嘉兴市≥60岁老年人流感疫苗和23价肺炎球菌多糖疫苗联合接种对呼吸系统感染疾病的保护效果和成本效益分析

Protective effectiveness and cost-benefit analyses of co-vaccination with influenza vaccine and 23-valent pneumococcal polysaccharide vaccine against respiratory infectious diseases among≥60-year-old people of Jiaxing city

目的评价老年人联合接种流感疫苗(Influenza vaccine,InfV)和23价肺炎球菌多糖疫苗(23-valent pneumococcal polysaccharide vaccine,PPV23)对呼吸系统感染疾病的保护效果(Vaccine effectiveness,VE)和成本效益。方法在嘉兴市预防接种门诊选取联合接种InfV和PPV23(接种组)、未接种InfV和PPV23(对照组)的≥60岁老年人,观察两组受试者1年内呼吸系统感染疾病临床结局,收集疫苗接种成本和相关医疗费用,分析联合接种的VE、人均净效益和效益成本比(Benefit-cost ratio,BCR)。结果接种组、对照组分别纳入受试者364名、360名,联合接种InfV和PPV23对呼吸系统感染疾病发病、就诊、住院、死亡的VE(95%CI)分别为38.30%(27.81%-47.26%)、47.56%(35.09%-57.65%)、31.04%(-3.21%-53.96%)、67.03%(-64.42%-93.39%);两组平均住院时间分别为6.75 d、11.53 d(t=15.74,P<0.001),平均住院次数分别为0.87次、1.85次(t=13.62,P<0.001)。联合接种的人均净效益为695元,BCR为2.61。结论老年人联合接种InfV和PPV23可显著减少呼吸系统感染疾病的发病、就诊和住院,且具有较好的成本效益。

Objective To evaluate the protective effectiveness and cost-benefit of co-vaccination with influenza vaccine(InfV)and 23-valent pneumococcal polysaccharide vaccine(PPV23)against respiratory infectious diseases in the elderly.Methods We enrolled≥60-year-olds in Jiaxing city vaccination clinics.Subjects received either co-administered InfV and PPV23 vaccines(vaccination group)or no vaccines(control group).We followed subjects for one year to assess respiratory infectious diseases clinical outcomes and obtained data on vaccination costs and relevant medical expenses to determine vaccine effectiveness(VE),net benefit per capita,and benefit-cost ratio(BCR)of co-vaccination.Results There were 364 subjects in the vaccination group and 360 in the control group.VEs(95%CI)of co-vaccination with InfV and PPV23 against incidence,medical visits,hospitalization,and death related to respiratory infectious diseases were 38.30%(27.81%-47.26%),47.56%(35.09%-57.65%),31.04%(-3.21%-53.96%),and 67.03%(-64.42%-93.39%),respectively.Average hospitalization durations were 6.75 days in the vaccination group and 11.53 days in the control group(t=15.74,P<0.001),with average hospitalization frequencies being 0.87 and 1.85(t=13.62,P<0.001).The net benefit per capita of co-vaccination was 695 yuan,yielding a BCR of 2.61.Conclusions Co-vaccination with InfV and PPV23 vaccines significantly reduced incidence,medical visits,and hospitalizations related to respiratory infectious diseases among the elderly,and was highly cost-beneficial.