1
|
Shen Y, Wang J, Wang J, Nicholas S, Maitland E, Lv M, Yin T, Zhu D. Effectiveness of financial incentives on influenza vaccination among older adults in China: a randomized clinical trial. Clin Microbiol Infect 2024:S1198-743X(24)00062-4. [PMID: 38341143 DOI: 10.1016/j.cmi.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/26/2024] [Accepted: 02/03/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVES To investigate the short-term and long-term effectiveness of different levels of financial incentives on increasing the willingness to vaccinate and vaccine uptake. METHODS A randomized controlled trial was conducted to investigate the effectiveness of financial incentives of three groups with monetary incentives (CNY 20, CNY 40, and CNY 60; 1 CNY = 0.13 EUR) vs. a control group-CNY 0-on influenza vaccine uptake among 720 older adults (≥60 years) in Beijing, China. The primary outcome was vaccine uptake, and the secondary outcomes were intention to vaccinate and length of time to immunization. RESULTS Financial incentive significantly promoted higher intention to influenza vaccination (120/178 [67.42%] vs. 442/542 [81.55%]; Relative Risk [RR], 1.21; 95% CI, 1.02-1.42) and higher vaccination participation (74/178 [41.57%] vs. 316/542 [58.30%]; RR, 1.39; 95% CI, 1.10-1.75). CNY 60 had the largest impact on the intention to vaccinate (15.00% vs. 13.48% and 13.90%) and vaccination uptake (19.42% vs. 14.05% and 16.67%) compared with CNY 20 and CNY 40. Time to vaccination was significantly lower among participants receiving incentives than those without ([37.21 days; 95% CI, 34.33-39.99] vs. [48.27 days; 95% CI, 43.47-53.07]; Hazard Ratio [HR] 1.57, 95% CI 1.22-2.03). We found no long-term influence of financial incentives on vaccination decisions in the following year (217/542, 40.04% vs. 65/178, 36.52%; RR 1.08, 95% CI 0.82-1.42). DISCUSSION Our study suggests that modest financial incentives will boost short-term influenza vaccination rates and shorten the length of time to immunization in China. No one single-time financial incentive had a long-term effect on future vaccination behaviours or helped establish regular vaccination behaviours.
Collapse
Affiliation(s)
- Yang Shen
- School of Public Health, Peking University, Beijing, China; China Center for Health Development Studies, Peking University, Beijing, China
| | - Jingyu Wang
- School of Public Health, Peking University, Beijing, China; China Center for Health Development Studies, Peking University, Beijing, China
| | - Jian Wang
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Beijing, China; Center for Health Economics and Management at School of Economics and Management, Wuhan University, Wuhan, China
| | - Stephen Nicholas
- Health Services Research and Workforce Innovation Centre, Newcastle Business School, University of Newcastle, Newcastle, NSW, Australia; Australian National Institite of Management and Commerce, Eveleigh, NSW, Australia
| | - Elizabeth Maitland
- School of Management, University of Liverpool, Liverpool, United Kingdom
| | - Min Lv
- Institute for Immunization and Prevention, Beijing Center for Disease Prevention and Control, Beijing, China.
| | - Tao Yin
- Department of Technology, Capital Institute of Pediatrics, Beijing, China.
| | - Dawei Zhu
- China Center for Health Development Studies, Peking University, Beijing, China; Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China; International Research Center for Medicinal Administration (IRCMA), Peking University, Beijing, China.
