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Hospital-based vaccination programs likely decrease chances of outbreaks, save costs

Greer AL. Pediatrics. 2011;doi:10.1542/peds.2010-0796.

Researchers noted “a progressive decrease” in the likelihood of an outbreak after the implementation of a hospital-based diphtheria-tetanus-acellular pertussis vaccine program.

Amy L. Greer, MSc, PhD, of the Public Health Agency of Canada, and David N. Fisman, MD, MPH, of University of Toronto, calculated the cost-effectiveness of vaccinating personnel in a neonatal ICU. Their calculations compared costs involved with no pertussis booster vaccination programs with a program that achieves between 25% and 95% vaccine coverage.

The researchers reported that the intervention reduced costs across the board, regardless of coverage rate.

“Once the monthly risk of an introduction exceeded 0.3%, implementation of an immunization program with at least 25% coverage provided both greater health and greater economic benefits than having no vaccine program,” the researchers wrote.

Greer and Fisman said there are several factors involved in starting vaccination campaigns at hospitals, most notably the vaccine cost, the hospital’s attrition rate and probability that a health care worker will come to work with infectious pertussis.

“We projected net cost savings with low-level boosting of pertussis immunization in the context of endemic pertussis activity in the community, but higher levels of vaccine coverage would become cost-saving in the context of community outbreaks and epidemics that markedly increase the risk of pertussis in the community,” the study researchers concluded. “These results suggest a novel approach to pertussis vaccination coverage for NICU health care workers.”

Disclosure: The researchers report no relevant financial disclosures.

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