Economic burden of pneumococcal infections in children under 5 years of age

Ceyhan, Mehmet; Ozsurekci, Yasemin; Aykac, Kubra; Hacibedel, Basak; Ozbilgili, Egemen

In Turkey, national implementation of the 7-valent PCV infant vaccination program followed by the implementation of 13-valent PCV in 2011 is associated with substantial improvements in the prevention of pneumococcal infections. The introduction of PCVs has been associated with a significant reduction both in invasive pneumococcal disease (IPD) and mucosal pneumococcal diseases in many countries. Following the introduction of PCV13 in the USA, IPD incidence decreased by 91% in children below 2 years of age due to the additional 6 serotypes. 15 In the UK, IPD due to PCV13-only serotypes decreased by 89% after the PCV13 National Immunization Program in children below 2 years of age as compared with the pre-PCV13 periods. 16 In Southern Israel, sequential implementation of PCV7 and PCV13 was associated with decreases in otitis media caused by PCV7 serotypes plus serotype 6A and then by 5 additional PCV13 serotypes (5VT: 1, 3, 5, 7F, 19A) by 96% and 85% in the respective periods. 17 The present study has also some limitations. Firstly, being a single center study is one of the limitations. Secondly, the pneumonia cases included in this study were not proven to be caused by S. pneumoniae; thus, lobar pneumonia cases were aimed to be included as they best represent pneumococcal pneumonia. Thirdly, only hospitalized patients with pneumonia were included. However, if non-hospitalized pneumonia patients were also included, contributory outcomes could be provided both in clinical and economic impact of vaccination. Despite these limitations, this study provides useful insights into economic burden of pneumococcal infections in children (0-5 years old) considering that there is very limited data in this area especially in Turkey. Therefore, further cost studies are needed, particularly in children, to set forth the economic burden of pneumococcal infections.