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Incorporating Herd Immunity Effects into Cohort Models of Vaccine Cost-Effectiveness

Author

Listed:
  • Chris T. Bauch

    (Department of Mathematics and Statistics, University of Guelph, Guelph, Ontario, Canada)

  • Andrea M. Anonychuk

    (Statistics and Epidemiology, GlaxoSmithKline Canada, Mississauga, Ontario, Canada, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada)

  • Thierry Van Effelterre

    (World-wide Bio Epidemiology, GlaxoSmithKline Biologicals, Rixensart, Belgium)

  • Ba' Z. Pham

    (Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada)

  • Maraki Fikre Merid

    (Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada)

Abstract

Background. Cohort models are often used in cost-effectiveness analysis (CEA) of vaccination. However, because they cannot capture herd immunity effects, cohort models underestimate the reduction in incidence caused by vaccination. Dynamic models capture herd immunity effects but are often not adopted in vaccine CEA. Objective. The objective was to develop a pseudo-dynamic approximation that can be incorporated into an existing cohort model to capture herd immunity effects. Methods. The authors approximated changing force of infection due to universal vaccination for a pediatric infectious disease. The projected lifetime cases in a cohort were compared under 1) a cohort model, 2) a cohort model with pseudo-dynamic approximation, and 3) an age-structured susceptible-exposed-infectious-recovered compartmental (dynamic) model. The authors extended the methodology to sexually transmitted infections. Results. For average to high values of vaccine coverage (P > 60%) and small to average values of the basic reproduction number (R 0 15), projected lifetime cases were similar under the dynamic model and the cohort model, both with and without pseudo-dynamic approximation. The approximation captures changes in the mean age at infection in the 1st vaccinated cohort. Conclusions. This methodology allows for preliminary assessment of herd immunity effects on CEA of universal vaccination for pediatric infectious diseases. The method requires simple adjustments to an existing cohort model and less data than a full dynamic model.

Suggested Citation

  • Chris T. Bauch & Andrea M. Anonychuk & Thierry Van Effelterre & Ba' Z. Pham & Maraki Fikre Merid, 2009. "Incorporating Herd Immunity Effects into Cohort Models of Vaccine Cost-Effectiveness," Medical Decision Making, , vol. 29(5), pages 557-569, September.
    • Handle: RePEc:sae:medema:v:29:y:2009:i:5:p:557-569
    DOI: 10.1177/0272989X09334419
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    Cited by:

    1. Greg Plosker, 2011. "Rotavirus Vaccine RIX4414 (Rotarix™)," PharmacoEconomics, Springer, vol. 29(11), pages 989-1009, November.
    2. Jamison Pike & Andrew J. Leidner & Harrell Chesson & Charles Stoecker & Scott D. Grosse, 2022. "Data-Related Challenges in Cost-Effectiveness Analyses of Vaccines," Applied Health Economics and Health Policy, Springer, vol. 20(4), pages 457-465, July.
    3. Thomas E Delea & Derek Weycker & Mark Atwood & Dion Neame & Fabián P Alvarez & Evelyn Forget & Joanne M Langley & Ayman Chit, 2017. "Cost-effectiveness of alternate strategies for childhood immunization against meningococcal disease with monovalent and quadrivalent conjugate vaccines in Canada," PLOS ONE, Public Library of Science, vol. 12(5), pages 1-17, May.

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