In the JournalsPerspective

Timely DTaP vaccination could reduce infant pertussis, hospitalizations

Timely DTaP vaccination among newborn infants could reduce cases of pertussis-related hospitalization and death, according to recent research in the Pediatric Infectious Disease Journal.

“The primary objective of this study was to estimate DTaP vaccination timeliness for the first three doses and investigate the potential impact of improved timeliness on health outcomes and costs in the U.S.,” Desmond Curran, MSc, PhD, and colleagues wrote. “Timely administration of infant pertussis vaccine doses could potentially reduce subsequent pertussis cases, hospitalizations, deaths and medical costs in infants aged younger than 1 year in the U.S.”

The researchers utilized the National Immunization Survey dataset to estimate current DTaP vaccination timeliness in the United States. Statistical analysis, using a Markov model, was used to calculate the potential impact of outcomes and cost of delayed vaccination compared with ACIP-recommended vaccination at 60 days, 120 days and 180 days. The researchers used data from recently published studies to determine the rate of infant hospitalization and death related to pertussis. 

Study results showed that DTaP vaccination of infants was estimated to be delayed by a mean of 16 days, 27 days, and 44 days, respectively, for each of the three doses when compared with the expected vaccination at 60 days, 120 days, and 180 days. Further, Curran and colleagues found that vaccinations that adhered to the schedule could prevent about 278 pertussis cases, 103 hospitalizations and one death in infants aged younger than 1 year.

The researchers also found that timely vaccinations would result in significant annual health care-related cost savings.

“Our results indicate that improving the timeliness of pertussis vaccination could potentially save $1.03 million over 1 year in direct medical costs in the U.S.,” Curran and colleagues wrote. “Reinvestment of such future savings into the development of interventions to improve timeliness of vaccination in high-risk groups could offer valuable public health benefits.” – by David Costill

Disclosure: Curran reports being employed by and holding stock ownership in the GlaxoSmithKline group of companies. Please see the full study for a list of all other authors’ relevant financial disclosures.

Timely DTaP vaccination among newborn infants could reduce cases of pertussis-related hospitalization and death, according to recent research in the Pediatric Infectious Disease Journal.

“The primary objective of this study was to estimate DTaP vaccination timeliness for the first three doses and investigate the potential impact of improved timeliness on health outcomes and costs in the U.S.,” Desmond Curran, MSc, PhD, and colleagues wrote. “Timely administration of infant pertussis vaccine doses could potentially reduce subsequent pertussis cases, hospitalizations, deaths and medical costs in infants aged younger than 1 year in the U.S.”

The researchers utilized the National Immunization Survey dataset to estimate current DTaP vaccination timeliness in the United States. Statistical analysis, using a Markov model, was used to calculate the potential impact of outcomes and cost of delayed vaccination compared with ACIP-recommended vaccination at 60 days, 120 days and 180 days. The researchers used data from recently published studies to determine the rate of infant hospitalization and death related to pertussis. 

Study results showed that DTaP vaccination of infants was estimated to be delayed by a mean of 16 days, 27 days, and 44 days, respectively, for each of the three doses when compared with the expected vaccination at 60 days, 120 days, and 180 days. Further, Curran and colleagues found that vaccinations that adhered to the schedule could prevent about 278 pertussis cases, 103 hospitalizations and one death in infants aged younger than 1 year.

The researchers also found that timely vaccinations would result in significant annual health care-related cost savings.

“Our results indicate that improving the timeliness of pertussis vaccination could potentially save $1.03 million over 1 year in direct medical costs in the U.S.,” Curran and colleagues wrote. “Reinvestment of such future savings into the development of interventions to improve timeliness of vaccination in high-risk groups could offer valuable public health benefits.” – by David Costill

Disclosure: Curran reports being employed by and holding stock ownership in the GlaxoSmithKline group of companies. Please see the full study for a list of all other authors’ relevant financial disclosures.

    Perspective

    Pertussis remains a major public health problem here in the United States with major epidemics of disease occurring despite high vaccination coverage rates in the infant and childhood populations.

    Pertussis morbidity and mortality has the greatest impact on the young infant population under 3 months of age. This is a population that is at the greatest risk for complications and hospitalizations and has the highest mortality rate from the disease. Strategies put forth by the CDC for trying to provide protection for these infants against pertussis disease include strong recommendations for vaccination of pregnant women during each pregnancy with a dose of Tdap vaccine between 27 and 36 weeks’ gestation and on-time, age-appropriate immunization of infants.

    Curran and colleagues estimated current DTaP vaccination timeliness in the U.S. for the first 3 vaccine doses using National Immunization Survey data and Markov modeling. It was found that DTaP vaccination was delayed by 16, 27, and 44 days for the first, second and third DTaP doses, respectively, relative to the recommended vaccination times at 60, 120, and 180 days of life (2, 4, and 6 months of age). This delay in vaccination increases the period of potential pertussis risk for these young infants.

    The model estimated that vaccination at the appropriate age could prevent 278 pertussis cases, 103 hospitalizations, and one death in the infant population under 1 year of age with savings of approximately $1.03 million in health care costs. The findings of this study really speak to the critical importance of ensuring that our young infant population is vaccinated on time and appropriately in order to give them optimal protection against pertussis disease and its associated morbidity and mortality.

    • Tina Q. Tan, MD
    • Professor of Pediatrics Feinberg School of Medicine Northwestern University Medical Director, International Patient Services Program Ann & Robert H. Lurie Children’s Hospital of Chicago

    Disclosures: Tan reports receiving research support from Merck and Sanofi Pasteur and consultant fees from GlaxoSmithKline.