Evidence map›Paper›PMID 34183204›Full record

ArticleVaccine2021

Evaluating the impact of a continued maternal pertussis immunisation programme in England: A modelling study and cost-effectiveness analysis.

Frank Sandmann, Mark Jit, Nick Andrews, Hannah L Buckley, Helen Campbell, Sonia Ribeiro, Bersabeh Sile, Julia Stowe, Elise Tessier, Mary Ramsay and 2 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
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, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 32% 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

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Maternal vaccination-current status, challenges, and opportunities.The journal of obstetrics and gynaecology research · 2023
    Review
  3. Review
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

12 authors at 2 institutions in 2 countries.

Frank SandmannStatistics, Modelling and Economics Department, National Infection Service (NIS), Public Health England (PHE), London, UK; Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine (LSHTM), London, UK.
Mark JitStatistics, Modelling and Economics Department, National Infection Service (NIS), Public Health England (PHE), London, UK; Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine (LSHTM), London, UK; School of Public Health, University of Hong Kong, Hong Kong SAR, China.
Nick AndrewsStatistics, Modelling and Economics Department, National Infection Service (NIS), Public Health England (PHE), London, UK.
Hannah L BuckleyPICANet, School of Medicine, University of Leeds, Leeds, UK.
Helen CampbellImmunisation and Countermeasures Department, National Infection Service (NIS), Public Health England (PHE), London, UK.
Sonia RibeiroImmunisation and Countermeasures Department, National Infection Service (NIS), Public Health England (PHE), London, UK.
Bersabeh SileImmunisation and Countermeasures Department, National Infection Service (NIS), Public Health England (PHE), London, UK.
Julia StoweImmunisation and Countermeasures Department, National Infection Service (NIS), Public Health England (PHE), London, UK.
Elise TessierImmunisation and Countermeasures Department, National Infection Service (NIS), Public Health England (PHE), London, UK.
Mary RamsayImmunisation and Countermeasures Department, National Infection Service (NIS), Public Health England (PHE), London, UK.
Gayatri AmirthalingamImmunisation and Countermeasures Department, National Infection Service (NIS), Public Health England (PHE), London, UK.
Yoon H ChoiStatistics, Modelling and Economics Department, National Infection Service (NIS), Public Health England (PHE), London, UK.
Public Health England · GBUniversity of Leeds · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAn unexpected resurgence of pertussis cases and infant deaths was observed in some countries that had switched to acellular pertussis vaccines in the primary immunisation schedule. In response to the outbreaks, maternal pertussis vaccination programmes in pregnant women have been adopted worldwide, including the USA in 2011 and the UK in 2012. Following the success of the programme in England, we evaluated the health and economic impact of stopping versus continuing the maternal pertussis immunisation to inform public health policy making.

methodsWe used a mathematical model to estimate the number of infant hospitalisations and deaths related to pertussis in England over 2019-2038. Losses in quality-adjusted life years, QALYs, were considered for infants (aged 0-2 months) who survived or died from pertussis, bereaved parents (of infants who died from pertussis), and women with pertussis (aged 20-44 years). Direct medical costs to the National Health Service included infant hospitalisations, maternal vaccinations, and disease in women. Costs and QALYs were discounted at 3.5%. Changes in the incremental cost-effectiveness ratio, ICER, were explored in sensitivity analyses.

resultsThe model supports continuing the maternal pertussis immunisation programme as a cost-effective intervention at an ICER of £14,500/QALY (2.5% and 97.5%-quantile: £7,300/QALY to £32,400/QALY). Stopping versus continuing the maternal programme results in an estimated mean of 972 (range 582 to 1489) versus 308 (184 to 471) infant hospitalisations annually. Results were most sensitive to the number of hospitalisations and deaths when stopping the maternal programme. At a cost-effectiveness threshold of £30,000/QALY, the probability of the maternal programme being cost-effective was 96.2%.

conclusionOur findings support continuing the maternal pertussis vaccination programme as otherwise higher levels of disease activity and infant mortality are expected to return. These results have led policy makers to decide to continue the maternal programme in the UK routine immunisation schedule.

Indexed as

Whooping CoughCost-Benefit AnalysisEnglandFemaleHumansImmunization ProgramsInfantPregnancyQuality-Adjusted Life YearsState MedicineVaccinationEconomic evaluationMaternal vaccinationMathematical modelPertussisPublic healthResurgence

Identifiers

PMID34183204
PMCPMC8429047
OpenAlexW3175515390

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.