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Vaccine. 2008 Mar 10;26(11):1420-31. doi: 10.1016/j.vaccine.2008.01.007. Epub 2008 Jan 29.

Alternative strategies for adult pneumococcal polysaccharide vaccination: a cost-effectiveness analysis.

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  • 1Section of Decision Sciences and Clinical Systems Modeling, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States.


Pneumococcal polysaccharide vaccination (PPV) to prevent invasive pneumococcal disease (IPD) is recommended at age 65 for most persons in the US. We used a Markov model to examine alternative PPV strategies, finding that vaccination at ages 50 and 65 prevented more IPD than present vaccination policies; four decennial vaccinations were most effective. The present vaccination policy costs $3341/QALY gained, vaccinations at 50/65 cost $23,120/QALY and four vaccinations (50/60/70/80) cost $54,451/QALY; results were sensitive to vaccine uptake assumptions, with current policy no longer favored at present vaccination rates. PPV at ages 50/65 may be clinically and, depending on cost-effectiveness criterion used, economically favored over present vaccination recommendations.

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