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. 2013 May 21:13:229.
doi: 10.1186/1471-2334-13-229.

Impact of 13-valent pneumococcal conjugate vaccine (PCV13) in a pandemic similar to the 2009 H1N1 in the United States

Lisa J McGarry  1 , Kristen E Gilmore, Jaime L Rubin, Keith P Klugman, David R Strutton, Milton C Weinstein
Affiliations

Impact of 13-valent pneumococcal conjugate vaccine (PCV13) in a pandemic similar to the 2009 H1N1 in the United States

Lisa J McGarry et al. BMC Infect Dis. .

Abstract

Background: High rates of bacterial coinfection in autopsy data from the 2009 H1N1 influenza ("flu") pandemic suggest synergies between flu and pneumococcal disease (PD) during pandemic conditions, and highlight the importance of interventions like the 13-valent pneumococcal conjugate vaccine (PCV13) that may mitigate the impact of a pandemic.

Methods: We used a decision-analytic model, estimated from published sources, to assess the impact of pediatric vaccination with PCV13 versus the 7-valent vaccine (PCV7) on PD incidence and mortality in a normal flu season (10% flu incidence) and in a pandemic similar to 2009-2010 H1N1 (20% flu incidence, mild virulence, high impact in children). Both direct and indirect (herd) effects against PD were considered. Effectiveness of PCV13 was extrapolated from observed PCV7 data, using assumptions of serotype prevalence and PCV13 protection against the 6 serotypes not in PCV7. To simulate 2009-2010 H1N1, autopsy data were used to estimate the overall proportion of flu deaths with bacterial coinfections. By assuming that increased risk of death during the pandemic occurred among those with comorbidity (using obesity as proxy) and bacterial coinfections primarily due to S. pneumoniae or S. aureus, we estimated the proportion co-infected among all (fatal and non-fatal) flu cases (7.6% co-infected with any organism; 2.2% with S. pneumoniae). PD incidence, mortality, and total healthcare costs were evaluated over a 1-year horizon.

Results: In a normal flu season, compared to PCV7, PCV13 is expected to prevent an additional 13,400 invasive PD (IPD) cases, 399,000 pneumonia cases, and 2,900 deaths, leading to cost savings of $472 M. In a pandemic similar to 2009-2010 H1N1, PCV13 would prevent 22,800 IPD cases, 872,000 pneumonia cases, and 3,700 deaths, resulting in cost savings of $1.0 B compared to PCV7.

Conclusions: In a flu pandemic similar to the 2009-2010 H1N1, protection against the 6 additional serotypes in PCV13 would likely be effective in preventing pandemic-related PD cases, mortality, and associated costs.

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Figures

Figure 1
Figure 1
Pneumococcal deaths averted for PCV13 vs. PCV7 pediatric vaccination in normal and pandemic influenza seasons.
See this image and copyright information in PMC

References

    1. Kamps BS, Hoffmann C, Preiser W. Influenza report 2006. http://www.influenzareport.com Accessed December 24, 2008.
    1. Trust for America’s Health. Pandemic flu and the potential for U.S. economic recession: a state-by-state analysis, March 2007. http://healthyamericans.org/reports/flurecession/ Accessed December 24, 2008.
    1. Taubenberger JK, Morens DM. 1918 Influenza: the mother of all pandemics. http://www.cdc.gov/ncidod/EID/vol12no01/05-0979.htm Accessed December 24, 2008. - PMC - PubMed
    1. Johnson NP, Mueller J. Updating the accounts: global mortality of the 1918–1920 “Spanish” influenza pandemic. Bull Hist Med. 2002;76(1):105–115. doi: 10.1353/bhm.2002.0022. - DOI - PubMed
    1. Muir R, Haswell Wilson G. Observations on influenza and its complications. Br Med J. 1919;1(3027):3–5. doi: 10.1136/bmj.1.3027.3. - DOI - PMC - PubMed

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