| |
Collapse
|
2
|
Curran D, Doherty TM, Lecrenier N, Breuer T. Healthy ageing: Herpes zoster infection and the role of zoster vaccination. NPJ Vaccines 2023; 8:184. [PMID: 38017011 PMCID: PMC10684688 DOI: 10.1038/s41541-023-00757-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 10/12/2023] [Indexed: 11/30/2023] Open
Abstract
Populations are ageing worldwide, with considerable time lived in ill-health, putting upwards pressure on healthcare budgets. Healthy ageing is defined as maintaining functional ability, including the ability to: meet basic needs; learn, grow and make decisions; be mobile; build and maintain relationships; and contribute to society. The risk and impact of infectious diseases increase with age due to immunosenescence. Vaccination can help to prevent disease in older adults, promoting healthy ageing and active lives. Herpes zoster (HZ) occurs when the varicella zoster virus is reactivated due to declining immunity. HZ is common, with a lifetime risk of one-third, and increases in incidence with age. HZ is associated with severe and intense pain, substantially affecting the functional status of patients as well as their overall health-related quality of life. HZ and its complications may result in prolonged morbidity, including persistent pain (post-herpetic neuralgia, PHN), hearing impairment, vision loss and increased risk of stroke and myocardial infarction. HZ and PHN are difficult to treat, substantiating the benefits of prevention. Vaccines to prevent HZ include a recombinant zoster vaccine (RZV). RZV has shown efficacy against the HZ burden of disease and HZ burden of interference on activities of daily living of over 90% in immunocompetent adults aged ≥50 years. Vaccine efficacy against HZ was maintained at over 70% at 10 years post-vaccination. Adult vaccination, including against HZ, has the potential to reduce burden of disease, thus helping to maintain functioning and quality of life to support healthy ageing in older adults.
Collapse
|
3
|
Lin J, Dobbins T, Wood JG, Bernardo C, Stocks NP, Liu B. Impact of a National Immunisation Program on herpes zoster incidence in Australia. J Infect 2022; 84:537-541. [PMID: 35038437 DOI: 10.1016/j.jinf.2022.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 01/01/2022] [Accepted: 01/08/2022] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To evaluate the impact of the National Herpes Zoster (zoster) Immunisation Program in Australia on zoster incidence. METHODS Ecological analysis of zoster incidence related to timing of implementation of the national program in vaccine-targeted (70-79 years) and non-targeted age groups (60-69 and 80-89 years) during January 2013-December 2018 was estimated using interrupted time-series analyses. RESULTS Prior to program commencement (Jan 2013-Oct 2016) in patients aged 60-69, 70-79 and 80-89 years, incidence was mostly stable averaging respectively 7.2, 9.6 and 10.8 per 1000 person-years. In the two years following program commencement, incidence fell steadily in those aged 70-79 years, with an estimated decrease of 2.25 (95% CI: 1.34, 3.17) per 1000 person-years per year, with women having a greater decrease than men (2.83 versus 1.68, p-interaction<0.01). In the two non-vaccine-program-targeted groups there was no evidence of reduction in zoster incidence: 60-69 years, 0.46 (95% CI: -0.46, 1.38) and 80-89 years, 0.11 (95% CI: -1.64, 1.87). CONCLUSIONS Two years after implementation, an estimated 7000 zoster cases were prevented through the national program. With known waning vaccine efficacy, continued surveillance is needed to ensure these early reductions in incidence are sustained.
Collapse
Affiliation(s)
- Jialing Lin
- School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Timothy Dobbins
- School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia.
| | - James G Wood
- School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Carla Bernardo
- Discipline of General Practice, Adelaide Medical School, University of Adelaide, Adelaide, SA 5005, Australia.
| | - Nigel P Stocks
- Discipline of General Practice, Adelaide Medical School, University of Adelaide, Adelaide, SA 5005, Australia.
| | - Bette Liu
- School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia.
