The clinical and economic impact of pneumococcal conjugate vaccine associated herd immunity in Canada

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Abstract
Since mid-2001 a heptavalent pneumococcal conjugate vaccine (PCV-7) against seven common pneumococcal serotypes has been available in Canada. The purpose of this study was to build upon existing economic evaluations and use recent herd immunity evidence to estimate the real-world clinical and economic effectiveness of PCV-7 in Canada. Effectiveness trial data evaluating the broad population level benefits of a PCV-7 programme in the United States (US) was reviewed. Estimates of the clinical and economic impacts of PCV-7 on adult pneumococcal disease were determined based on epidemiological and cost data available from the US and Canada. Using recent effectiveness data demonstrating the herd immunity effect of PCV-7, Canada ould prevent 8,531 cases of adult pneumococcal disease with an estimated reduction of 51 cases of meningitis, 785 cases of bacteraemia, and 7,695 cases of pneumonia, respectively. This reduction in adult disease not only represents a substantial clinical benefit but is also expected to save an additional Canadian $40 million from the Canadian healthcare system perspective. Herd immunity resulting from a universal childhood PCV-7 programme will have a substantial clinical and economic impact on populations > 20 years of age, thereby making PCV-7 a clinically important and cost-saving intervention for the Canadian healthcare system.