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Table 4 Parameter Values

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

Parameter Age group (years)
0- < 2 2-4 5-17 18-49 50-64 65+
Annual non-pandemic baseline incidence rates / 100,000 a       
  Pneumococcal meningitis 3.54 0.98 0.27 0.71 1.37 2.39
  Pneumococcal bacteremia 33.9 13.2 2.16 6.97 18.5 35.5
  All-cause pneumonia 8,749 7,752 1,648 750 328 2,163
Percent of meningitis that results in deafness b 13% 13% 6% 13% 13% 13%
Percent of meningitis that results in disability b 7% 7% 5% 7% 7% 7%
Case-Fatality Rates       
  Pneumococcal meningitisc 6.9% 4.0% 10.0% 10.4% 11.4% 23.8%
  Pneumococcal bacteremiac 0.9% 0.4% 4.2% 6.2% 11.3% 15.7%
  All-cause hospitalized pneumoniad 0.4% 0.2% 0.3% 1.2% 2.5% 6.3%
Direct effects (% reduction in disease at time of vaccination) e       
  IPD 49.8% -- -- -- -- --
  All-cause hospitalized pneumonia 16.2% -- -- -- -- --
vAll-cause non-hospitalized pneumonia 3.8% -- -- -- -- --
Indirect effects (% reduction in disease) f       
  IPD 32.7% 39.4% 34.4% 34.5% 24.5% 27.4%
  All-cause hospitalized pneumonia 22.5% 0.0% 9.2% 11.3% 8.7% 6.9%
All-cause non-hospitalized pneumonia 6.2% 0.0% 4.7% 5.9% 3.7% 3.4%
Direct Medical Costs ($2008)       
  Meningitis episodeg $17,048 $17,048 -- -- -- --
  Bacteremia episodeg $3,253 $3,253 -- -- -- --
  Cost of invasive disease episodeg -- -- $12,738 $17,956 $22,135 $17,216
  Lifetime cost of deafnessh $96,788 $96,788 $91,663 $73,530 $48,435 $35,261
  Lifetime cost of disabilityh $499,409 $499,409 $472,965 $379,402 $249,915 $181,940
  Hospitalized pneumonia episodeh $7,276 $7,276 $4,994 $9,248 $10,148 $9,872
  Non-hospitalized pneumonia episodei $233 $233 $308 $308 $308 $308
  Vaccine Price (per dose)       
  PCV7 $73 -- -- -- -- --
  PCV13 $100 -- -- -- -- --
  Vaccine administration $11 -- -- -- -- --
QALY Inputs (all ages) j,k Meningitis Bacteremia Hospitalized Pneumonia Non-Hospitalized Pneumonia Deafness (utility) Disability (utility)
  0.023 0.008 0.006 0.004 0.73 0.68
  1. Note: Comprehensive information related to estimation and references is available in two previously published studies [15, 22].
  2. a. Incidence rate estimates assume a steady state utilizing 2007 as the baseline year. IPD incidence estimated from unpublished ABCs data provided by Matt Moore [24]. Hospitalized pneumonia incidence estimated from Grijalva [20] with updated estimates for kids <5 years from January 16, 2010 issue of the MMWR. Non-hospitalized pneumonia incidence estimated from analyses of National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS) 2006 (U.S. Dept. of Health and Human Services, National Center for Health Statistics [27, 28].
  3. b. Estimated from Lieu [29] and Shepard [30].
  4. c. Adapted from ABCs Report: Emerging Infections Program Network. Streptococcus pneumoniae 2007 and Tsai [32].
  5. d. Fatality rates estimated from National Vital Statistics report [32]; converted to case-fatality rates by applying rate of death to incidence rates from Grijalva et al. [20].
  6. e. IPD estimated from serotype coverage of PCV13 from ABCs data assuming 94% efficacy against those types. Hospitalized pneumonia adapted from PCV7 efficacy in Black [35] adjusted for PCV13 serotype coverage. Non-hospitalized pneumonia adapted from PCV7 efficacy in Hansen [36] adjusted for PCV13 serotype coverage.
  7. f. IPD estimated from serotype-specific prevalence from ABCs data. Pneumonia estimated using age-specific reductions in disease observed after the introduction of PCV7 in 2000, adjusted by serotype coverage.
  8. g. Estimates for all ages adapted from Ray et al. [44].
  9. h. Estimated from Ray et al. [44] for children <5 years; adjusted by relative difference in discounted life expectancy to obtain lifetime costs for older age groups.
  10. i. Estimates for <5 years adapted from Ray et al. [44]; estimates for >5 years assumes 1 physician visit, 46% of patients receive chest radiograph, blood count and culture, and one course of zithromycin.
  11. j. QALY decrements adapted from Melegaro and Edmunds [48], a cost-effectiveness study in England and Wales that synthesized estimates from various primary sources.
  12. k. Utilities for chronic health states estimated from retrospective studies of meningococcal complications [49, 50].