| |
Collapse
|
4
|
Hoe Nam L, Chiu CH, Heo JY, Ip M, Jung KS, Menzies R, Pearce R, Buchy P, Chen J, Nissen M, Oh KB. The need for pertussis vaccination among older adults and high-risk groups: a perspective from advanced economies of the Asia Pacific region. Expert Rev Vaccines 2021; 20:1603-1617. [PMID: 34734556 DOI: 10.1080/14760584.2021.1990759] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Influenza and pneumococcal vaccines are the most regularly prescribed vaccines amongst adults <65 years of age. Pertussis booster vaccines (available as combined diphtheria-tetanus-acellular pertussis, Tdap) uptake is relatively low in many countries in the Asia-Pacific region. Increasing Tdap vaccination is a strategy that may aid healthy aging.Areas Covered: Epidemiology data, including notification reports from 6 advanced economies in Asia (Australia, Hong Kong, New Zealand, Singapore, South Korea, and Taiwan) were reviewed to assess the pertussis disease burden and identify high-risk groups. Existing Tdap vaccination recommendations were reviewed. Current vaccination practices were discussed to benchmark and identify barriers and success factors for Tdap booster vaccination in older adults.Expert Opinion: The available evidence supports Tdap vaccination at an individual level for the prevention of pertussis, along with tetanus and diphtheria in those aged 65+ years, together with influenza and pneumococcal vaccination. Data gaps need to be filled to support the development of national/supranational recommendations for pertussis booster vaccination. Groups at higher risk of pertussis infection and its complications, including those with chronic obstructive pulmonary disease and asthma, could be considered as priority groups. Increasing disease awareness and establishing adult vaccination registries could improve vaccine coverage and promote healthy aging.
Collapse
Affiliation(s)
- Leong Hoe Nam
- Infectious Diseases, Mount Elizabeth Novena Hospital, Singapore, Singapore
| | - Cheng-Hsun Chiu
- Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Jung Yeon Heo
- Department of Infectious Diseases, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Margaret Ip
- Department of Microbiology, The Chinese University of Hong Kong, Hong Kong, The People's Republic of China
| | - Ki-Suck Jung
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
| | - Robert Menzies
- School of Population Health, University of New South Wales, Sydney, Australia
| | | | | | | | | | | |
Collapse
|
5
|
Abstract
Immunosenescence and comorbidities increase the susceptibility of older adults with diabetes mellitus (DM) to vaccine-preventable diseases, hospitalization, disability, or death. This systematic review synthesizes research on protecting older adults with DM during pandemics, exploring vaccine safety, tolerance, and vaccination uptake by older adults in anticipation of seasonal influenza outbreaks during the current COVID-19 threat. Addressed were: (a) age-related factors influencing the effectiveness of vaccines against infectious disease in older adults; (b) vaccine safety, tolerance, effectiveness for older persons with DM; and (c) issues affecting older adults accepting immunization recommendations. Medline and CINAHL databases yielded 214 studies with 43 meeting inclusion criteria (32 descriptive and 11 controlled trials). Findings show altered glycemic control stimulates proinflammatory mediators, increasing infection risk, vaccines, and annual revaccinations safely reduce hospitalization rates, mortality outcomes, without affecting glycemic control. However, vaccines fail to evoke optimal antibody responses in older adults. Unawareness, fear of side effects, tend to lower vaccination participation.
Collapse
Affiliation(s)
- Leena Almasri
- Donald W. Reynolds Center of Geriatric Nursing Excellence, Fran and Earl Ziegler College of Nursing, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Barbara J Holtzclaw
- Donald W. Reynolds Center of Geriatric Nursing Excellence, Fran and Earl Ziegler College of Nursing, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| |
Collapse
|
6
|
Abstract
Current vaccination policy in most high-income countries aims to counteract the decline in cell-mediated immunity to varicella zoster virus that occurs with advancing age or immunosuppression. The aim of this review was to describe the burden of illness associated with herpes zoster (HZ) and post-herpetic neuralgia (PHN) risks and their impact on the social and common life in infected people. The effectiveness/efficacy and cost effectiveness of the immunization strategy will be presented through the review of the literature relevant to the live attenuated HZ vaccine (ZLV) licensed in 2006 and the recombinant HZ vaccine (RZV). The latter has very recently been approved to protect aged people aged ≥ 50 years against HZ morbidity including its complications, and associated health-care costs. Finally, this review also provides data with respect of precautions of using and safety of ZVL and RVZ.
