ABSTRACT

Introduction

Meningococcal vaccines to protect against invasive meningococcal disease (IMD) vary in terms of vaccine technology and serogroup coverage (Polysaccharide MnACWY, conjugated C and ACWY, outer membrane vesicle–based or protein-based B vaccines), and the national recommendations for each of them vary in terms of target population and number of doses. We sought to understand factors associated with the evolution of meningococcal vaccination program recommendations in four countries with formal evaluation processes: the UK, US, the Netherlands, and Canada.

Areas covered

A targeted review of published literature and internet sources for the four countries relating to meningococcal vaccination decision-making was conducted. The review focused on the impact of cost-effectiveness analyses on vaccine policy decisions and the extent to which variation in incidence of IMD and its potential catastrophic consequences influenced policy decisions.

The evolution of meningococcal vaccine recommendations in the four countries was mainly driven by changes in vaccine availability and changes in serogroup incidence. Public pressure due to the catastrophic nature of IMD influenced recommendations. The role of cost-effectiveness analyses varied across the 4 countries.

Expert Opinion

The value of implementing meningococcal vaccination programs should be assessed using factors beyond those included in traditional cost-effectiveness analyses.

中文翻译：

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在美国、英国、荷兰和加拿大脑膜炎球菌病疫苗接种计划的决策中使用成本效益分析

摘要

介绍

预防侵袭性脑膜炎球菌病 (IMD) 的脑膜炎球菌疫苗在疫苗技术和血清群覆盖率（多糖 MnACWY、结合 C 和 ACWY、基于外膜囊泡或基于蛋白质的 B 疫苗）以及国家对每种疫苗的建议方面各不相同因目标人群和剂量而异。我们试图了解与具有正式评估流程的四个国家脑膜炎球菌疫苗接种计划建议演变相关的因素：英国、美国、荷兰和加拿大。

覆盖区域

对四个国家与脑膜炎球菌疫苗接种决策相关的已发表文献和互联网资源进行了有针对性的审查。审查的重点是成本效益分析对疫苗政策决策的影响，以及 IMD 发生率的变化及其潜在灾难性后果对政策决策的影响程度。

这四个国家脑膜炎球菌疫苗推荐的演变主要是由疫苗供应的变化和血清群发病率的变化驱动的。由于 IMD 的灾难性性质导致的公众压力影响了建议。成本效益分析在这 4 个国家中的作用各不相同。

专家意见

实施脑膜炎球菌疫苗接种计划的价值应使用传统成本效益分析之外的因素进行评估。