective efficacy. Nevertheless, the available data support the use of SB-3 for infant immunisation, as well as providing a suitable basis for the development of new combination vaccines.
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Affiliation(s)
- S S Patel
- Adis International Limited, Auckland, New Zealand
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