Collapse
|
7
|
Kizmaz M, Kumtepe Kurt B, Çetin Kargin N, Döner E. Influenza, pneumococcal and herpes zoster vaccination rates among patients over 65 years of age, related factors, and their knowledge and attitudes. Aging Clin Exp Res 2020; 32:2383-2391. [PMID: 31776859 DOI: 10.1007/s40520-019-01423-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 11/14/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND In this study, we aimed to determine influenza, pneumococcal, and herpes zoster (HZ) vaccination status, among patients aged 65 or above, and to determine their level of knowledge about these vaccines and the factors affecting the vaccination rates. METHODS This was a cross-sectional descriptive study conducted through face-to-face interviews with patients who were admitted to Gemerek State Hospital Family Medicine Clinics. The questionnaire prepared by the researchers following the literature review was applied by researchers. RESULTS The study included a total of 326 participants with a mean age of 71.59 ± 6.96 (min: 65, max: 96). Influenza, pneumococcal, and HZ vaccination rates were 21.8% (n = 71), 4.3% (n = 14), and 1.8% (n = 6), respectively. The odds ratio (OR) in the patients for whom influenza vaccination was recommended was calculated to be 15.25 compared to those for whom influenza vaccination was not recommended (95% CI 8.73-26.64, p < 0.001), OR in the patients for whom pneumococcal vaccination was recommended was calculated to be 257.5 compared to those for whom pneumococcal vaccination was not recommended (95% CI 50.75-1306.44, p < 0.001), and OR in the patients for whom HZ vaccination was recommended was calculated to be 126.0 compared to those for whom HZ vaccination was not recommended (95% CI 18.59-853.92, p < 0.001). CONCLUSIONS The main findings of the present study are that the vaccination rate for all three vaccines is low, vaccination recommendation by a physician significantly increases vaccination rates, and the vaccination rate of patients, who have been informed by the physician about the vaccine, is higher.
Collapse
Affiliation(s)
- Muhammet Kizmaz
- Department of Family Medicine, Gemerek State Haspital, Sivas, Turkey.
| | | | | | - Ezgi Döner
- Department of Quality Nursing, Gemerek State Haspital, Sivas, Turkey
| |
Collapse
|
8
|
Abstract
Inappropriate drug prescribing is an avoidable cause of adverse drug events, sources of an increase in morbimortality, excess spending and a decrease in quality of life. Many actions exist to improve prescribing quality and to secure the medication circuit in nursing homes. As part of the deployment of telemedicine, the benefit of a medico-pharmaceutical tele-expertise system for medication is evident.
Collapse
Affiliation(s)
- Maeva Montaleytang
- AP-HM, service pharmacie, hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille, France; Laboratoire de pharmacie clinique, faculté de pharmacie, Aix-Marseille Université, 27, boulevard Jean-Moulin, CS 30064, 13385 Marseille Cedex 5, France
| | - Florian Correard
- AP-HM, service pharmacie, hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille, France; Laboratoire de pharmacie clinique, faculté de pharmacie, Aix-Marseille Université, 27, boulevard Jean-Moulin, CS 30064, 13385 Marseille Cedex 5, France
| | | | | | - Aurélie Daumas
- AP-HM, service de médecine interne, gériatrie et thérapeutique, hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille, France.
| |
Collapse
|
9
|
Abstract
Adults age 65 or older are at increased risk for acute and chronic diseases. Patients in this group who are up to date with all CDC-recommended vaccinations can reduce morbidity and mortality. This article discusses a quality improvement project across four NP-owned primary care clinics in which all clinical staff received an educational intervention focused on best vaccination practices and Medicare billing strategies. This project yielded improved vaccination rates in the older adult patient population over a 3-month period.
