Vaccine-preventable haemophilus influenza type B disease burden and cost-effectiveness of infant vaccination in Indonesia

Pediatr Infect Dis J. 2008 May;27(5):438-43. doi: 10.1097/INF.0b013e318165f1ba.

Abstract

Background: Most of Asia, including Indonesia, does not use Haemophilus influenzae type b (Hib) conjugate vaccines. We estimated total vaccine-preventable disease burden and the cost-effectiveness of Hib conjugate vaccine in Indonesia.

Methods: Hib pneumonia and meningitis incidences for children with access to health care were derived from a randomized vaccine probe study on Lombok Island, Indonesia during 1998-2002. Incidences were adjusted for limited access to care. Health system and patient out-of-pocket treatment cost data were collected concurrent with the probe study. For Hib vaccine in monovalent and combined (with DTP-HepB) presentations, we used 2007 UNICEF vaccine prices of US$3.30 and $3.75 per dose.

Results: For the 2007 Indonesian birth cohort, Hib vaccine would prevent meningitis in 1 of every 179 children, pneumonia in 1 of every 18 children, and 4.9% of mortality among those younger than 5 years. The total incremental societal costs of introducing Hib vaccine in monovalent and pentavalent presentations were, respectively, US$11.74 and $8.93 per child vaccinated. Annual discounted treatment costs averted amounted to 20% of pentavalent vaccine costs. For the pentavalent vaccine, the incremental costs per discounted death and disability adjusted life-year averted amounted to US$3102 and $74, respectively, versus $4438 and $102 for monovalent vaccine.

Conclusions: Routine infant Hib vaccination would prevent a large burden of pediatric illness and death in Indonesia. Even without external funding support, Hib vaccine will be a highly cost-effective intervention in either a monovalent or pentavalent presentation based on commonly used benchmarks.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Child, Preschool
  • Cost of Illness
  • Cost-Benefit Analysis
  • Haemophilus Infections / epidemiology*
  • Haemophilus Infections / immunology*
  • Haemophilus Infections / mortality
  • Haemophilus Infections / prevention & control
  • Haemophilus Vaccines / economics*
  • Haemophilus Vaccines / immunology*
  • Haemophilus influenzae type b / immunology*
  • Health Care Costs / statistics & numerical data
  • Humans
  • Incidence
  • Indonesia / epidemiology
  • Infant
  • Infant, Newborn
  • Meningitis, Haemophilus / epidemiology
  • Meningitis, Haemophilus / microbiology
  • Meningitis, Haemophilus / prevention & control
  • Pneumonia / epidemiology
  • Pneumonia / microbiology
  • Pneumonia / prevention & control
  • Vaccination / economics*
  • Vaccines, Conjugate / economics
  • Vaccines, Conjugate / immunology

Substances

  • Haemophilus Vaccines
  • Vaccines, Conjugate