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Open Access Highly Accessed Research article

Impact of routine PCV7 (Prevenar) vaccination of infants on the clinical and economic burden of pneumococcal disease in Malaysia

Syed Aljunid12*, Gulifeiya Abuduxike1, Zafar Ahmed2, Saperi Sulong2, Amrizal Muhd Nur2 and Adrian Goh3

Author Affiliations

1 United Nations University-International Institute For Global Health, Kuala Lumpur, Malaysia

2 International Case-Mix and Clinical Coding Centre, UKM Medical Centre, Faculty of Medicine, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia

3 Azmi Burhani Consulting, Kelana Jaya, Malaysia

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BMC Infectious Diseases 2011, 11:248  doi:10.1186/1471-2334-11-248

Published: 21 September 2011

Abstract

Background

Pneumococcal disease is the leading cause of vaccine-preventable death in children younger than 5 years of age worldwide. The World Health Organization recommends pneumococcal conjugate vaccine as a priority for inclusion into national childhood immunization programmes. Pneumococcal vaccine has yet to be included as part of the national vaccination programme in Malaysia although it has been available in the country since 2005. This study sought to estimate the disease burden of pneumococcal disease in Malaysia and to assess the cost effectiveness of routine infant vaccination with PCV7.

Methods

A decision model was adapted taking into consideration prevalence, disease burden, treatment costs and outcomes for pneumococcal disease severe enough to result in a hospital admission. Disease burden were estimated from the medical records of 6 hospitals. Where local data was unavailable, model inputs were obtained from international and regional studies and from focus group discussions. The model incorporated the effects of herd protection on the unvaccinated adult population.

Results

At current vaccine prices, PCV7 vaccination of 90% of a hypothetical 550,000 birth cohort would incur costs of RM 439.6 million (US$128 million). Over a 10 year time horizon, vaccination would reduce episodes of pneumococcal hospitalisation by 9,585 cases to 73,845 hospitalisations with cost savings of RM 37.5 million (US$10.9 million) to the health system with 11,422.5 life years saved at a cost effectiveness ratio of RM 35,196 (US$10,261) per life year gained.

Conclusions

PCV7 vaccination of infants is expected to be cost-effective for Malaysia with an incremental cost per life year gained of RM 35,196 (US$10,261). This is well below the WHO's threshold for cost effectiveness of public health interventions in Malaysia of RM 71,761 (US$20,922).