Collapse
Affiliation(s)
- Wendy L Wright
- Wendy L. Wright is a family NP and owner of Wright and Associates Family Healthcare, Amherst and Concord, N.H. Debra Pettit Bruns is an assistant professor at the University of Alabama, Capstone College of Nursing, Tuscaloosa, Ala. Adele Susan Feeney is the FNP program coordinator at the University of Massachusetts, Worcester Graduate School of Nursing, Worcester, Mass. Shelley R. Strowman is an associate professor of practice at Simmons University, Department of Nursing, Boston, Mass
| | | | | | | |
Collapse
|
10
|
Doherty TM, Connolly MP, Del Giudice G, Flamaing J, Goronzy JJ, Grubeck-Loebenstein B, Lambert PH, Maggi S, McElhaney JE, Nagai H, Schaffner W, Schmidt-Ott R, Walsh E, Di Pasquale A. Vaccination programs for older adults in an era of demographic change. Eur Geriatr Med 2018; 9:289-300. [PMID: 29887922 PMCID: PMC5972173 DOI: 10.1007/s41999-018-0040-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 03/02/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Populations are aging worldwide. This paper summarizes some of the challenges and opportunities due to the increasing burden of infectious diseases in an aging population. RESULTS Older adults typically suffer elevated morbidity from infectious disease, leading to increased demand for healthcare resources and higher healthcare costs. Preventive medicine, including vaccination can potentially play a major role in preserving the health and independence of older adults. However, this potential of widespread vaccination is rarely realized. Here, we give a brief overview of the problem, discuss concrete obstacles and the potential for expanded vaccination programs to promote healthy aging. CONCLUSION The increasing healthcare burden of infectious diseases expected in aging populations could, to a large extent, be reduced by achieving higher vaccination coverage among older adults. Vaccination can thus contribute to healthy aging, alongside healthy diet and physical exercise. The available evidence indicates that dedicated programs can achieve substantial improvements in vaccination coverage among older adults, but more research is required to assess the generalizability of the results achieved by specific interventions (see Additional file 1).
Collapse
Affiliation(s)
| | - Mark P Connolly
- Global Market Access Solutions, St-Prex, Switzerland
- Unit of PharmacoEpidemiology and PharmacoEconomics, Department of Pharmacy, University of Groningen, Groningen, The Netherlands
| | | | - Johan Flamaing
- Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium
- Division of Gerontology and Geriatrics, KU Leuven, Leuven, Belgium
| | - Jorg J Goronzy
- Division of Immunology and Rheumatology, Department of Medicine, Stanford University, Stanford, CA, USA
| | | | | | - Stefania Maggi
- CNR Institute of Neuroscience, Aging Branch, Padua, Italy
| | | | - Hideaki Nagai
- Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Tokyo, Japan
| | | | | | - Edward Walsh
- Department of Medicine, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA
| | | |
Collapse
|
11
|
Lang PO, Bourgue C, Csajka C. Détection des prescriptions inappropriées, les critères STOPP/START. Actualités Pharmaceutiques 2018. [DOI: 10.1016/j.actpha.2017.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
12
|
Del Giudice G, Goronzy JJ, Grubeck-Loebenstein B, Lambert PH, Mrkvan T, Stoddard JJ, Doherty TM. Fighting against a protean enemy: immunosenescence, vaccines, and healthy aging. NPJ Aging Mech Dis 2018; 4:1. [PMID: 29285399 DOI: 10.1038/s41514-017-0020-0] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 11/09/2017] [Accepted: 11/27/2017] [Indexed: 12/16/2022] Open
Abstract
The progressive increase of the aged population worldwide mandates new strategies to ensure sustained health and well-being with age. The development of better and/or new vaccines against pathogens that affect older adults is one pivotal intervention in approaching this goal. However, the functional decline of various physiological systems, including the immune system, requires novel approaches to counteract immunosenescence. Although important progress has been made in understanding the mechanisms underlying the age-related decline of the immune response to infections and vaccinations, knowledge gaps remain, both in the areas of basic and translational research. In particular, it will be important to better understand how environmental factors, such as diet, physical activity, co-morbidities, and pharmacological treatments, delay or contribute to the decline of the capability of the aging immune system to appropriately respond to infectious diseases and vaccination. Recent findings suggest that successful approaches specifically targeted to the older population can be developed, such as the high-dose and adjuvanted vaccines against seasonal influenza, the adjuvanted subunit vaccine against herpes zoster, as well as experimental interventions with immune-potentiators or immunostimulants. Learning from these first successes may pave the way to developing novel and improved vaccines for the older adults and immunocompromised. With an integrated, holistic vaccination strategy, society will offer the opportunity for an improved quality of life to the segment of the population that is going to increase most significantly in numbers and proportion over future decades.
