Evidence map›Paper›PMID 34045104›Full record

ArticleVaccine2021

Is further research on adult pneumococcal vaccine uptake improvement programs worthwhile? Α value of information analysis.

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

Abstract read
In one paragraph

Article in Vaccine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. 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

8 authors.

Angela R WateskaUniversity of Pittsburgh, School of Medicine, Pittsburgh, PA, United States. Electronic address: arw74@pitt.edu.
Mary Patricia NowalkUniversity of Pittsburgh, School of Medicine, Pittsburgh, PA, United States. Electronic address: tnowalk@pitt.edu.
Hawre JalalUniversity of Pittsburgh, Graduate School of Public Health, Pittsburgh, PA, United States. Electronic address: hjalal@pitt.edu.
Chyongchiou J LinThe Ohio State University College of Nursing, United States. Electronic address: lin.3782@osu.edu.
Lee H HarrisonUniversity of Pittsburgh, School of Medicine, Pittsburgh, PA, United States; University of Pittsburgh, Graduate School of Public Health, Pittsburgh, PA, United States. Electronic address: lharriso@edc.pitt.edu.
William SchaffnerVanderbilt University School of Medicine, Nashville, TN, United States. Electronic address: william.schaffner@vanderbilt.edu.
Richard K ZimmermanUniversity of Pittsburgh, School of Medicine, Pittsburgh, PA, United States. Electronic address: zimmer@pitt.edu.
Kenneth J SmithUniversity of Pittsburgh, School of Medicine, Pittsburgh, PA, United States. Electronic address: smithkj2@upmc.edu.

Funding

Analyzing Adult Pneumococcal Vaccination Implementation in the UnderservedR01AI116575 · NIAID · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI SMITH, KENNETH J · 2016 to 2023
$2.8M
Understanding the Impact of Opioid Policies on the Opioid Epidemic Using Graphical Causal Models and Causal DiscoveryK01DA048985 · NIDA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI JALAL, HAWRE · 2020 to 2021
$360k
NIAID NIH HHS R01 AI116575NIDA NIH HHS K01 DA048985
6 · The paper itself

Abstract

backgroundPneumococcal vaccination policy for US adults is evolving, but previous research has shown that programs to increase vaccine uptake are economically favorable, despite parameter uncertainty. Using value of information (VOI) analysis and prior analyses, we examine the value of further research on vaccine uptake program parameters.

methodsIn US 50-64-year-olds, current vaccine recommendations with and without an uptake program were analyzed. In older adults, current recommendations and an alternative strategy (polysaccharide vaccine for all, adding conjugate vaccine only for the immunocompromised) with and without uptake programs were examined. Uptake program parameters were derived from a clinical trial (absolute uptake increase 12.3% [range 0-25%], per-person cost $1.78 [range $0.70-$2.26]), with other parameters obtained from US databases. VOI analyses incorporated probabilistic sensitivity analysis outputs into R-based regression techniques.

resultsIn 50-64-year-olds, an uptake program cost $54,900/QALY gained compared to no uptake program. For ages ≥65, the program cost $287,000/QALY gained with the alternative strategy and $765,000/QALY with current recommendations. In younger adults, population-level expected value of perfect information (EVPI) was $59.7 million at $50,000/QALY gained and $2.8 million at $100,000/QALY gained. In older adults, EVPI values ranged from ~$1 million to $34.5 million at $100,000 and $200,000/QALY thresholds. The population expected value of partial perfect information (EVPPI) for combined uptake program cost and uptake improvement parameters in the younger population was $368,700 at $50,000/QALY and $43,900 at $100,000/QALY gained thresholds. In older adults, population EVPPI for vaccine uptake program parameters was $0 at both thresholds, reaching a maximum value of $445,000 at a $225,000/QALY threshold. Other model parameters comprised larger components of the global EVPI.

conclusionVOI results do not support further research on pneumococcal vaccine uptake programs in adults at commonly cited US cost-effectiveness benchmarks. Further research to reduce uncertainty in other aspects of adult pneumococcal vaccination is justifiable.

Indexed as

Pneumococcal InfectionsPneumococcal VaccinesAgedCost-Benefit AnalysisHumansImmunization ProgramsQuality-Adjusted Life YearsStreptococcus pneumoniaeVaccinationVaccines, ConjugatePneumococcal VaccinesVaccines, ConjugateAdult pneumococcal vaccinationCost-effectiveness analysisValue of information analysis

Identifiers

PMID34045104
PMCPMC8296468

What OpenQuestion holds

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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.