Format

Send to

Choose Destination
See comment in PubMed Commons below
Am J Epidemiol. 2016 Jun 15;183(12):1159-70. doi: 10.1093/aje/kwv347. Epub 2016 May 13.

Cost-Effectiveness of Pertussis Vaccination During Pregnancy in the United States.

Abstract

Vaccination against pertussis has reduced the disease burden dramatically, but the most severe cases and almost all fatalities occur in infants too young to be vaccinated. Recent epidemiologic evidence suggests that targeted vaccination of mothers during pregnancy can reduce pertussis incidence in their infants. To evaluate the cost-effectiveness of antepartum maternal vaccination in the United States, we created an age-stratified transmission model, incorporating empirical data on US contact patterns and explicitly modeling parent-infant exposure. Antepartum maternal vaccination incurs costs of $114,000 (95% prediction interval: 82,000, 183,000) per quality-adjusted life-year, in comparison with the strategy of no adult vaccination, and is cost-effective in the United States according to World Health Organization criteria. By contrast, vaccinating a second parent is not cost-effective, and vaccination of either parent postpartum is strongly dominated by antepartum maternal vaccination. Nonetheless, postpartum vaccination of mothers who were not vaccinated antepartum improves upon the current recommendation of untargeted adult vaccination. Additionally, the temporary direct protection of the infant due to maternal antibody transfer has efficacy for infants comparable to that conferred to toddlers by the full primary vaccination series. Efficient protection against pertussis for infants begins before birth. We highly recommend antepartum vaccination for as many US mothers as possible.

KEYWORDS:

cost-effectiveness; dynamic transmission model; maternal antibody transfer; maternal immunization; pertussis; social contact patterns; vaccine policy; whooping cough

PMID:
27188951
PMCID:
PMC4908210
[Available on 2017-06-15]
DOI:
10.1093/aje/kwv347
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Silverchair Information Systems
    Loading ...
    Support Center