Vaccinare
Costi-benefici dei vaccini antipertosse acellulari e anti-Hib
COST/BENEFIT OF IMMUNIZATION FOR PERTUSSIS AND HAEMOPHILUS TYPE B
GIORGIO BARTOLOZZI
Clinica Pediatrica I, Università di Firenze
Gennaio 1997 - pagg. 35 -40
Abstract
The Author proposes a cost/benefit analysis
for pertussis and haemophilus type b vaccines.
Cost/benefit of the new acellular pertussis
vaccines is higher than for the wholecell
vaccines due to the higher cost of the
former, but better acceptance of the acellular
vaccine by paediatricians and by users
due to reduced incidence of side effects may
favour higher coverage. Calculations are
difficult for the Hib vaccine. The incidence of
invasive disease due to Hib in Italy has been
evaluated by two different studies. The national
surveillance system showed an incidence
oif 5 per 100.000 children under 2 years,
while a smaller cohort study showed an incidence
of 24 cases/100.000 children under
2 years. Under notification in the first study
and geographical selection in the second
may explain the difference. The incidence of
invasive Hib disease in Italy seems to be
substantially lower than in Northern European
countries. Due to the high cost of the
Hib vaccine, it may be questioned whether
Hib immunization is a priority in Italy. Hib
vaccine remains indicated in high risk cases.
Parole chiave
Suggerite dall'AI
Classificazione MeSH
Bibliografia
1. Sansoni A, Rappuoli R, Viti S et al: Immunity
to Haemophilus influenzae tipo b on sample
population from central Italy. Vaccine 10,
627-630, 1992.
2. Peltola H, Kayhty , Virtanen M et al: Prevention of Haemophilus influenzae type b bacteriemic infection with the capsular polysaccharide vaccine. N Engl J Med 310, 1561-66, 1984.
3. Schneerson R, Robbins JB, Parke JC: Quantitative and qualitatiave analyses of serum antibodies elicited in adults by H. influenzae type b and Pneumococcus type 6A capsular polysaccharides-tetanus toxoid conjugates. Infect Immu 52, 519-28, 1986.
4. Anderson PW, Pichichero ME, Insel RA: Vaccines consisting of periodate-cleaved oligosaccharides from the capsule of H. influenzae type b coupled to a protein carrier: Structural and temporal requirements from priming in the human infant. J Immunol 137, 1181-6, 1986.
5. Granoff DM, Holmes SJ: Comparative immunogenicity of Haemophilus influenzae type b polysaccharide-protein conjugate vaccines. Vaccine 9, 30-37 ( suppl ), 1991.
6. Granoff DM, Anderson EL, Osterholm MT et al: Differences in the immunogenicity of three Haemophilus influenzae type b conjugate vaccines in infants. J Pediatr 121, 187-94, 1992.
7. Turner RB, Cimino CO, Sullivan BJ: Prospective comparison of the immune response of infants to three Haemophilus influenzae type b vaccines. Pediatr Infect Dis J 10, 108-12, 1991.
8. CDC, Immunization Practices Advisory Committee ( ACIP ): Haemophilus b conjugate vaccines for prevention of Haemophilus influenzae type b disease among infants and children two months of age and older. MMWR 40 (n° RR-1 ), 1-7, 1991.
9. Committee on Infectious Diseases (American Academy of Pediatrics ): Haemophilus influenzae type b conjugate vaccines: reccomendations for immunization of infants and children 2 months of age and older: Update. Pediatrics 88, 169-72, 1991.
10. Decker MD, Edwards KM, Bradley R, Palmer P: Comparative trial in infant of four conjugate Haemophilus influenzae type b vaccines. J Pediatr 120 184-89, 1992.
11. Goepp JG, Hoehnboken M, Almeido-Hill J, Santosham M: Persistent urinary antigen excretion in infants vaccinated with Haemophilus influenzae tipe b capsular polysaccharide conjugated with outer membrane protein from Neisseria meningitidis. Pediatr Infect Dis J 11, 2-5, 1992.
12. Pabst HF, Spady DW: Effect of brest-feeding on antibody response to conjugate vaccine. Lancet 336, 269-270, 1990.
13. Givner LB, Woods CR, Abramson JS: The practice of pediatrics in the era of vaccines effective against Haemophilus influenzae type b. Pediatrics 93, 680-1, 1994.
