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Health and economic evaluation of vaccination against pertussis in China: a 40-year analysis

  • Dan Wu
    Correspondence
    Dan Wu and Rize Jing contributed equally as the first authors
    Affiliations
    National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China
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  • Rize Jing
    Correspondence
    Dan Wu and Rize Jing contributed equally as the first authors
    Affiliations
    School of Public Administration and Policy, Renmin University of China, Beijing 100872, China
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  • Hui Zheng
    Affiliations
    National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China
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  • Kun He
    Affiliations
    China Center for Health Development Studies, Peking University, Beijing 100191, China
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  • Yixing Li
    Affiliations
    National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China
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  • Wenzhou Yu
    Affiliations
    National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China
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  • Zundong Yin
    Correspondence
    Corresponding author: Corresponding author: Dr. Zundong Yin, National Immunization Program, Chinese Center for Disease Control and Prevention, No 27, Nanwei Rd, Xicheng District, Beijing 100050, China.
    Affiliations
    National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China
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  • Hai Fang
    Correspondence
    Corresponding author: Prof. Hai Fang, China Center for Health Development Studies, Peking University, No. 38 Xueyuan Rd, Haidian District, Beijing 100191, China. .
    Affiliations
    China Center for Health Development Studies, Peking University, Beijing 100191, China

    Peking University Health Science Center, Chinese Center for Disease Control and Prevention Joint Research Center for Vaccine Economics, Beijing 100191, China
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Published:October 31, 2022DOI:https://doi.org/10.1016/j.jval.2022.10.011
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      Abstract

      Objective

      To evaluate the health and economic impact of DTwP and DTaP vaccination on pertussis prevention and control in China during the 40 years from 1978 to 2017.

      Methods

      We conducted cost-benefit analyses with a decision tree model populated with historical vaccination coverage levels and pertussis incidence and mortality data from before 1978 and during 1978-2017. We modeled 40 birth cohorts from birth until death. Costs and benefits were estimated from direct cost and societal perspectives (direct and indirect costs). Costs and benefits were adjusted to 2017 US dollars, and future values were discounted at a 3% annual rate. We calculated net benefit values (net savings) and benefit-cost ratios (BCRs) of pertussis vaccination of children under five years of age. We conducted sensitivity analyses by varying key parameters within plausible ranges.

      Results

      Without DTwP/DTaP vaccination, there would be an estimated 115.76 million pertussis cases and 426,650 pertussis deaths in the 40 cohorts. With DTwP/DTaP vaccination, pertussis cases and deaths were decreased by an estimated 92.57% and 97.43%, saving 46,987.81 million USD in direct costs and 82,013.37 million USD from societal perspective. Pertussis vaccination program costs were 2,168.76 million USD and 3,961.28 million USD from direct cost and societal perspectives. BCRs were 21.67:1 from the direct cost perspective and 20.70:1 from the societal perspective. Sensitivity analyses showed the results to be robust.

      Conclusions

      Over the lifetime of 40 birth cohorts, China’s immunization program is preventing 93% of pertussis cases and 97% of pertussis deaths, resulting in substantial savings to the health care system and society.

      Keywords

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