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Acellular Vaccine

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T R Einarson – One of the best experts on this subject based on the ideXlab platform.

  • Economic impact of the introduction of an Acellular pertussis Vaccine in Canada: a 6-year analysis.
    Vaccine, 2009
    Co-Authors: M Iskedjian, T R Einarson, Gaston De Serres, John H. Walker
    Abstract:

    Abstract Background Between July 1997 and April 1998, Canadian public health agencies switched from the whole cell Vaccine to the Acellular Vaccine for pertussis immunization. The Acellular Vaccine provided better efficacy and fewer adverse events than the whole cell Vaccine did. Objective To determine the economic impact of replacing the whole cell Vaccine with an Acellular Vaccine in Canada. Methods A decision analytic model was developed comparing costs and outcomes of pertussis vaccination for Canadian children born in the years 1991–2004. Effectiveness was measured as number of avoided pertussis cases as well as the number of avoided hospital admissions. Incremental costs per avoided pertussis case and per avoided hospital admission were calculated for Ministry of Health (MoH) and societal (SOC) perspectives. Various one-way sensitivity analyses as well as a Monte Carlo simulation were performed by varying key model parameters. Results The switch in immunization programs resulted in an incremental cost to the MoH of CAD $108 per pertussis case avoided (CAD $0.96 per child-year). From the SOC perspective, there was a savings of CAD $184 per pertussis case avoided (CAD $0.13 per child-year). The one-way sensitivity analyses provided incremental cost-effective ratios (ICERs) ranging from an incremental cost of CAD $1034 per avoided pertussis case from the MoH perspective to a saving of CAD $1583 per avoided case from the SOC perspective. The Monte Carlo simulation confirmed the robustness of these results. Conclusions Pertussis vaccination with AcE was cost-saving from the societal perspective and cost-effective from the Ministry of Health perspective.

  • Economic Evaluation of an Extended Acellular Pertussis Vaccine Program for Adolescents in Québec, Canada
    Pediatric Drugs, 2005
    Co-Authors: M Iskedjian, John H. Walker, Gaston De Serres, T R Einarson
    Abstract:

    Objective: Pertussis is a frequent cause of cough illness in adolescents. In Canada, immunization against pertussis in public programs has been restricted to children under 7 years of age. The purpose of this analysis was to estimate the health and economic impact of an additional booster dose of the Acellular Vaccine in adolescents in Québec. Method: We performed a cost-effectiveness analysis, based on a predictive spreadsheet dynamic model following a cohort of 90 929 adolescents in Québec from the age of 14 years over a 10-year period from the Québec Ministry of Health (MOH) and societal (SOC) perspectives. The model was used to compare costs (2003 values) and benefits of an adolescent vaccination program (AVP), including a diptheria, tetanus, and Acellular pertussis (dTacp) Vaccine administered at age 14 years, with current practice. Results: From the MOH perspective, a booster vaccination of dTacp at age 14 years via the AVP would produce a yearly additional expected cost of $Can1.06 per adolescent with an incremental cost-effectiveness ratio (ICER) of $Can480 per pertussis case avoided based on a 10-year period. When outcomes are discounted at 3%, the ICER rises to $Can527 per discounted pertussis case avoided. From the SOC perspective, the AVP would cost $Can0.83 per adolescent per year with an additional cost per avoided pertussis case of $Can377 ($Can414 per additional discounted case of pertussis avoided). Over the 10-year period, 2012 non-discounted cases of pertussis would be prevented with approximately two hospital admissions averted. Conclusion: This study suggests that administering a booster dose of dTacp at age 14 years to replace the diptheria and tetanus vaccination will slightly increase the economic burden from MOH and SOC perspectives; however, the number of pertussis cases and the number of hospital admissions will decrease.

  • Economic evaluation of an extended Acellular pertussis Vaccine program for adolescents in Québec, Canada.
    Paediatric drugs, 2005
    Co-Authors: M Iskedjian, John H. Walker, Gaston De Serres, T R Einarson
    Abstract:

    Objective: Pertussis is a frequent cause of cough illness in adolescents. In Canada, immunization against pertussis in public programs has been restricted to children under 7 years of age. The purpose of this analysis was to estimate the health and economic impact of an additional booster dose of the Acellular Vaccine in adolescents in Quebec.

M Iskedjian – One of the best experts on this subject based on the ideXlab platform.