14. Black SB, Shinefield H: The Kaiser Permanente Pediatrics Vaccine Study Group, Immunization with oligosaccharide conjugate Haemophilus influenzae type b (HbOC) vaccine on a large health maintenance organization population: Extended follow-up and impact on Haemophilus influenzae disease epidemiology. Pediatr Infect Dis J 11, 610-13, 1992.
15. Vadheim CM, Greenberg DP, Eriksen E et al: Eradication of Haemophilus influenzae type b disease in Southern California. Arch Pediatr Adolesc Med 148, 51-6, 1994.
16. Murphy TV, Pastor P, Medley F et al: Decreased Haemophilus colonization in children vaccinated with Haemophilus influenzae type b conjugate vaccine. J Pediatr 122, 517-23, 1993.
17. Mohle-Boetani JC, Ajello G, Breneman E et al: Carriage of Haemophilus influenzae type b in children after widespread vaccination with conjugate Haemophilus influenzae type b vaccines. Pediatr Infect Dis J 12, 589-93, 1993.
18. CDC, ACIP: Recommendations for use of Haemophilus b conjugate vaccines and combined Diphtheria, Tetanus, Pertussis, and Haemophilus b vaccine. MMWR 42 (N° RR- 13 ) 1-15, 1993.
19. Anderson EL, Decker MD, Englund JA et al: Interchangeability of conjugated Haemophilus influenzae type b vaccines in infants. JAMA 273, 849-853, 1995.
20. Paradiso PR, Hogerman DA, Madore DV et al: Safety and immunogenicity of a combined diphtheria, tetanus, pertussis and Haemophilus influenzae type b vaccine in young infant. Pediatrics 92, 827-32, 1993.
21. D’Alessandro D, Pompa MG, Squarcione S, Fara GM: Meningiti da Haemophilus influenzae tipo b in Italia. Federazione Medica 411-5, 1995.
22. Ministero della Sanità: Meningiti da Haemophilus influenzae tipo b in Italia nel 1995. Comunicazione personale.
23. Ticca F, Cortis E, Graziani MC et al: Razionale della vaccinazione antiemofilo. Medico e Bambino 13, 494-6, 1994.
24. Titone L, di Gangi M, Romano A et al: Aspetti eziologici delle meningiti purulente. Gior Mal Infett Parass 40, 1227-31, 1988.
25. Tozzi AE, Salmaso S, Ciofi ML et al: Incidence of invasive Haemophilus influenzae type b disease in italian children. In stampa su Europ J Epidemiol 1997.
26. Cellesi C, Rossolini A, Balestrieri G et al: Retrospective survey on the epidemiology of H. influenzae type b meningitis in Italy (1987- 91). Microbiologica 18, 183-6, 1995.
2. Peltola H, Kayhty , Virtanen M et al: Prevention of Haemophilus influenzae type b bacteriemic infection with the capsular polysaccharide vaccine. N Engl J Med 310, 1561-66, 1984.
3. Schneerson R, Robbins JB, Parke JC: Quantitative and qualitatiave analyses of serum antibodies elicited in adults by H. influenzae type b and Pneumococcus type 6A capsular polysaccharides-tetanus toxoid conjugates. Infect Immu 52, 519-28, 1986.
4. Anderson PW, Pichichero ME, Insel RA: Vaccines consisting of periodate-cleaved oligosaccharides from the capsule of H. influenzae type b coupled to a protein carrier: Structural and temporal requirements from priming in the human infant. J Immunol 137, 1181-6, 1986.
5. Granoff DM, Holmes SJ: Comparative immunogenicity of Haemophilus influenzae type b polysaccharide-protein conjugate vaccines. Vaccine 9, 30-37 ( suppl ), 1991.
6. Granoff DM, Anderson EL, Osterholm MT et al: Differences in the immunogenicity of three Haemophilus influenzae type b conjugate vaccines in infants. J Pediatr 121, 187-94, 1992.
