The economic evaluation of a vaccination against pertussis infection in children in Moscow

Abstract

Actuality. Previously, we calculated the economic consequences of the booster vaccination against pertussis infection (CI) with the tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine, combined, adsorbed (INN) in some regions of the Russian Federation, which showed that the public benefit within 7 years after immunization could potentially exceed the cost of vaccination 1.23 times. At the same time, it is important to provide an economic justification for vaccination for a megalopolis, such as Moscow, with an underestimation of the diagnosis of the disease in conditions of high population density, contributing to the spread of infection. Materials and methods. The assessment of the economic benefits of obtaining an epidemiological gain during revaccination was carried out within the framework of a market economy using an assessment of the cost of the disease. The calculations were based on data on the cost of CI treatment in Moscow, considering cases of complicated and mild course and on the basis of current tariffs of the OMI system. Modeling was performed based on morbidity rates, taking into account the underestimation of detectability in a cohort of 14-year-olds numbering 100 thousand people. Two scenarios were compared, providing for the preservation of the existing procedure of revaccination only at 6 years (95% coverage) and the scenario in which the second revaccination of all adolescents was carried out at 14 years. Using the model, epidemiological indicators of changes in the incidence of CI were determined, and direct and indirect costs were calculated on their basis. When testing the sensitivity of the model, other levels of vaccination of 14-year-old children were also used in the calculations. Results. Booster revaccination of a conditional cohort of 100,000 children aged 14 years with the mentioned vaccine will reduce the incidence of pertussis during the period of saving immune protection (7 years) by 53.7% (from 1702.5 to 788.4 cases per 100 thousand of the population of these ages). This epidemiological gain will be accompanied by an economic benefit calculated in the metric of the total cost of prevented cases of the disease, which will amount to 155.4 million rubles. For a cohort of 100 thousand revaccinated adolescents of 14 years. The economic benefits accompanying a potential reduction in the incidence of infants can range from 254.4 to 470.5 million rubles, depending on the nature and intensity of contacts between adolescents and younger children. Conclusion. With the given parameters of underestimating the diagnosis and cost of the vaccine in the population over 14 years of age in Moscow, revaccination of adolescents is an economically justified measure.