  • Economic impact of the introduction of an Acellular pertussis Vaccine in Canada: a 6-year analysis.
    Vaccine, 2009
    Co-Authors: M Iskedjian, T R Einarson, Gaston De Serres, John H. Walker
    Abstract:

    Abstract Background Between July 1997 and April 1998, Canadian public health agencies switched from the whole cell Vaccine to the Acellular Vaccine for pertussis immunization. The Acellular Vaccine provided better efficacy and fewer adverse events than the whole cell Vaccine did. Objective To determine the economic impact of replacing the whole cell Vaccine with an Acellular Vaccine in Canada. Methods A decision analytic model was developed comparing costs and outcomes of pertussis vaccination for Canadian children born in the years 1991–2004. Effectiveness was measured as number of avoided pertussis cases as well as the number of avoided hospital admissions. Incremental costs per avoided pertussis case and per avoided hospital admission were calculated for Ministry of Health (MoH) and societal (SOC) perspectives. Various one-way sensitivity analyses as well as a Monte Carlo simulation were performed by varying key model parameters. Results The switch in immunization programs resulted in an incremental cost to the MoH of CAD $108 per pertussis case avoided (CAD $0.96 per child-year). From the SOC perspective, there was a savings of CAD $184 per pertussis case avoided (CAD $0.13 per child-year). The one-way sensitivity analyses provided incremental cost-effective ratios (ICERs) ranging from an incremental cost of CAD $1034 per avoided pertussis case from the MoH perspective to a saving of CAD $1583 per avoided case from the SOC perspective. The Monte Carlo simulation confirmed the robustness of these results. Conclusions Pertussis vaccination with AcE was cost-saving from the societal perspective and cost-effective from the Ministry of Health perspective.

  • Economic Evaluation of an Extended Acellular Pertussis Vaccine Program for Adolescents in Québec, Canada
    Pediatric Drugs, 2005
    Co-Authors: M Iskedjian, John H. Walker, Gaston De Serres, T R Einarson
    Abstract:

    Objective: Pertussis is a frequent cause of cough illness in adolescents. In Canada, immunization against pertussis in public programs has been restricted to children under 7 years of age. The purpose of this analysis was to estimate the health and economic impact of an additional booster dose of the Acellular Vaccine in adolescents in Québec. Method: We performed a cost-effectiveness analysis, based on a predictive spreadsheet dynamic model following a cohort of 90 929 adolescents in Québec from the age of 14 years over a 10-year period from the Québec Ministry of Health (MOH) and societal (SOC) perspectives. The model was used to compare costs (2003 values) and benefits of an adolescent vaccination program (AVP), including a diptheria, tetanus, and Acellular pertussis (dTacp) Vaccine administered at age 14 years, with current practice. Results: From the MOH perspective, a booster vaccination of dTacp at age 14 years via the AVP would produce a yearly additional expected cost of $Can1.06 per adolescent with an incremental cost-effectiveness ratio (ICER) of $Can480 per pertussis case avoided based on a 10-year period. When outcomes are discounted at 3%, the ICER rises to $Can527 per discounted pertussis case avoided. From the SOC perspective, the AVP would cost $Can0.83 per adolescent per year with an additional cost per avoided pertussis case of $Can377 ($Can414 per additional discounted case of pertussis avoided). Over the 10-year period, 2012 non-discounted cases of pertussis would be prevented with approximately two hospital admissions averted. Conclusion: This study suggests that administering a booster dose of dTacp at age 14 years to replace the diptheria and tetanus vaccination will slightly increase the economic burden from MOH and SOC perspectives; however, the number of pertussis cases and the number of hospital admissions will decrease.

  • Economic evaluation of an extended Acellular pertussis Vaccine program for adolescents in Québec, Canada.
    Paediatric drugs, 2005
    Co-Authors: M Iskedjian, John H. Walker, Gaston De Serres, T R Einarson
    Abstract:

    Objective: Pertussis is a frequent cause of cough illness in adolescents. In Canada, immunization against pertussis in public programs has been restricted to children under 7 years of age. The purpose of this analysis was to estimate the health and economic impact of an additional booster dose of the Acellular Vaccine in adolescents in Quebec.

Scott A. Halperin – One of the best experts on this subject based on the ideXlab platform.