7. Turner RB, Cimino CO, Sullivan BJ: Prospective comparison of the immune response of infants to three Haemophilus influenzae type b vaccines. Pediatr Infect Dis J 10, 108-12, 1991.
8. CDC, Immunization Practices Advisory Committee ( ACIP ): Haemophilus b conjugate vaccines for prevention of Haemophilus influenzae type b disease among infants and children two months of age and older. MMWR 40 (n° RR-1 ), 1-7, 1991.
9. Committee on Infectious Diseases (American Academy of Pediatrics ): Haemophilus influenzae type b conjugate vaccines: reccomendations for immunization of infants and children 2 months of age and older: Update. Pediatrics 88, 169-72, 1991.
10. Decker MD, Edwards KM, Bradley R, Palmer P: Comparative trial in infant of four conjugate Haemophilus influenzae type b vaccines. J Pediatr 120 184-89, 1992.
11. Goepp JG, Hoehnboken M, Almeido-Hill J, Santosham M: Persistent urinary antigen excretion in infants vaccinated with Haemophilus influenzae tipe b capsular polysaccharide conjugated with outer membrane protein from Neisseria meningitidis. Pediatr Infect Dis J 11, 2-5, 1992.
12. Pabst HF, Spady DW: Effect of brest-feeding on antibody response to conjugate vaccine. Lancet 336, 269-270, 1990.
13. Givner LB, Woods CR, Abramson JS: The practice of pediatrics in the era of vaccines effective against Haemophilus influenzae type b. Pediatrics 93, 680-1, 1994.
14. Black SB, Shinefield H: The Kaiser Permanente Pediatrics Vaccine Study Group, Immunization with oligosaccharide conjugate Haemophilus influenzae type b (HbOC) vaccine on a large health maintenance organization population: Extended follow-up and impact on Haemophilus influenzae disease epidemiology. Pediatr Infect Dis J 11, 610-13, 1992.
15. Vadheim CM, Greenberg DP, Eriksen E et al: Eradication of Haemophilus influenzae type b disease in Southern California. Arch Pediatr Adolesc Med 148, 51-6, 1994.
16. Murphy TV, Pastor P, Medley F et al: Decreased Haemophilus colonization in children vaccinated with Haemophilus influenzae type b conjugate vaccine. J Pediatr 122, 517-23, 1993.
17. Mohle-Boetani JC, Ajello G, Breneman E et al: Carriage of Haemophilus influenzae type b in children after widespread vaccination with conjugate Haemophilus influenzae type b vaccines. Pediatr Infect Dis J 12, 589-93, 1993.
18. CDC, ACIP: Recommendations for use of Haemophilus b conjugate vaccines and combined Diphtheria, Tetanus, Pertussis, and Haemophilus b vaccine. MMWR 42 (N° RR- 13 ) 1-15, 1993.
19. Anderson EL, Decker MD, Englund JA et al: Interchangeability of conjugated Haemophilus influenzae type b vaccines in infants. JAMA 273, 849-853, 1995.
20. Paradiso PR, Hogerman DA, Madore DV et al: Safety and immunogenicity of a combined diphtheria, tetanus, pertussis and Haemophilus influenzae type b vaccine in young infant. Pediatrics 92, 827-32, 1993.
21. D’Alessandro D, Pompa MG, Squarcione S, Fara GM: Meningiti da Haemophilus influenzae tipo b in Italia. Federazione Medica 411-5, 1995.
22. Ministero della Sanità: Meningiti da Haemophilus influenzae tipo b in Italia nel 1995. Comunicazione personale.
23. Ticca F, Cortis E, Graziani MC et al: Razionale della vaccinazione antiemofilo. Medico e Bambino 13, 494-6, 1994.
24. Titone L, di Gangi M, Romano A et al: Aspetti eziologici delle meningiti purulente. Gior Mal Infett Parass 40, 1227-31, 1988.
25. Tozzi AE, Salmaso S, Ciofi ML et al: Incidence of invasive Haemophilus influenzae type b disease in italian children. In stampa su Europ J Epidemiol 1997.
26. Cellesi C, Rossolini A, Balestrieri G et al: Retrospective survey on the epidemiology of H. influenzae type b meningitis in Italy (1987- 91). Microbiologica 18, 183-6, 1995.