Elsevier

Vaccine

Volume 29, Issue 17, 12 April 2011, Pages 3329-3334
Vaccine

Projected health benefits and costs of pneumococcal and rotavirus vaccination in Uganda☆

https://doi.org/10.1016/j.vaccine.2010.12.122Get rights and content

Abstract

We determined impact and cost-effectiveness of pneumococcal and rotavirus vaccination programs among children < 5 years of age in Uganda from the public health system perspective. Disease-specific models compared the disease burden and cost with and without a vaccination program. If introduced, pneumococcal and rotavirus vaccine programs will save 10,796 and 5265 lives, respectively, prevent 94,071 Streptococcus pneumoniae and 94,729 rotavirus cases in children < 5 years, and save 3886 and 996 million Ugandan shillings ($2.3 and $0.6 million US dollars), respectively, in direct medical costs annually. At the GAVI price ($0.15/dose), pneumococcal vaccine will be cost-saving and rotavirus vaccine highly cost-effective.

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Background

Acute respiratory infections and diarrheal diseases are leading causes of childhood illness and death worldwide. Two of the most important vaccine-preventable pathogens in each disease group, Streptococcus pneumoniae and rotavirus, respectively, are together responsible for over 2 million deaths annually among children < 5 years of age globally [1], [2], [3]. In Uganda, S. pneumoniae accounts for approximately one-third of pneumonia and bacterial meningitis among children < 5 years [4], [5], [6].

Overview of models

Disease-specific, decision-tree models were used to estimate the impact and cost-effectiveness of national pneumococcal and rotavirus immunization programs, respectively, by comparing the cost and burden of disease with and without such programs [9], [10]. The models were created for use in developing country settings and estimate health outcomes and direct medical costs associated with pneumococcal and rotavirus disease for an annual birth cohort of 1.4 million followed for a 5-year period.

Disease burden

Annually, pneumococcal infection results in 3212 cases of pneumococcal pneumonia, 28 cases of pneumococcal meningitis, and 139 non-pneumonia, non-meningitis IPD per 100,000 children < 5 years of age in Uganda (Table 3) [5]. By age 5 years, 1 in every 6 children will have had pneumococcal pneumonia, 1 in every 714 children will have had pneumococcal meningitis, and 1 in every 144 children will have had non-pneumonia, non-meningitis IPD [5].

Rotavirus diarrheal illnesses result in 192 deaths, 204

Discussion

The 10-valent pneumococcal conjugate vaccine will be cost-saving to the health-care system and monovalent rotavirus vaccine will be highly cost-effective if introduced into the national immunization program in Uganda at the GAVI subsidized price of $0.15 per dose. Annually, a pneumococcal vaccination program would save 622 million Ushs ($0.4 million USD) and a rotavirus vaccination program would have a net cost of 1071 million Ushs ($0.6 million USD). Both vaccines would have substantial health

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    ☆

    The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention (CDC).

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