Collapse
|
13
|
Abstract
Herpes zoster (HZ) or “shingles” results from a reactivation of the varicella zoster virus (VZV) acquired during primary infection (chickenpox) and surviving in the dorsal root ganglia. In about 20% of cases, a complication occurs, known as post-herpetic neuralgia (PHN). A live attenuated vaccine against VZV is available for the prevention of HZ and subsequent PHN. The present study aims to update an earlier evaluation estimating the cost-effectiveness of the HZ vaccine from a Swiss third party payer perspective. It takes into account updated vaccine prices, a different age cohort, latest clinical data and burden of illness data. A Markov model was developed to simulate the lifetime consequences of vaccinating 15% of the Swiss population aged 65–79 y. Information from sentinel data, official statistics and published literature were used. Endpoints assessed were number of HZ and PHN cases, quality-adjusted life years (QALYs), costs of hospitalizations, consultations and prescriptions. Based on a vaccine price of CHF 162, the vaccination strategy accrued additional costs of CHF 17,720,087 and gained 594 QALYs. The incremental cost-effectiveness ratio (ICER) was CHF 29,814 per QALY gained. Sensitivity analyses showed that the results were most sensitive to epidemiological inputs, utility values, discount rates, duration of vaccine efficacy, and vaccine price. Probabilistic sensitivity analyses indicated a more than 99% chance that the ICER was below 40,000 CHF per QALY. Findings were in line with existing cost-effectiveness analyses of HZ vaccination. This updated study supports the value of an HZ vaccination strategy targeting the Swiss population aged 65–79 y.
Collapse
Affiliation(s)
- Patricia R Blank
- a University of Basel, Institute of Pharmaceutical Medicine (ECPM) , Basel , Switzerland
| | - Zanfina Ademi
- a University of Basel, Institute of Pharmaceutical Medicine (ECPM) , Basel , Switzerland
| | | | - Thomas D Szucs
- a University of Basel, Institute of Pharmaceutical Medicine (ECPM) , Basel , Switzerland
| | - Matthias Schwenkglenks
- a University of Basel, Institute of Pharmaceutical Medicine (ECPM) , Basel , Switzerland
| |
Collapse
|
14
|
Esposito S, Bonanni P, Maggi S, Tan L, Ansaldi F, Lopalco PL, Dagan R, Michel JP, van Damme P, Gaillat J, Prymula R, Vesikari T, Mussini C, Frank U, Osterhaus A, Celentano LP, Rossi M, Guercio V, Gavazzi G. Recommended immunization schedules for adults: Clinical practice guidelines by the Escmid Vaccine Study Group (EVASG), European Geriatric Medicine Society (EUGMS) and the World Association for Infectious Diseases and Immunological Disorders (WAidid). Hum Vaccin Immunother 2016; 12:1777-94. [PMID: 27135390 PMCID: PMC4964839 DOI: 10.1080/21645515.2016.1150396] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Revised: 01/19/2016] [Accepted: 02/01/2016] [Indexed: 12/27/2022] Open
Abstract
Rapid population aging has become a major challenge in the industrialized world and progressive aging is a key reason for making improvement in vaccination a cornerstone of public health strategy. An increase in age-related disorders and conditions is likely to be seen in the near future, and these are risk factors for the occurrence of a number of vaccine-preventable diseases. An improvement in infectious diseases prevention specifically aimed at adults and the elderly can therefore also decrease the burden of these chronic conditions by reducing morbidity, disability, hospital admissions, health costs, mortality rates and, perhaps most importantly, by improving the quality of life. Among adults, it is necessary to identify groups at increased risk of vaccine-preventable diseases and highlight the epidemiological impact and benefits of vaccinations using an evidence-based approach. This document provides clinical practice guidance on immunization for adults in order to provide recommendations for decision makers and healthcare workers in Europe. Although immunization is considered one of the most impactful and cost-effective public health measures that can be undertaken, vaccination coverage rates among adults are largely lower than the stated goal of ≥ 95% among adults, and stronger efforts are needed to increase coverage in this population. Active surveillance of adult vaccine-preventable diseases, determining the effectiveness of the vaccines approved for marketing in the last 5 y, the efficacy and safety of vaccines in immunocompromised patients, as well as in pregnant women, represent the priorities for future research.
