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Predicted Effects of a New Combination Vaccine on Childhood Immunization Coverage Rates and Vaccination Activities

  • Original Research Article
  • Published:
Disease Management & Health Outcomes

Abstract

Introduction

A new combination vaccine, diphtheria-tetanus-acellular pertussis (DTaP)-hepatitis B (HepB)-inactivated poliovirus vaccine (IPV) [DTaP-HepB-IPV], recently became available for use in the US primary infant-vaccination series. Our objectives were to estimate its effects on immunization-coverage rates, vaccination activities, and health-system costs in US dollars (2003 values).

Methods

A model was developed and applied to medical records of 775 children born in mid-2001 who received primary care at 32 private pediatrics centers. DTaP-HepB-IPV use was predicted by applying decision rules to selectively substitute it for component vaccines, in compliance with the Advisory Committee on Immunization Practices’ minimum age and time interval criteria. The model considered effects of DTaP-HepB-IPV on use of HepB at age <6 weeks, and HepB, HepB-Haemophilus influenzae type B (Hib), Hib, DTaP, and IPV at age 6 weeks to 2 years.

Results

At 2 years of age, DTaP-HepB-IPV would increase the proportion of children receiving three or more doses of DTaP (95.6% vs 96.4%; p = 0.02), HepB (91.7% vs 95.2%; p < 0.001), IPV (90.7% vs 96.3%; p < 0.001), and each of these vaccines (86.2% vs 94.6%; p < 0.001), compared with those receiving each component in singular or combination vaccinations other than DTaP-HepB-IPV. Coverage rates would also be increased for recommended doses of all three component vaccines at ages 1 and 1½ years. At 2 years of age, the use of DTaP-HepB-IPV would also reduce the number of injections (17.3 vs 14.6; p < 0.001), vaccination visits (6.8 vs 6.6; p = 0.006), and administration costs ($US240 vs $US203; p = 0.004), compared with those receiving each component in singular or combination vaccinations other than DTaP-HepB-IPV.

Conclusion

DTaP-HepB-IPV use is estimated to improve immunization coverage rates while reducing the number of vaccine injections, vaccination visits, and costs.

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Notes

  1. The use of trade names is for product identification purposes only and does not imply endorsement.

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Acknowledgments

This study was sponsored through an unrestricted research grant from GlaxoSmithKline (GSK). GSK exercised no control or influence in either the study’s methods or this manuscript.

Allen Meyerhoff and R. Jake Jacobs have each received honoraria from GSK for meeting attendance and David Greenberg has received honoraria from GSK for meeting attendance and investigator fees for participation in GSK clinical trials. No author owns or has owned any GSK stock.

We thank Tracey Craddock for her work in organizing participating centers and their patients, Kurt Luedke for developing the software to implement the model, and GSK for their unrestricted research grant.

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Authors and Affiliations

  1. Capitol Outcomes Research Inc., 6188 Old Franconia Road, Alexandria, Virginia, VA 22310, USA

    Allen S. Meyerhoff & R. Jake Jacobs

  2. Children’s Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA

    David P. Greenberg

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  1. Allen S. Meyerhoff
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  2. David P. Greenberg
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Correspondence to Allen S. Meyerhoff.

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Meyerhoff, A.S., Greenberg, D.P. & Jake Jacobs, R. Predicted Effects of a New Combination Vaccine on Childhood Immunization Coverage Rates and Vaccination Activities. Dis-Manage-Health-Outcomes 13, 317–326 (2005). https://doi.org/10.2165/00115677-200513050-00004

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