Evidence map›Paper›PMID 33077536›Full record

ArticleCMAJ open

Pertussis vaccination in pregnancy in Canada: a cost-utility analysis.

Bahaa Abu-Raya, Doug Coyle, Julie A Bettinger, Wendy Vaudry, Scott A Halperin, Manish Sadarangani, for members of the Canadian Immunization Monitoring Program, ACTive (IMPACT)

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

Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.3field-weighted citation impact, top 43% 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

1 citing paper in PubMed, 5 citations in OpenAlex.

  1. Article
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 4 institutions in 1 country.

Bahaa Abu-RayaVaccine Evaluation Center (Abu-Raya, Bettinger, Sadarangani), BC Children's Hospital Research Institute; Division of Infectious Diseases (Abu-Raya, Bettinger, Sadarangani), Department of Pediatrics, University of British Columbia, Vancouver, BC; School of Epidemiology and Public Health (Coyle), University of Ottawa, Ottawa, Ont.; Stollery Children's Hospital (Vaudry), Women and Children's Health Research Institute, University of Alberta, Edmonton, Alta.; Canadian Center for Vaccinology (Halperin), IWK Health Centre and Dalhousie University, Halifax, NS.
Doug CoyleVaccine Evaluation Center (Abu-Raya, Bettinger, Sadarangani), BC Children's Hospital Research Institute; Division of Infectious Diseases (Abu-Raya, Bettinger, Sadarangani), Department of Pediatrics, University of British Columbia, Vancouver, BC; School of Epidemiology and Public Health (Coyle), University of Ottawa, Ottawa, Ont.; Stollery Children's Hospital (Vaudry), Women and Children's Health Research Institute, University of Alberta, Edmonton, Alta.; Canadian Center for Vaccinology (Halperin), IWK Health Centre and Dalhousie University, Halifax, NS.
Julie A BettingerVaccine Evaluation Center (Abu-Raya, Bettinger, Sadarangani), BC Children's Hospital Research Institute; Division of Infectious Diseases (Abu-Raya, Bettinger, Sadarangani), Department of Pediatrics, University of British Columbia, Vancouver, BC; School of Epidemiology and Public Health (Coyle), University of Ottawa, Ottawa, Ont.; Stollery Children's Hospital (Vaudry), Women and Children's Health Research Institute, University of Alberta, Edmonton, Alta.; Canadian Center for Vaccinology (Halperin), IWK Health Centre and Dalhousie University, Halifax, NS.
Wendy VaudryVaccine Evaluation Center (Abu-Raya, Bettinger, Sadarangani), BC Children's Hospital Research Institute; Division of Infectious Diseases (Abu-Raya, Bettinger, Sadarangani), Department of Pediatrics, University of British Columbia, Vancouver, BC; School of Epidemiology and Public Health (Coyle), University of Ottawa, Ottawa, Ont.; Stollery Children's Hospital (Vaudry), Women and Children's Health Research Institute, University of Alberta, Edmonton, Alta.; Canadian Center for Vaccinology (Halperin), IWK Health Centre and Dalhousie University, Halifax, NS.
Scott A HalperinVaccine Evaluation Center (Abu-Raya, Bettinger, Sadarangani), BC Children's Hospital Research Institute; Division of Infectious Diseases (Abu-Raya, Bettinger, Sadarangani), Department of Pediatrics, University of British Columbia, Vancouver, BC; School of Epidemiology and Public Health (Coyle), University of Ottawa, Ottawa, Ont.; Stollery Children's Hospital (Vaudry), Women and Children's Health Research Institute, University of Alberta, Edmonton, Alta.; Canadian Center for Vaccinology (Halperin), IWK Health Centre and Dalhousie University, Halifax, NS.
Manish SadaranganiVaccine Evaluation Center (Abu-Raya, Bettinger, Sadarangani), BC Children's Hospital Research Institute; Division of Infectious Diseases (Abu-Raya, Bettinger, Sadarangani), Department of Pediatrics, University of British Columbia, Vancouver, BC; School of Epidemiology and Public Health (Coyle), University of Ottawa, Ottawa, Ont.; Stollery Children's Hospital (Vaudry), Women and Children's Health Research Institute, University of Alberta, Edmonton, Alta.; Canadian Center for Vaccinology (Halperin), IWK Health Centre and Dalhousie University, Halifax, NS manish.sadarangani@bcchr.ubc.ca.
for members of the Canadian Immunization Monitoring Program, ACTive (IMPACT)
Izaak Walton Killam Health Centre · CAUniversity of British Columbia · CABC Children's Hospital · CADalhousie University · CA

Funding

CIHR
6 · The paper itself

Abstract

backgroundThe Canadian National Advisory Committee on Immunization recommends universal vaccination against pertussis in pregnancy. We assessed the cost-effectiveness of vaccination with tetanus-diphtheria-acellular pertussis (Tdap) vaccine in pregnancy in Canada.

methodsWe conducted a cost-utility analysis comparing a vaccination program to no program corresponding with the 2017 Canadian guideline for economic evaluation from the Canadian Agency for Drugs and Technologies in Health. We developed 2 models - part decision tree, part Markov model - to estimate the long-term cost and quality-adjusted life-years (QALYs) for pregnant women and their infants. We obtained epidemiologic data from 2006 to 2015, and derived costs and utility values from relevant sources. Results were reported in 2019 Canadian dollars. We obtained expected values through probabilistic analysis, with methodologic and structural uncertainty assessed through scenario analyses. The analysis adopted an acquisition price of Tdap vaccine of $12.50, with scenario analysis conducted to identify the threshold price for vaccination to be cost-effective.

resultsIn the base-case scenario, for every 1000 pregnant women vaccinated, the program would lead to a gain of 0.3 QALYs, occurring solely in infants, at an increased total cost of $12 987, or $44 301 per QALY gained. Based on a threshold of $50 000 per QALY gained, vaccination would have been cost-effective in 6 of the 10 years included in the model (range of incremental costs $20 463-$100 348 per QALY gained). The threshold cost for Tdap vaccine to be cost-effective over the 10-year horizon was $14.03.

interpretationBased on a threshold of $50 000 per QALY gained, vaccination against pertussis in pregnancy would be cost-effective if the acquisition cost per vaccine were $14.03 or less. Province- and territory-specific analyses should be done to inform local decision-making.

Indexed as

Cost-Benefit AnalysisCanadaDiphtheria-Tetanus-acellular Pertussis VaccinesFemaleHumansModels, EconomicPregnancyQuality-Adjusted Life YearsVaccinationWhooping CoughDiphtheria-Tetanus-acellular Pertussis Vaccines

Identifiers

PMID33077536
PMCPMC7588263
OpenAlexW3093363459

What OpenQuestion holds

Textmetadata
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.