Collapse
Affiliation(s)
- Susanna Esposito
- Pediatric Highly Intensive Care Unit, University of Milan, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Bonanni
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Stefania Maggi
- CNR - Institute of Neuroscience, Aging Branch Center for Research, Padua, Italy
| | - Litjan Tan
- Immunization Action Coalition, St Paul, MN, USA
| | - Filippo Ansaldi
- Department of Health Sciences, University of Genoa, IRCCS San Martino-IST University Teaching Hospital, Genoa, Italy
| | | | - Ron Dagan
- Pediatric Infectious Disease Unit, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva, Israel
| | | | - Pierre van Damme
- Vaccine & Infectious Disease Institute, Antwerp University, Wilrijk, Belgium
| | | | - Roman Prymula
- Department of Social Medicine, Faculty of Medicine, Charles University, Sokolska, Hradec Kralove, Czech Republic
| | - Timo Vesikari
- Vaccine Research Center, Tampere University Hospital, Tampere, Finland
| | - Cristina Mussini
- Clinic of Infectious Diseases, University of Modena and Reggio Emilia, Modena, Italy
| | - Uwe Frank
- Division of Infection Control and Hospital Epidemiology, Department of Infectious Diseases, Heidelberg University, Heidelberg, Germany
| | | | | | - Marta Rossi
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Valentina Guercio
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Gaetan Gavazzi
- University Clinic of Geriatric Medicine, University Hospital of Grenoble, and GREPI University of Grenoble-Alpes, Grenoble, France
| |
Collapse
|
15
|
Kristensen M, van Lier A, Eilers R, McDonald SA, Opstelten W, van der Maas N, van der Hoek W, Kretzschmar ME, Nielen MM, de Melker HE. Burden of four vaccine preventable diseases in older adults. Vaccine 2016; 34:942-9. [PMID: 26752065 DOI: 10.1016/j.vaccine.2015.12.052] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 12/14/2015] [Accepted: 12/23/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Implementation of additional targeted vaccinations to prevent infectious diseases in the older adults is under discussion in different countries. When considering the added value of such preventive measures, insight into the current disease burden will assist in prioritization. The aim of this study was derive the first estimates of the disease burden in adults aged 50 years or over in the Netherlands for influenza, pertussis, pneumococcal disease and herpes zoster. METHODS The average annual disease burden for these four diseases in the Netherlands was calculated for the period 2010-2013 using the disability-adjusted life years (DALY) measure. Disease models and parameters were obtained from previous research. Where possible we adapted these models specifically for older adults and applied age-specific parameters derived from literature. The disease burden based on these adapted models and parameters was compared with the disease burden based on the general population models. RESULTS The estimated average annual disease burden was from high to low: pneumococcal disease (37,223 DALYs/year), influenza (7941 DALYs/year), herpes zoster (942 DALYs/year), and pertussis (812 DALYs/year). The adaptation of models and parameters specifically for the elderly resulted in a higher disease burden compared to the use of general population models. CONCLUSIONS Among older adults, the disease burden in the period 2010-2013 was highest for pneumococcal disease, mostly because of high mortality, followed by influenza. Disease burden of herpes zoster and pertussis was relatively low and consisted mostly of years lived with disability. Better information on the course of infectious diseases and long-term consequences would enable more accurate estimation of disease burden in older adults.
