Abstract

Introduction

This systematic review aims to provide a critical summary of economic evaluations of pneumococcal vaccines for adults aged 50 years or older in low- and middle-income countries (LMICs): a 23-valent polysaccharide vaccine (PPSV23), and a 13-valent conjugated vaccine (PCV13).

Areas covered

We systematically searched for studies published until February 2020 in PubMed and Web of Science. Searching strategies in this literature review were done using various combinations of terms related to “economic evaluation or cost-effectiveness or cost-benefit or cost-utility”, “pneumococcal or PPSV or PCV or PPV”, and “vaccine or vaccination or immunization” in all fields. To be included, each study had to meet our inclusion criteria. Two authors reviewed and extracted studies. From 1,711 records, we included 18 studies for this review. All 18 studies were cost-effectiveness analysis. Compared with no vaccination, either PPSV23 or PCV13 was economically favorable, highly cost-effective, and in many cases, cost-saving for older adults. Studies compared one vaccination (PPSV23 or PCV13) over another and had different findings.

Expert opinion

While all studies recommended either PPSV23 or PCV13 for older adults in LMICs, substantial questions about potential bias in studies and whether conclusions hold after including the impact of indirect protection.

中文翻译：

---

中低收入国家50岁以上成年人肺炎球菌疫苗的成本效益：系统评价

摘要

介绍

本系统综述旨在提供针对中低收入国家（LMIC）的50岁以上成年人肺炎球菌疫苗的经济评估的重要摘要：一种23价多糖疫苗（PPSV23）和一种13价结合物疫苗（PCV13）。

覆盖区域

我们系统地搜索了直到2020年2月在PubMed和Web of Science中发表的研究。本文献综述的检索策略是使用与“经济评估或成本效益或成本效益或成本效用”，“肺炎球菌或PPSV或PCV或PPV”以及“疫苗或疫苗或免疫”相关的各种术语组合来完成的在所有领域。要纳入，每项研究都必须符合我们的纳入标准。两位作者审查并提取了研究。从1,711条记录中，我们包括18项研究供本评价。所有18项研究均为成本效益分析。与不接种疫苗相比，PPSV23或PCV13在经济上都很有利，具有很高的成本效益，并且在许多情况下，可以节省老年人的成本。研究将一种疫苗（PPSV23或PCV13）与另一种疫苗进行了比较，并得出了不同的发现。

专家意见

尽管所有研究均建议LMIC的老年人使用PPSV23或PCV13，但有关研究的潜在偏倚以及包括间接保护的影响后是否得出结论的实质性问题。