Objectives: This study aimed to assess the cost-effectiveness of introducing universal maternal pertussis immunisation under the national vaccine programme in Thailand.
Methods: We conducted a cost-utility analysis from a societal perspective to compare maternal vaccination with (1) TdaP vaccine, (2) Td vaccine and aP vaccine, and (3) Td vaccine only. We constructed two decision-tree models with Markov elements, each following a different clinical pathway, to allow us to examine structural uncertainty. Costs were converted to 2021 Thai Baht (THB) and a discount rate of 3% was applied to health and cost outcomes, with sensitivity analysis at 0% and 6%. Parameter uncertainty was investigated through deterministic and probabilistic sensitivity analysis, with expected value of perfect information analysis.
Results: Maternal pertussis vaccination would avert 27 cases and up to one death per year. The incremental cost-effectiveness ratio (ICER) for adding aP to the maternal immunisation schedule is 2,184,025 THB/QALY and the ICER for replacing maternal Td vaccination with TdaP is 3,198,101 THB/QALY. Maternal pertussis vaccination only becomes favourable in the probabilistic sensitivity analysis at cost-effectiveness thresholds above 6,000,000 THB/QALY, far above the Thai threshold of 160,000 THB/QALY. If incidence is less than 397 cases per 100,000, maternal pertussis vaccination will not be cost-effective in Thailand, within the plausible range for vaccine effectiveness and probability of hospitalisation. Budget impact is dominated by vaccination costs, which represent 12% and 18% of the 2021 national vaccine programme budget for introducing aP vaccine or for switching Td with TdaP vaccine, respectively.
Conclusions: We have found that maternal pertussis immunisation is not cost-effective in Thailand. Although there may be substantial under-reporting of pertussis cases, comparison with hospital data suggests that most under-reported cases are not hospitalised and therefore have negligible impact on our results. However, considerations such as affordability and local manufacturing may also be important for national immunisation programme decision-making.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9644008 | PMC |
| http://dx.doi.org/10.1007/s40273-022-01207-w | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Decay Rates of Maternal Tetanus, Diphtheria, and Pertussis Antibody Levels in Early and Moderate-to-Late Preterm and Term Infants at Birth and at Two Months.
Open Forum Infect Dis
January 2025
Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
A post hoc analysis of maternally derived antibodies at birth and age 2 months following second trimester maternal Tdap vaccination between 20 and 24 weeks' gestational age (GA) showed a faster decay rate of Tdap-related immunoglobulin G in early preterms born before 32 weeks' GA compared with moderate-to-late preterms and full-terms. This is different from previous studies and merits further research.
View Article and Find Full Text PDFVaccination of pregnant women: an overview of European policies and strategies to promote it.
Front Public Health
December 2024
Department of Medicine and Surgery, University of Perugia, Perugia, Italy.
Maternal immunization is a valuable tool for protecting mother and unborn child from vaccine-preventable diseases. However, the implementation of strategies for vaccinating pregnant women has only recently gained traction. This work is aimed at providing an overview of European vaccination strategies and gathering evidence on interventions enhancing vaccination knowledge, attitudes, and behaviors (KAB) in pregnant women.
View Article and Find Full Text PDFSafety, Efficacy, and Effectiveness of Maternal Vaccination against Respiratory Infections in Young Infants.
Semin Respir Crit Care Med
December 2024
South Africa Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Lower respiratory tract infection (LRTI) is a major cause of neonatal morbidity and mortality worldwide. Maternal vaccination is an effective strategy in protecting young infants from LRTI, particularly in the first few months after birth when infant is most vulnerable, and most primary childhood vaccinations have not been administered. Additionally, maternal vaccination protects the mother from illness during pregnancy and the postnatal period, and the developing fetus from adverse outcomes such as stillbirth and prematurity.
View Article and Find Full Text PDFSafety and immunogenicity of an acellular pertussis vaccine containing genetically detoxified pertussis toxin administered to pregnant women living with and without HIV and their newborns (WoMANPOWER): a randomised controlled trial in Uganda.
Lancet Glob Health
January 2025
Centre for Neonatal and Paediatric Infection and Vaccine Institute, City St George's, University of London, London, UK; Makerere University-Johns Hopkins University Research Collaboration, Kampala, Uganda; UK Health Security Agency, Salisbury, UK.
Background: Immunisation in pregnancy against pertussis can reduce severe disease in infancy. There are few data on the safety and immunogenicity of vaccines given to pregnant women living with HIV and their infants. We aimed to describe the safety and immunogenicity of a tetanus-diphtheria-acellular pertussis (TdaP) vaccine containing genetically detoxified pertussis toxin given to pregnant women living with HIV and the effect of the vaccine on infant whole-cell pertussis vaccine responses.
View Article and Find Full Text PDFEffect of HIV and Malaria in Pregnancy on Pertussis-specific Antibodies and Transplacental Antibody Transfer: A Secondary Analysis of a Prospective Cohort Study in Mozambican Pregnant Women and Their Infants.
Pediatr Infect Dis J
December 2024
From the Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique.
Article Synopsis
- Maternal HIV and malaria infections during pregnancy can negatively impact the transfer of pertussis immunity from mothers to their infants.
- A study in Mozambique, involving 270 mother-infant pairs, found that mothers with HIV had significantly lower placental transfer of pertussis-specific antibodies compared to those without HIV.
- The findings suggest that addressing maternal HIV through healthcare interventions and immunization could help protect infants from pertussis.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!