Collapse
Affiliation(s)
- Maartje Kristensen
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands.
| | - Alies van Lier
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands.
| | - Renske Eilers
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Epidemiology, PO Box 30.001, 9700 RB Groningen, The Netherlands.
| | - Scott A McDonald
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands.
| | - Wim Opstelten
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands.
| | - Nicoline van der Maas
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands.
| | - Wim van der Hoek
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands.
| | - Mirjam E Kretzschmar
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands.
| | - Mark M Nielen
- NIVEL, Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN Utrecht, The Netherlands.
| | - Hester E de Melker
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands.
| |
Collapse
|
16
|
Baratali L, Lang PO. [Pneumococcal infections: Appraisal and perspectives in terms of adult vaccination]. Presse Med 2015; 44:1155-61. [PMID: 26363530 DOI: 10.1016/j.lpm.2015.04.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 04/02/2015] [Accepted: 04/16/2015] [Indexed: 11/26/2022] Open
Abstract
Pneumococcal diseases are the first cause of bacterial infections in adult and in the aged adult. While its considerable morbi-mortality is potentially preventable through vaccination, the interest of anti-pneumococcal vaccination in these populations is still debated. Effectiveness appraisal of current anti-pneumococcal vaccines and the perspectives in terms of preventive strategies against Streptococcus pneumoniae infections in the adult population are presented.
Collapse
Affiliation(s)
- Laila Baratali
- CHUV, service de médecine interne, 46, rue du Bugnon, 1011 Lausanne, Suisse
| | - Pierre Olivier Lang
- CHUV, service de médecine interne, 46, rue du Bugnon, 1011 Lausanne, Suisse; CHUV, service de gériatrie et de réhabilitation gériatrique, Mont Paisible 16 (MP16/04/414), 1011 Lausanne, Suisse; Anglia Ruskin University, Health and wellbeing academy, Cambridge, Royaume-Uni.
| |
Collapse
|
17
|
Abstract
Individuals with chronic kidney disease (CKD) are vulnerable to vaccine-preventable infections due to impaired immunity, immunosuppressive treatments and dialysis. Protection of CKD patients by vaccination is hampered by reduced efficacy of vaccines and safety concerns for transplant candidates or recipients. 'Cocooning' vaccination policies, targeting the protection of a vulnerable individual through immunization of close contacts, have recently been introduced for infants and, to a lesser degree, for high-risk groups of immunocompromised individuals. In this article, we discuss the potentiality of implementing cocoon strategies for the high-risk group of CKD patients and conclude that this not yet officially recommended policy can substantially contribute to protection against infection and motivate vaccination among families and healthcare workers.
Collapse
Affiliation(s)
- Maria Bitsori
- a Department of Paediatrics, University Hospital, Heraklion 71003, Greece
| | | |
Collapse
|
18
|
Lang PO, Aspinall R. Can we translate vitamin D immunomodulating effect on innate and adaptive immunity to vaccine response? Nutrients 2015; 7:2044-60. [PMID: 25803545 PMCID: PMC4377899 DOI: 10.3390/nu7032044] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 03/09/2015] [Accepted: 03/12/2015] [Indexed: 12/11/2022] Open
Abstract
Vitamin D (VitD), which is well known for its classic role in the maintenance of bone mineral density, has now become increasingly studied for its extra-skeletal roles. It has an important influence on the body’s immune system and modulates both innate and adaptive immunity and regulates the inflammatory cascade. In this review our aim was to describe how VitD might influence immune responsiveness and its potential modulating role in vaccine immunogenicity. In the first instance, we consider the literature that may provide molecular and genetic support to the idea that VitD status may be related to innate and/or adaptive immune response with a particular focus on vaccine immunogenicity and then discuss observational studies and controlled trials of VitD supplementation conducted in humans. Finally, we conclude with some knowledge gaps surrounding VitD and vaccine response, and that it is still premature to recommend “booster” of VitD at vaccination time to enhance vaccine response.
Collapse
Affiliation(s)
- Pierre Olivier Lang
- Geriatric medicine and Geriatric rehabilitation division, Department of medicine, University Hospital of Lausanne (CHUV), CH-1011 Lausanne, Switzerland.
- Health and Wellbeing academy, Anglia Ruskin University, CM1 1SQ Cambridge, UK.
| | - Richard Aspinall
- Health and Wellbeing academy, Anglia Ruskin University, CM1 1SQ Cambridge, UK.
| |
Collapse
|