For adults, Pneumococcal vaccination may be more cost effective from 13 kon'yuhatnoy previously reserved for children (Prevnar 13) than the currently recommended 23-valent version (Pneumovax 23), with modeling studies. The cost of quality of life year was estimated at $ 28,900 with 13-serotype vaccine (PCV13) compared with $ 34,600 from 23-serotype vaccine polysaharydnoy (PPSV23), said Kenneth J. Smith, MD from the University of Pittsburgh, and colleagues. These figures were within the range considered moderate evidence for adoption of a measure, but change some assumptions about the effectiveness of new vaccines eliminated its advantages, the group announced on February 22/29 issue
American Medical Association. "PCV13 may prevent more pneumococcal infections compared with current vaccination recommendations PPSV23 while remaining economically justified," they concluded. Conjugated vaccine covers 13 bacterial serotypes, which make up the majority of invasive pneumonia. He replaced semyvalentnom version for children in 2010 and was expanded indication for the population >> << last month. While the 23-valent vaccine covers more serotypes, and thus may prevent more cases of invasive pneumonia, it has great efficacy against the most common nonbacteremia cases. 13-valent conjugated vaccine will probably be better to prevent cases of pneumonia that are not related blood infections, the results of similar conjugated vaccines against seven serotypes. If this assumption is not justified, the profitability of 13-valent vaccine for adults can be too. The sensitivity analysis suggested that the new vaccine cost prohibitive $ 131,000 per quality year of life if it is low efficacy against nonbacteremic pneumonia compared with $ 34,600 for the 23-valent vaccine. Another question mark in the weight changes in the routine vaccination of adults recommendations is that not enough time was accumulated with a new vaccine in the pediatric population to show a significant effect of immunity to adults they often infect, Eugene D. Shapiro I., Dr. MD, Yale University, noted in the accompanying editorial. "To the extent that immunization of children with PCV13 reduces the risk of pneumococcal pneumonia in adults nonbacteremic, in favor of immunization of adults with PCV13 will also be reduced," he wrote. Any level of strattera prescription collective immunity included profitability numbers in favor of 13-valent vaccine to provide 23-valent vaccine top. But the researchers noted that the strategy they are modeled with 13-valent vaccine may solve the problem of low absorption pneumonia vaccination in adults. Guide to promote pneumococcal vaccination from 65 years or sooner if there is concomitant disease. While about half of them in 50 years of such evidence, which now include smoking or asthma, less than 30% are vaccinated, Shapiro said. Thus, the study modeled cost-effectiveness in a hypothetical cohort of U.S. 50-year, using data from the CDC bacterial surveillance program, the National Hospital Discharge Review and National Inpatient Sample data and national survey of health. Regular 13-valent vaccine at the age of 50 and 65 years for all, not just those with concomitant diseases, raised the cost of quality of life for some years to $ 45,100. This strategy, "though with a higher return on relationships, considering the complexity of risk-based guidelines and according to the distance of comorbidities based strategies on the example of recent changes in influenza vaccination recommendations," Smith wrote the group. The study has some limitations, including lack of data on the effectiveness of PCV13 and unknown herd size effects and changes in the distribution of serotypes result of childhood PCV13. Overall, the results should help in deciding how to change or pneumococcal vaccination recommendations, despite the lack of definitive data on factors such as efficiency and immunity herd Shapiro completed. Randomized study among 85,000 adults PCV13 in the Netherlands aged 64 and above, and we're collecting data from end December 2011. The results of this study are expected in 2013. .