  • nature evolution and appraisal of adverse events and antibody response associated with the fifth consecutive dose of a five component Acellular pertussis based combination Vaccine
    Vaccine, 2003
    Co-Authors: Scott A. Halperin, Elaine L Mills, Luis Barreto, Roland Guasparini, David W Scheifele, Garry Humphreys, Bruce Smith
    Abstract:

    Abstract We performed a randomized, controlled clinical trial to characterize the evolution of the adverse events associated with the fifth consecutive dose of an Acellular pertussis Vaccine, and to assess the level of discomfort associated with the injection and the attitude of parents concerning these events. A total of 505 children who had received either four doses of Acellular pertussis Vaccine or whole-cell pertussis Vaccine were given a fifth dose of one of the two Vaccines. Adverse events were monitored by parents and collected by telephone or home visit at 4, 8, 12, 24, 48 and 72 h, and 7 and 28 days after immunization. Rates of injection site redness ≥50 mm were similar in recipients of five doses of Acellular pertussis Vaccine (32.8%) or five doses of whole-cell pertussis Vaccine (43.3%). Injection site swelling, tenderness, and decreased arm movement were all more frequent in children who received five doses of whole-cell pertussis Vaccine. Antibody levels before or after immunization did not predict those children who had increased injection site reactions. The children rated the injection site reactions as significantly more severe after five consecutive doses of whole-cell Vaccine. Parent satisfaction was higher after the Acellular Vaccine. We conclude that a fifth consecutive dose of a whole-cell pertussis Vaccine is associated with high rates of tender redness and swelling at the injection site, in contrast to a fifth consecutive dose of an Acellular pertussis Vaccine which is associated with high rates of non-painful redness. However, parents will still need to be aware of the high rates of injection site reactions expected after a fifth dose of Acellular pertussis Vaccine.

  • adverse reactions and antibody response to four doses of Acellular or whole cell pertussis Vaccine combined with diphtheria and tetanus toxoids in the first 19 months of life
    Vaccine, 1996
    Co-Authors: Scott A. Halperin, Luis Barreto, Brian J Eastwood, B Friesen, Lorna Medd, William Meekison, Roland Guasparini
    Abstract:

    To assess the safety, immunogenicity, and lot consistency of a five-component Acellular pertussis Vaccine combined with diphtheria and tetanus toxoid (Connaught Laboratories Limited), we randomly allocated 432 infants to receive one of three lots of an Acellular pertussis Vaccine or a single lot of whole cell pertussis Vaccine. Infants were immunized at 2, 4 and 6 months of age and between 17 and 19 months of age. Local and systemic adverse reactions were reported significantly more frequently by recipients of the whole cell than Acellular Vaccine after each dose. The antibody response against pertussis toxin, filamentous hemagglutinin, and 69 kDa protein was of greater magnitude in Acellular pertussis Vaccine recipients than whole cell pertussis Vaccine recipients. Small differences were detected amongst the Vaccine lots tested. We conclude that the Acellular pertussis Vaccine is safe and immunogenic for the first four doses in children under 2 years of age.

  • Acellular pertussis Vaccine as a booster dose for seventeen- to nineteen-month-old children immunized with either whole cell or Acellular pertussis Vaccine at two, four and six months of age.
    The Pediatric infectious disease journal, 1995
    Co-Authors: Scott A. Halperin, Elaine L Mills, Luis Barreto, Carolyn Pim, Brian Eastwood
    Abstract:

    The safety and immunogenicity of two formulations of an Acellular pertussis Vaccine as a booster at 17 to 19 months of age were assessed in children immunized at 2, 4 and 6 months of age with Acellular or whole cell pertussis Vaccine. In Study I 86 children primed with a five-component Acellular Vaccine combined with diphtheria and tetanus toxoids or with a whole cell pertussis-diphtheria-tetanus Vaccine were boosted with the same Vaccine. Local reactions (64% vs. 93% ; relative risk, 0.7 ; 95% confidence interval, 0.5 to 0.9) and systemic reactions (68% vs. 97% ; relative risk, 0.7 ; 95% confidence interval, 0.5 to 0.9) were less common after the fourth dose of Acellular Vaccine than after the fourth dose of whole cell Vaccine. In Study II 96 children primed with either an Acellular or whole cell pertussis Vaccine were boosted with an Acellular Vaccine. Local adverse reactions after booster immunization with Acellular Vaccine were more common in children primed with Acellular Vaccine than those primed with whole cell Vaccine (68% vs. 33% ; relative risk, 2.1 ; 95% confidence interval, 1.3 to 3.3). Antibody response to pertussis toxin, filamentous hemagglutinin and fimbriae were higher before and 1 month after the booster dose in children primed with the Acellular Vaccine. We conclude that the Acellular pertussis Vaccine is safe and immunogenic when used for the booster dose in children primed with either whole cell or Acellular Vaccine but is associated with local reactions.