Evidence map›Paper›PMID 32086950›Full record

ArticleJournal of the American Geriatrics Society2020

Cost-Effectiveness of Pneumococcal Vaccination Policies and Uptake Programs in US Older Populations.

Angela R Wateska, Mary Patricia Nowalk, Chyongchiou J Lin, Lee H Harrison, William Schaffner, Richard K Zimmerman, Kenneth J Smith

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Geriatrics Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
1.0field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 11 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Angela R WateskaDepartment of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Mary Patricia NowalkDepartment of Family Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Chyongchiou J LinDepartment of Family Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Lee H HarrisonDepartment of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
William SchaffnerDepartment of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee.
Richard K ZimmermanDepartment of Family Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Kenneth J SmithDepartment of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.ORCID 0000-0001-8088-566X
University of Pittsburgh · USVanderbilt University · US

Funding

Analyzing Adult Pneumococcal Vaccination Implementation in the UnderservedR01AI116575 · NIAID · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI SMITH, KENNETH J · 2016 to 2023
$2.8M
NIAID NIH HHS R01 AI116575NIAID NIH HHS R01 AI11657503
6 · The paper itself

Abstract

BACKGROUND/

objectivesRecently revised vaccination recommendations for US adults, aged 65 years and older, include both 23-valent pneumococcal polysaccharide vaccine (PPSV23) and 13-valent pneumococcal conjugate vaccine (PCV13), with PCV13 now recommended for immunocompetent older people based on shared decision making. The public health impact and cost-effectiveness of this recommendation or of pneumococcal vaccine uptake improvement interventions are unclear.

designMarkov decision analysis. SETTING AND

participantsHypothetical 65-year-old general and black population cohorts.

interventionCurrent pneumococcal vaccination recommendations for US older people, an alternative policy omitting PCV13 in immunocompetent older people, and vaccine uptake improvement programs.

resultsThe current pneumococcal vaccination recommendation was the most effective strategy, but afforded slight public health benefits compared to an alternative (PPSV23 for all older people plus PCV13 for the immunocompromised) and cost greater than $750 000 per quality-adjusted life-year (QALY) gained in either population group with a vaccine uptake improvement program (absolute uptake increase = 12.3%; cost = $1.78/eligible patient) in place. The alternative strategy was more economically favorable, but cost greater than $100 000/QALY in either population, with or without an uptake intervention. Results were robust in sensitivity analyses; however, in black older people, the alternative strategy with an uptake program was most likely to be favored in probabilistic sensitivity analyses at a $150 000/QALY gained threshold.

conclusionCurrent pneumococcal vaccination recommendations for US older people are economically unfavorable compared to an alternative strategy omitting PCV13 in the immunocompetent. The alternative recommendation with an uptake improvement program may be economically reasonable in black population analyses and could be worth considering as a population-wide recommendation if mitigating racial disparities is a priority. J Am Geriatr Soc 68:1271-1278, 2020.

Indexed as

Cost-Benefit AnalysisHealth PolicyQuality-Adjusted Life YearsAgedBlack PeopleFemaleHumansImmunization ProgramsMaleModels, StatisticalPneumococcal VaccinesPneumonia, PneumococcalVaccination13-valent pneumococcal vaccine23-valent pneumococcal capsular polysaccharide vaccinePneumococcal Vaccinescost-effectiveness analysispneumococcal vaccinationracial disparities

Identifiers

PMID32086950
PMCPMC7299822
OpenAlexW3007163817

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.